Information and Communication Technology Use for Alleviation of Disability Onset in Socially Isolated Older Adults: A Longitudinal Cohort Study

Introduction: Delaying the onset of disability is important for maintaining independence and quality of life in community-dwelling older adults. Given that social isolation is a significant risk factor for disability, effective means associated with social isolation are needed to alleviate disability. Although information and communication technology (ICT) may be a reasonable measure considering the recent social contexts due to the coronavirus disease 2019 pandemic, further insights are required. This study aimed to investigate whether ICT use could alleviate the onset of disability in community-dwelling older adults with and without social isolation.
Methods: This longitudinal cohort study on 4,346 community-dwelling independent Japanese older adults (mean age, 73.5±5.3 years) was conducted between 2017 and 2018. Participants were classified into four groups based on social isolation (the condition where two or more of the following measures were met: domestic isolation, less social contact, and social disengagement) and ICT users (those who had recently used a computer or a smartphone) and followed up to assess disability incidence for 24 months after baseline assessments. Cox proportional-hazards regression models were used to identify the effect of social isolation and ICT use on the risk of disability onset by adjusting by age, sex, education history, number of medications, eye disease, level of annual income, mini-mental state examination, geriatric depression scale 15, and gait speed.
Results: Most participants belonged to the group of non-social isolation and ICT users (44.7%), followed by non-social isolation and ICT non-users (41.7%), social isolation and ICT non-users (8.2%), and social isolation and ICT users (5.4%). At the follow-up, 2.2%, 5.5%, 2.4%, and 12.4% of the participants in the above order developed disability (p < 0.01). Cox regression models revealed a significantly higher risk of disability onset in the social isolation and ICT non-users group than in the social isolation and ICT users group (HR=2.939; 95% Confidence interval [CI] 1.029-8.397; p=0.044). In the subgroup analysis stratified by social isolation, ICT use significantly reduced the risk of disability onset in the socially isolated group (HR=0.320; 95% CI 0.109-0.943; p=0.039), although the same association was not observed in the non-socially isolated group (HR=0.845; 95% CI 0.565-1.264; p=0.411).
Conclusion: ICT use can alleviate the onset of disability in socially isolated older adults in a community setting. Considering ICT-applied methods for alleviation of disability is beneficial for older adults in social isolation.