{"title":"Heterogeneity in the association between internet use and dementia among older adults: A machine-learning analysis","authors":"Atsushi Nakagomi , Katsunori Kondo , Koichiro Shiba","doi":"10.1016/j.archger.2025.105912","DOIUrl":null,"url":null,"abstract":"<div><h3>Background & aims</h3><div>Internet use among older adults may reduce the risk of dementia, but it remains unknown how the effects vary across individuals. The aim of this study was to rigorously examine heterogeneity in the association between internet use and dementia among older adults with a machine learning approach.</div></div><div><h3>Methods</h3><div>This cohort study used data from the Japan Gerontological Evaluation Study involving functionally independent adults aged 65 or older (n = 5,451). The exposure, internet use a few times a month or more often, was assessed with the 2016 survey (baseline) and covariates (potential confounders and effect modifiers) were assessed with the 2013 survey (pre-baseline). Follow-up continued until 2022, identifying 5.5-year dementia onset (n = 549) using the public long-term care insurance system. Using the generalized random forest algorithm, we estimated how the association between internet use and dementia onset during a 5.5-year follow-up period varies by pre-baseline sociodemographic characteristics and health conditions.</div></div><div><h3>Results</h3><div>Internet use was on average associated with a lower risk of dementia (estimated population average effect = -0.033; 95 % CI: -0.051, -0.016). However, we found evidence of between-individual heterogeneity in this association, where internet use appeared more beneficial among individuals who reported middle income, higher education levels, and were socially and physically inactive at the pre-baseline wave.</div></div><div><h3>Conclusions</h3><div>Internet use may disproportionately benefit people based on socioeconomic status, suggesting equity concerns of universal implementation. Understanding such effect heterogeneity can inform more targeted public health interventions.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"136 ","pages":"Article 105912"},"PeriodicalIF":3.5000,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of gerontology and geriatrics","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0167494325001694","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background & aims
Internet use among older adults may reduce the risk of dementia, but it remains unknown how the effects vary across individuals. The aim of this study was to rigorously examine heterogeneity in the association between internet use and dementia among older adults with a machine learning approach.
Methods
This cohort study used data from the Japan Gerontological Evaluation Study involving functionally independent adults aged 65 or older (n = 5,451). The exposure, internet use a few times a month or more often, was assessed with the 2016 survey (baseline) and covariates (potential confounders and effect modifiers) were assessed with the 2013 survey (pre-baseline). Follow-up continued until 2022, identifying 5.5-year dementia onset (n = 549) using the public long-term care insurance system. Using the generalized random forest algorithm, we estimated how the association between internet use and dementia onset during a 5.5-year follow-up period varies by pre-baseline sociodemographic characteristics and health conditions.
Results
Internet use was on average associated with a lower risk of dementia (estimated population average effect = -0.033; 95 % CI: -0.051, -0.016). However, we found evidence of between-individual heterogeneity in this association, where internet use appeared more beneficial among individuals who reported middle income, higher education levels, and were socially and physically inactive at the pre-baseline wave.
Conclusions
Internet use may disproportionately benefit people based on socioeconomic status, suggesting equity concerns of universal implementation. Understanding such effect heterogeneity can inform more targeted public health interventions.
期刊介绍:
Archives of Gerontology and Geriatrics provides a medium for the publication of papers from the fields of experimental gerontology and clinical and social geriatrics. The principal aim of the journal is to facilitate the exchange of information between specialists in these three fields of gerontological research. Experimental papers dealing with the basic mechanisms of aging at molecular, cellular, tissue or organ levels will be published.
Clinical papers will be accepted if they provide sufficiently new information or are of fundamental importance for the knowledge of human aging. Purely descriptive clinical papers will be accepted only if the results permit further interpretation. Papers dealing with anti-aging pharmacological preparations in humans are welcome. Papers on the social aspects of geriatrics will be accepted if they are of general interest regarding the epidemiology of aging and the efficiency and working methods of the social organizations for the health care of the elderly.