PDF(Pubmed)
Abstract：
UNASSIGNED: Older people are more likely to be excluded from the digital world, and this has been linked to poor health outcomes. The extent and direction of the influence of digital exclusion on functional dependency is, however, not well understood. We aimed to investigate the association between digital exclusion and functional dependency among older adults from high-income countries (HICs) and low- and middle-income countries (LMICs).
UNASSIGNED: In this multicohort study, we pooled individual-level data from five longitudinal cohort studies that included nationally representative samples of older adults across 23 countries, including the Health and Retirement Study (HRS), the English Longitudinal Study of Aging (ELSA), the Survey of Health, Ageing and Retirement in Europe (SHARE), the China Health and Retirement Longitudinal Study (CHARLS), and the Mexican Health and Aging Study (MHAS). The digital exclusion was recorded as an absence from internet use by self-reported. We assessed basic activities of daily living (BADL) and instrumental activities of daily living (IADL), and we used interval-of-need methods to categorize the functional dependency. We applied generalized estimating equations models fitting Poisson model to investigate the association of digital exclusion with difficulties in BADL or IADL and functional dependency, adjusting for the causal-directed-acyclic-graph (DAG) minimal sufficient adjustment set (MSAS), including gender, age level, labour force status, education, household wealth level, marital status, and co-residence with children.
UNASSIGNED: We included 108,621 participants recruited between 2010 and 2018 with a median follow-up of 3 phrases. Digital exclusion in older adults varied across countries, ranging from 23.8% in Denmark (SHARE) to 96.9% in China (CHARLS). According to the crude model, digital exclusion was significantly associated with functional dependency. In the MSAS-adjusted model, those associations remained statistically significant: HRS (incidence rate ratio [IRR] = 1.40, 95% confidence interval [CI] 1.34-1.48 for BADL; 1.71 [1.61-1.82] for IADL), ELSA (1.31 [1.22-1.40] in BADL and 1.37 [1.28-1.46] in IADL), SHARE (1.69 [1.61-1.78] in BADL and 1.70 [1.63-1.78] in IADL), CHARLS (2.15 [1.73-2.67] in BADL and 2.59 [2.06-3.25] in IADL), and MHAS (1.15 [1.09-1.21] in BADL and 1.17 [1.09-1.25] in IADL). In the subgroup analyses, the associations were more pronounced in the oldest-old (aged ≥ 80 years old).
UNASSIGNED: There is a substantial proportion of older adults who are excluded from the Internet, especially those in LMIC. Older people excluded from the Internet regardless of whether they live in HICs or LMICs are more likely to develop functional dependency. It should be made a priority to remove barriers to Internet access in order to assist older people in maintaining their independence and, consequently, to reduce the care burden associated with the ageing population worldwide.
UNASSIGNED: The National Natural Science Foundation of China (No. 71904004).
UNASSIGNED: In this multicohort study, we pooled individual-level data from five longitudinal cohort studies that included nationally representative samples of older adults across 23 countries, including the Health and Retirement Study (HRS), the English Longitudinal Study of Aging (ELSA), the Survey of Health, Ageing and Retirement in Europe (SHARE), the China Health and Retirement Longitudinal Study (CHARLS), and the Mexican Health and Aging Study (MHAS). The digital exclusion was recorded as an absence from internet use by self-reported. We assessed basic activities of daily living (BADL) and instrumental activities of daily living (IADL), and we used interval-of-need methods to categorize the functional dependency. We applied generalized estimating equations models fitting Poisson model to investigate the association of digital exclusion with difficulties in BADL or IADL and functional dependency, adjusting for the causal-directed-acyclic-graph (DAG) minimal sufficient adjustment set (MSAS), including gender, age level, labour force status, education, household wealth level, marital status, and co-residence with children.
UNASSIGNED: We included 108,621 participants recruited between 2010 and 2018 with a median follow-up of 3 phrases. Digital exclusion in older adults varied across countries, ranging from 23.8% in Denmark (SHARE) to 96.9% in China (CHARLS). According to the crude model, digital exclusion was significantly associated with functional dependency. In the MSAS-adjusted model, those associations remained statistically significant: HRS (incidence rate ratio [IRR] = 1.40, 95% confidence interval [CI] 1.34-1.48 for BADL; 1.71 [1.61-1.82] for IADL), ELSA (1.31 [1.22-1.40] in BADL and 1.37 [1.28-1.46] in IADL), SHARE (1.69 [1.61-1.78] in BADL and 1.70 [1.63-1.78] in IADL), CHARLS (2.15 [1.73-2.67] in BADL and 2.59 [2.06-3.25] in IADL), and MHAS (1.15 [1.09-1.21] in BADL and 1.17 [1.09-1.25] in IADL). In the subgroup analyses, the associations were more pronounced in the oldest-old (aged ≥ 80 years old).
UNASSIGNED: There is a substantial proportion of older adults who are excluded from the Internet, especially those in LMIC. Older people excluded from the Internet regardless of whether they live in HICs or LMICs are more likely to develop functional dependency. It should be made a priority to remove barriers to Internet access in order to assist older people in maintaining their independence and, consequently, to reduce the care burden associated with the ageing population worldwide.
