Internet Use and Higher-Level Functional Capacity Decline Suppression in Japanese Older Adults with Low Education: A JAGES 2016-2019 Longitudinal Study (Preprint)

Abstract

Higher-Level Functional Capacity (HLFC) is crucial for the independent living of older adults. While Internet use positively impacts older adults’ health, its effect on HLFC and how this effect varies with educational attainment remains uncertain.

This longitudinal study aimed to investigate whether Internet use could mitigate the risk of HLFC decline and if this benefit extends to older adults with lower levels of education.

Data were sourced from the Japan Gerontological Evaluation Study (JAGES), encompassing 8,050 community-dwelling adults aged 65 and older from 2016 to 2019. The study focused on those who maintained independence from 2016 to 2019, identifying participants with independent HLFC in 2016. The Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) defined HLFC operationally, consisting of three subscales: instrumental activities of daily living (IADL), intellectual activity, and social role. The primary variable was the frequency of Internet use in 2016; participants who used the Internet more than once a month were classified as Internet users, while the rest were considered non-users. The study compared the effects of Internet use on HLFC decline across educational levels of ≤9 years, 10–12 years, and ≥13 years using Poisson regression analysis adjusted for robust standard error to calculate the risk ratio (RR) and 95% confidence interval (CI) for HLFC decline in 2019.

After adjusting for demographic and health condition risk factors, Internet use was significantly linked to a decreased risk of HLFC decline in older adults over three years, including those with lower educational levels. Internet users with ≤9 years of educational attainment experienced a suppressed decline in the total score (RR[CI] 0.57 [0.43–0.76]), IADL (0.58 [0.38–0.91]), intellectual activity (0.60 [0.41–0.89]), and social role (0.74 [0.56–0.97]) compared to non-users. Participants with 10–12 years of education showed suppression rates of (0.78 [0.63–0.98]), (0.59 [0.39–0.90]), (0.91 [0.63–1.31]), and (0.82 [0.68–0.9998]) respectively, and those with ≥13 years displayed (0.65 [0.51–0.85]), (0.55 [0.36–0.83]), (0.64 [0.37–1.10]), and (0.83 [0.64–1.08]) respectively.

The findings indicate that Internet use supports the maintenance of HLFC independence in older adults with higher education and those with lower educational levels. Encouraging Internet use among older adults with lower levels of education through future policies could help narrow functional health disparities associated with educational attainment.