Abstract
ObjectiveTo determine if older men who use computers have lower risk of developing dementia.MethodsCohort study of 5506 community-dwelling men aged 69 to 87 years followed for up to 8.5 years. Use of computers measured as daily, weekly, less than weekly and never. Participants also reported their use of email, internet, word processors, games or other computer activities. The primary outcome was the incidence of ICD-10 diagnosis of dementia as recorded by the Western Australian Data Linkage System.Results1857/5506 (33.7%) men reported using computers and 347 (6.3%) received a diagnosis of dementia during an average follow up of 6.0 years (range: 6 months to 8.5 years). The hazard ratio (HR) of dementia was lower among computer users than non-users (HR = 0.62, 95%CI = 0.47–0.81, after adjustment for age, educational attainment, size of social network, and presence of depression or of significant clinical morbidity). The HR of dementia appeared to decrease with increasing frequency of computer use: 0.68 (95%CI = 0.41–1.13), 0.61 (95%CI = 0.39–0.94) and 0.59 (95%CI = 0.40–0.87) for less than weekly, at least weekly and daily. The HR of dementia was 0.66 (95%CI = 0.50–0.86) after the analysis was further adjusted for baseline cognitive function, as measured by the Mini-Mental State Examination.ConclusionOlder men who use computers have lower risk of receiving a diagnosis of dementia up to 8.5 years later. Randomised trials are required to determine if the observed associations are causal.
Highlights
As the World’s population ages, the number of people experiencing cognitive decline and dementia will continue to increase
Data from the Bronx Aging Study showed that the hazard of dementia over 5 years was decreased amongst older adults involved in cognitively stimulating activities, with the lowest risk observed for the most active participants [6]
Subsequent randomized trial of cognitive training for adults aged 65–94 years (ACTIVE trial) found that the 10-week intervention was associated with specific cognitive gains over 2 years [7], whereas reasoning training led to less pronounced decline in selfreported instrumental activities of daily living over 5 years [8]
Summary
Ethics statement The study was conducted according to the principles expressed in the Declaration of Helsinki, and the Human Research Ethics Committee of the University of Western Australia approved the study protocol and all men provided written informed consent to participate. 30 men were excluded from further participation in this study because they had a recorded diagnosis of dementia in the Western Australian Data Linkage System (WADLS) prior to the date of their assessment (prevalent cases – please see details about the diagnosis of dementia below) Another 47 men did not answer the questions regarding the use of computers and were excluded, leaving a study sample of 5506 participants. They completed the 15item Geriatric Depression Scale (GDS-15) during HIMS wave 2 and, a priori, those with a total score of 7 or more were considered to display clinically significant depressive symptoms at the time of assessment This relatively high cut-point was chosen to ensure high specificity for the diagnosis of depression in this sample [17]. Alpha was set at 5% and all statistical tests were two-tailed
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