Policy awareness among community-dwelling older adults: The roles of cognitive status and digital access

Policy awareness is a key prerequisite for the effective use of government programs among older adults. In increasingly digitalized information environments, access to policy information may depend not only on digital resources but also on cognitive capacity. However, limited evidence exists regarding whether the relationships between informational resources and policy awareness differ according to cognitive function. This study conducted a secondary analysis using data from the 2023 National Survey of Older Koreans, a nationally representative survey based on stratified multistage cluster sampling. The analytic sample included 9,951 community-dwelling adults aged 65 years or older. Policy awareness was measured using 11 items assessing awareness of government programs for older adults (range 0-22). Cognitive status was categorized using K-MMSE-2 scores into normal cognition, mild cognitive impairment, and moderate-to-severe cognitive impairment. Complex samples general linear models were applied to examine factors associated with policy awareness and to test interaction effects between cognitive status and key predictors. The weighted mean policy awareness score was 8.34 (SE = 0.13). Policy awareness differed significantly across cognitive groups, with the lowest scores observed among those with moderate-to-severe cognitive impairment and the highest among those with normal cognition. The overall model was statistically significant (Wald F = 14.59, p < 0.001) and the model explained 12.9% of the variance in policy awareness (R2 = 0.129). Significant interaction effects were observed between cognitive status and digital access (p < 0.001) and between cognitive status and depression (p = 0.003). The association between digital access and policy awareness appeared stronger among older adults with mild cognitive impairment compared with those with normal cognition. These findings suggest that cognitive status moderates the relationship between digital access and policy awareness. Improving digital access may be associated with higher levels of policy awareness among cognitively vulnerable older adults.