UNASSIGNED: The National Natural Science Foundation of China (No. 71904004).
摘要：
未经评估：老年人更有可能被排除在数字世界之外，这与不良的健康结果有关。数字排斥对功能依赖的影响程度和方向是，然而,不是很了解。我们旨在调查高收入国家（HIC）和低收入和中等收入国家（LMICs）老年人的数字排斥与功能依赖之间的关系。
未经证实：在这项多队列研究中，我们汇集了来自五项纵向队列研究的个人水平数据，这些研究包括23个国家的具有全国代表性的老年人样本，包括健康与退休研究（HRS），英国老龄化纵向研究（ELSA），健康调查，欧洲的老龄化和退休（SHARE），中国健康与退休纵向研究(CHARLS)，墨西哥健康与老龄化研究（MHAS）。通过自我报告，数字排除被记录为不使用互联网。我们评估了日常生活的基本活动（BADL）和日常生活的工具活动（IADL），我们使用需要间隔方法对函数依赖进行分类。我们应用广义估计方程模型拟合泊松模型来研究数字排除与BADL或IADL困难和函数依赖性的关联，调整因果有向无环图(DAG)最小充分调整集(MSAS)，包括性别,年龄水平,劳动力状况，教育,家庭财富水平，婚姻状况,与孩子共同居住。
UNASSIGNED：我们纳入了2010年至2018年招募的108,621名参与者，中位随访时间为3个短语。老年人的数字排斥因国家而异，从丹麦的23.8%(份额)到中国的96.9%(份额)不等。根据粗略的模型，数字排除与功能依赖显著相关.在MSAS调整模型中，这些关联仍然具有统计学意义：HRS（BADL的发生率比率[IRR]=1.40，95％置信区间[CI]1.34-1.48；IADL的1.71[1.61-1.82]），ELSA（BADL中为1.31[1.22-1.40]，IADL中为1.37[1.28-1.46]），股份（BADL为1.69[1.61-1.78]，IADL为1.70[1.63-1.78]），CHARLS（BADL中为2.15[1.73-2.67]，IADL中为2.59[2.06-3.25]），和MHAS（BADL为1.15[1.09-1.21]，IADL为1.17[1.09-1.25]）。在亚组分析中，这些关联在年龄最大的老年人(≥80岁)中更为明显.
未经评估：有相当比例的老年人被排除在互联网之外，尤其是在LMIC。被排除在互联网之外的老年人，无论他们生活在HIC还是LMIC，都更有可能发展功能依赖。应优先考虑消除互联网接入障碍，以帮助老年人保持独立性，因此,减轻全球人口老龄化带来的护理负担。
联合国：国家自然科学基金委员会（编号：71904004).
未经证实：在这项多队列研究中，我们汇集了来自五项纵向队列研究的个人水平数据，这些研究包括23个国家的具有全国代表性的老年人样本，包括健康与退休研究（HRS），英国老龄化纵向研究（ELSA），健康调查，欧洲的老龄化和退休（SHARE），中国健康与退休纵向研究(CHARLS)，墨西哥健康与老龄化研究（MHAS）。通过自我报告，数字排除被记录为不使用互联网。我们评估了日常生活的基本活动（BADL）和日常生活的工具活动（IADL），我们使用需要间隔方法对函数依赖进行分类。我们应用广义估计方程模型拟合泊松模型来研究数字排除与BADL或IADL困难和函数依赖性的关联，调整因果有向无环图(DAG)最小充分调整集(MSAS)，包括性别,年龄水平,劳动力状况，教育,家庭财富水平，婚姻状况,与孩子共同居住。
UNASSIGNED：我们纳入了2010年至2018年招募的108,621名参与者，中位随访时间为3个短语。老年人的数字排斥因国家而异，从丹麦的23.8%(份额)到中国的96.9%(份额)不等。根据粗略的模型，数字排除与功能依赖显著相关.在MSAS调整模型中，这些关联仍然具有统计学意义：HRS（BADL的发生率比率[IRR]=1.40，95％置信区间[CI]1.34-1.48；IADL的1.71[1.61-1.82]），ELSA（BADL中为1.31[1.22-1.40]，IADL中为1.37[1.28-1.46]），股份（BADL为1.69[1.61-1.78]，IADL为1.70[1.63-1.78]），CHARLS（BADL中为2.15[1.73-2.67]，IADL中为2.59[2.06-3.25]），和MHAS（BADL为1.15[1.09-1.21]，IADL为1.17[1.09-1.25]）。在亚组分析中，这些关联在年龄最大的老年人(≥80岁)中更为明显.
未经评估：有相当比例的老年人被排除在互联网之外，尤其是在LMIC。被排除在互联网之外的老年人，无论他们生活在HIC还是LMIC，都更有可能发展功能依赖。应优先考虑消除互联网接入障碍，以帮助老年人保持独立性，因此,减轻全球人口老龄化带来的护理负担。
联合国：国家自然科学基金委员会（编号：71904004).
