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Digital-Use Discontinuation as a Follow-Up Marker of Cognitive and Depressive Vulnerability in Later Life: A
Yang Liu1,2, Yi Wei1,2, Shengde Wu1,2
1Department of Urology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Children and Adolescents' Health and Diseases, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.
Abstract:
BackgroundDigital inclusion in later life is often measured as static user/non-user status, although older adults may enter, remain in, remain outside, or leave digital environments.ObjectiveTo examine whether digital-use transitions, particularly discontinuation, mark cognitive and depressive vulnerability.MethodsWe analyzed harmonized longitudinal data from CHARLS, ELSA, HRS, and SHARE. Adjacent-wave internet-use transitions were classified as persistent non-use, adoption, persistent use, or discontinuation. Cohort-specific forward, reverse, pre-transition, and marker analyses were pooled with random-effects methods where appropriate.ResultsAcross 250,379 transition intervals, discontinuation was preceded by lower cognition and more depressive symptoms, and was associated with lower subsequent cognition (β = -0.145) and higher depressive symptoms (β = 0.094) than sustained use. Adoption was associated with higher cognition and, on average, fewer depressive symptoms than persistent non-use. Baseline vulnerability predicted lower adoption and higher discontinuation. Adding discontinuation to baseline risk models produced only small gains in discrimination.
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