AbstractBackgroundOlder adults are increasingly crossing the digital divide, regularly engaging with technologies such as the internet, smartphones, and personal computers. Two distinct theories of the cognitive impact of this digital engagement have been raised. According to the digital distraction hypothesis, regular engagement with technology acutely negatively effects cognition by increasing distractions and decreases cognitive skills over the long‐term by regularly offloading tasks such as recall of facts, directions, and other daily memory tasks into digital technologies. By contrast, according to the technological reserve hypothesis, regular engagement with technology acutely benefits functioning via use of assistive technologies and can reduce long‐term risk for cognitive disorders with age by promoting complex cognitive engagement, sustained connection, and acquisition of digital based compensatory skills.MethodRandom effects meta‐analysis was used to pool effect sizes, with primary effect sizes reported as odds ratios (odds of developing a cognitive diagnosis or odds of having lower cognitive scores as appropriate to each study). We conducted systematic evaluations of study quality and to determine the influence of socioeconomic, education, age, and type of technology.ResultOf 6,183 records identified, 26 studies met inclusion criteria and were included in the final analysis. Engagement with smartphones, computers, and/or the internet was associated with decreased risk of cognitive decline, mild cognitive impairment, and dementia (pooled OR = 0.45, 95% CI 0.318‐0.637, p<.0001; I2 = 99.2%; Figure 1). Potential confounding variables, such as adjustment for socioeconomic factors and education or type of technology measured did not moderate this relationship (Figure 2). Study quality was generally good (Figure 3), though all studies assessed technology use by self‐report and few measured intraindividual changes in technology use over time.ConclusionEngagement with everyday digital technologies is associated with decreased risk of cognitive decline and dementia, consistent with the technological reserve hypothesis. While these studies do not prove causality of this relationship, they do highlight the potential for digital health approaches to promote cognitive health and well being with age. Limitations, particularly with regard to understanding digital disparities and incorporating objective digital use metrics in future studies are discussed in detail.