This study investigates how internet use moderates cognitive health disparities between rural and urban older adults in Brazil. It uses data from 9,257 adults aged 50 and above from the second wave of the Brazilian Longitudinal Study of Aging (2019–2021) and conducts multivariable linear regression analyses. Findings indicate that urban residents had better general cognitive health outcomes than rural residents. A significant interaction effect between internet use and rural–urban residency was observed for general cognitive health. Internet use attenuated rural–urban differences in cognitive functioning. These results suggest that interventions that enable and promote internet use among underserved older adults, particularly those in rural areas, could have significant value in Brazil.
BertolaL.SuemotoC. K.AlibertiM. J. R.Gomes GonçalvesN.PinhoP. J. M. R.Castro-CostaE.Lima-CostaM. F.FerriC. P. (2023). Prevalence of dementia and cognitive impairment No dementia in a large and diverse nationally representative sample: The ELSI-brazil study. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 78(6), 1060–1068. https://doi.org/10.1093/gerona/glad025
2.
BragaL. de. S.CaiaffaW. T.CeolinA. P. R.AndradeF. B. deLima-CostaM. F. (2019). Perceived discrimination among older adults living in urban and rural areas in Brazil: A national study (ELSI-Brazil). BMC Geriatrics, 19(1), 67. https://doi.org/10.1186/s12877-019-1076-4
3.
Castro-CostaE.Lima-CostaM. F.AndradeF. B. deSouzaP. R. B. deJr.FerriC. P. (2018). Cognitive function among older adults: ELSI-brazil results. Revista de saude publica, 52(Suppl 2), 4s. https://doi.org/10.11606/S1518-8787.2018052000629
4.
ChaiY.XianG.WangM.GuoL.LuoS. (2024). Aging wisely: The impact of Internet use on older adults’ mental health. Journal of affective disorders, 364, 139–145. https://doi.org/10.1016/j.jad.2024.08.076
5.
ChenY.LvC.LiX.ZhangJ.ChenK.LiuZ.LiH.FanJ.QinT.LuoL.ZhangZ. (2019). The positive impacts of early-life education on cognition, leisure activity, and brain structure in healthy aging. Aging, 11(14), 4923–4942. https://doi.org/10.18632/aging.102088
6.
CloustonS. A. P.SmithD. M.MukherjeeS.Yun ZhangM.HouW.LinkB. G.RichardsM. (2020). Education and cognitive decline: An integrative analysis of global longitudinal studies of cognitive aging. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 75(7), e151–e160. https://doi.org/10.1093/geronb/gbz053
7.
DowneyL. (2013). Rural populations and health: Determinants, disparities, and solutions. Preventing Chronic Disease, 10, 130097. https://doi.org/10.5888/PCD10.130097
8.
FarinaM. (2024). Understanding the role of education in cognitive functioning among older Brazilians. Innovation in Aging, 8(Suppl 1), 88–89. https://doi.org/10.1093/geroni/igae098.0276
9.
FletcherJ.ToppingM.ZhengF.LuQ. (2021). The effects of education on cognition in older age: Evidence from genotyped siblings. Social Science & Medicine, 280, 114044. https://doi.org/10.1016/j.socscimed.2021.114044
10.
GlauberR. (2022). Rural depopulation and the rural‐urban gap in cognitive functioning among older adults. The Journal of Rural Health: Official Journal of the American Rural Health Association and the National Rural Health Care Association, 38(4), 696–704. https://doi.org/10.1111/jrh.12650
11.
GoncalvesN. G.AvilaJ.BertolaL.ObregonA.FerriC.WongR.SuemotoC. (2023). Rural–urban disparities in cognitive performance in Brazil and Mexico. Innovation in Aging, 7(Suppl 1), 284–285. https://doi.org/10.1093/geroni/igad104.0946
12.
HertzogC.KramerA. F.WilsonR. S.LindenbergerU. (2008). Enrichment effects on adult cognitive development: Can the functional capacity of older adults be preserved and enhanced?Psychological Science in the Public Interest: A Journal of the American Psychological Society, 9(1), 1–65. https://doi.org/10.1111/j.1539-6053.2009.01034.x
JongebloedH.AndersonK.WinterN.NguyenL.HugginsC. E.SaviraF.CooperP.YuenE.PeetersA.RasmussenB.ReddyS.CroweS.BhoyrooR.MuhammadI.UgaldeA. (2024). The digital divide in rural and regional communities: A survey on the use of digital health technology and implications for supporting technology use. BMC Research Notes, 17(1), 90. Article 1. https://doi.org/10.1186/s13104-024-06687-x
15.
KaminS. T.LangF. R. (2020). Internet use and cognitive functioning in late adulthood: Longitudinal findings from the survey of health, ageing and retirement in Europe (SHARE). The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 75(3), 534–539. https://doi.org/10.1093/geronb/gby123
16.
KimY. K.HanS. H. (2022). Internet use and cognitive functioning in later life: Focus on asymmetric effects and contextual factors. The Gerontologist, 62(3), 425–435. https://doi.org/10.1093/geront/gnab149
17.
