Heterogeneity in the association between internet use and dementia among older adults: A machine-learning analysis.

• Internet use was associated with dementia among older adults. • A generalized random forest algorithm flexibly uncovered heterogeneity in the association. • Multidimensional heterogeneity was observed across income, education, and population density. • Findings highlight complex heterogeneity miss...

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Publicado en:Archives of Gerontology & Geriatrics Vol. 136
Autores principales: Nakagomi, Atsushi, Kondo, Katsunori, Shiba, Koichiro
Formato: research Journal Article
Publicado: Elsevier B.V. Sep2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2025
      vid: 136
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      pub: Elsevier B.V.
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        185777224
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        10.1016/j.archger.2025.105912
        185777224
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        atl: Heterogeneity in the association between internet use and dementia among older adults: A machine-learning analysis.
      aug:
        au:
          Nakagomi, Atsushi
          Kondo, Katsunori
          Shiba, Koichiro
        affil: Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoicho, Inage-ku, Chiba-city, Chiba 263-8522, Japan
      sug:
        subj:
          Internet Utilization
          Dementia Risk Factors
          Risk Assessment
          Machine Learning Methods
          Human
          Middle Age
          Aged
          Aged, 80 and Over
          Prospective Studies
          Japan
          Random Forest
          Algorithms
          Social Class
          Sociodemographic Factors
          Educational Status
          Population Density
          Media Exposure
          Survey Research
          Insurance, Long Term Care
          Health Status In Old Age
          Descriptive Statistics
          Confidence Intervals
          Physical Activity In Old Age
          Gerontologic Care
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
      ab: • Internet use was associated with dementia among older adults. • A generalized random forest algorithm flexibly uncovered heterogeneity in the association. • Multidimensional heterogeneity was observed across income, education, and population density. • Findings highlight complex heterogeneity missed by traditional analytical methods. 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. 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. 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. 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.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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