KrugR. D. R.d’OrsiE.XavierA. J. (2019). Association between use of internet and the cognitive function in older adults, populational longitudinal study EpiFloripa idoso. Revista Brasileira de Epidemiologia, 22, e190012. https://doi.org/10.1590/1980-549720190012
18.
LadouceS.DonaldsonD. I.DudchenkoP. A.IetswaartM. (2017). Understanding Minds in Real-World Environments: Toward a Mobile Cognition Approach. Frontiers in human neuroscience, 10, 694. https://doi.org/10.3389/fnhum.2016.00694
19.
LiL.ZengY.ZhangZ.FuC. (2020). The impact of internet use on health outcomes of rural adults: Evidence from China. International Journal of Environmental Research and Public Health, 17(18), 6502. https://doi.org/10.3390/ijerph17186502
20.
Lima-CostaM. F.de Melo MambriniJ. V.Bof de AndradeF.de SouzaP. R. B.de VasconcellosM. T. L.NeriA. L.Castro-CostaE.MacinkoJ.de OliveiraC. (2023). Cohort profile: The Brazilian longitudinal study of ageing (ELSI-Brazil). International Journal of Epidemiology, 52(1), e57–e65. https://doi.org/10.1093/ije/dyac132
21.
Lima-CostaM. F.De OliveiraC.MacinkoJ.MarmotM. (2012). Socioeconomic inequalities in health in older adults in Brazil and England. American Journal of Public Health, 102(8), 1535–1541. https://doi.org/10.2105/AJPH.2012.300765
22.
LövdénM.FratiglioniL.GlymourM. M.LindenbergerU.Tucker-DrobE. M. (2020). Education and cognitive functioning across the life span. Psychological Science in the Public Interest: A Journal of the American Psychological Society, 21(1), 6–41. https://doi.org/10.1177/1529100620920576
ManiA.MullainathanS.ShafrE.ZhaoJ. (2020). Scarcity and cognitive function around payday: A conceptual and empirical analysis. Journal of the Association for Consumer Research, 5(4), 365–376. https://doi.org/10.1086/709885
25.
NakayamaL. F.BinottiW. W.Link WoiteN.FernandesC. O.AlfonsoP. G.CeliL. A.RegatieriC. V. (2023). The digital divide in Brazil and barriers to telehealth and equal digital health care: Analysis of internet access using publicly available data. Journal of Medical Internet Research, 25, e42483. https://doi.org/10.2196/42483
26.
NishijimaM.IvanauskasT. M.SartiF. M. (2017). Evolution and determinants of digital divide in Brazil (2005–2013). Telecommunications Policy, 41(1), 12–24. https://doi.org/10.1016/j.telpol.2016.10.004
27.
Passarelli-AraujoH.de SouzaG. M. (2023). Urban-rural health disparities in Brazil: Do sociodemographic attributes play a role?Preventive Medicine, 175, 107679. https://doi.org/10.1016/j.ypmed.2023.107679
28.
QuialheiroA.FigueiróT. H.RechC. R.MarquesL. P.PaivaK. M.XavierA. J.d'OrsiE. (2022). Can internet use reduce the incidence of cognitive impairment? Analysis of the EpiFloripa aging cohort study (2009-2019). Preventive Medicine, 154, 106904. https://doi.org/10.1016/j.ypmed.2021.106904
29.
Romañach ÁlvarezL. S.FarinaM. P.MuñozE. (2025). Neighborhood social and physical environment and cognitive function among Brazilian adults aged 50+. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 80(7), gbaf092. https://doi.org/10.1093/geronb/gbaf092
30.
SaenzJ. L.DownerB.GarciaM. A.WongR. (2018). Cognition and context: Rural–urban differences in cognitive aging among older Mexican adults. Journal of Aging and Health, 30(6), 965–986. https://doi.org/10.1177/0898264317703560
31.
TaoZ.LuB.WangX. (2022). Urban-rural disparity in cognitive performance among older Chinese adults: Explaining the changes from 2008 to 2018. Frontiers in Public Health, 10. https://doi.org/10.3389/fpubh.2022.843608
32.
WangK.ChenX. S.KangS. Y.SmithB. D.GuD. (2024). Older adults' online activities and cognition: Investigating the psychological mechanisms and age and gender differences. Social Science & Medicine, 352, 116988. https://doi.org/10.1016/j.socscimed.2024.116988
XiaX.YuanP.ZhaoX.JiaF. R.LiB.CaiP. (2024). Effect of internet use on cognitive function of middle-aged and elderly adults in China: Evidence from China family panel studies. Journal of Alzheimer's Disease Reports, 8(1), 387–397. https://doi.org/10.3233/ADR-230137
35.
YuX.MuA.WuX.ZhouL. (2022). Impact of internet use on cognitive decline in middle-aged and older adults in China: Longitudinal observational study. Journal of Medical Internet Research, 24(1), e25760. https://doi.org/10.2196/25760
ZivinK.LlewellynD. J.LangI. A.VijanS.KabetoM. U.MillerE. M.LangaK. M. (2010). Depression among older adults in the United States and England. The American Journal of Geriatric Psychiatry: Official Journal of the American Association for Geriatric Psychiatry, 18(11), 1036–1044. https://doi.org/10.1097/JGP.0b013e3181dba6d2
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