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Article(id=1241522925170389004, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241522919977841545, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202309486, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1695657600000, receivedDateStr=2023-09-26, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773931731741, onlineDateStr=2026-03-19, pubDate=1710000000000, pubDateStr=2024-03-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773931731741, onlineIssueDateStr=2026-03-19, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773931731741, creator=13701087609, updateTime=1773931731741, updator=13701087609, issue=Issue{id=1241522919977841545, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='5', pageStart='769', pageEnd='960', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773931730503, creator=13701087609, updateTime=1773931880386, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241523548695622547, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241522919977841545, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241523548695622548, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241522919977841545, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=883, endPage=887, ext={EN=ArticleExt(id=1241522927334649932, articleId=1241522925170389004, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=A study on the influence of internet use on the cognitive function of the elderly in China, columnId=1228016572451718132, journalTitle=Modern Preventive Medicine, columnName=Health and Social Behavior, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the current situation of cognitive function of the elderly in China and the influence of internet use on the cognitive function of the elderly.

Methods

In total 10 546 people aged 60 and above were included in the study. The t-test and variance analysis were used to analyze the differences of cognitive function among elderly groups with different characteristics. Multiple linear regression model was used to explore the effect of internet use on the cognitive function of the elderly.

Results

A total of 2 987 elderly people used the internet, accounting for 28.32% of the total, and the average score of cognitive function of the elderly who used the internet was 14.75±1.86. The average score of cognitive function of the elderly who had not used the internet was 13.34±2.91. There was a significant difference between the two groups (t=-29.48, P < 0.001). The use of the internet was related to the cognitive function of the elderly (β = 0.12, 95%CI: 0.608-0.845, P < 0.001), and the cognitive function of the elderly who used the Internet was better.

Conclusion

Internet use has an impact on the cognitive function of the elderly, and it is suggested that targeted measures be taken to improve the cognitive function of the elderly.

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目的

分析我国老年人的认知功能现状以及互联网使用对老年人认知功能的影响。

方法

将10 546名60岁及以上老年人纳入研究范围，运用t检验法和方差分析法分析不同特征老年群体的认知功能差异，运用多元线性回归模型探究互联网使用对老年人认知功能的影响。

结果

共有2 987位老年人使用互联网，约占总人数的28.32%；使用互联网的老年人认知功能平均得分为（14.75±1.86）分，没有使用过互联网的老年人人认知功能平均得分为（13.34±2.91）分，两者差异具有统计学意义（t=-29.48，P<0.001）；互联网使用与老年人认知功能相关（β=0.12，95%CI：0.608～0.845，P<0.001），使用互联网的老年人认知功能更好。

结论

互联网使用会对老年人认知功能产生影响，建议采取针对性措施来改善老年人的认知功能。

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钱爱兵，E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=XkYaDeyaugNdY//oDBUvpQ==, magXml=7iUif01TpkI85NCejgWWJw==, pdfUrl=null, pdf=1Qpx0fBswaxNFakdf+kz6g==, pdfFileSize=521074, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=h2mP8n1yRJ71mccCfMPgbg==, mapNumber=null, authorCompany=null, fund=null, authors=

朱欣叶（1999—），女，硕士在读，研究方向：老年健康、卫生政策

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朱欣叶（1999—），女，硕士在读，研究方向：老年健康、卫生政策

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Variables and assignments

, figureFileSmall=null, figureFileBig=null, tableContent=
变量赋值方式
认知功能MMSE量表得分
互联网使用0=否，1=是
性别0=女，1=男
年龄（岁）0=60～69，1=70～79，2=80～89
文化程度0=小学以下，1=小学，2=初中，3=高中及以上
婚姻状况0=无配偶，1=有配偶
居住地0=农村，1=城镇
经济水平0=低，1=中，2=高
吸烟0=否，1=是
BMI0=正常，1=偏轻，2超重，3=肥胖
ADL0=正常，1=轻度失能，2=中度失能，3=重度失能
), ArticleFig(id=1241678307247313212, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522925170389004, language=CN, label=表1, caption=

变量和赋值

, figureFileSmall=null, figureFileBig=null, tableContent=
变量赋值方式
认知功能MMSE量表得分
互联网使用0=否，1=是
性别0=女，1=男
年龄（岁）0=60～69，1=70～79，2=80～89
文化程度0=小学以下，1=小学，2=初中，3=高中及以上
婚姻状况0=无配偶，1=有配偶
居住地0=农村，1=城镇
经济水平0=低，1=中，2=高
吸烟0=否，1=是
BMI0=正常，1=偏轻，2超重，3=肥胖
ADL0=正常，1=轻度失能，2=中度失能，3=重度失能
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Distribution of general characteristics and results of univariate analysis

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变量分组人数百分比（%）认知功能得分t/F值P值
均值标准差
全体老年人无10 546100.0013.742.73
互联网使用否7 55971.6813.342.91-29.48<0.001
是2 98728.3214.751.86
性别女5 16348.9613.612.81-4.72<0.001
男5 38351.0413.862.65
年龄（岁）60～694 72544.8014.382.18486.82<0.001
70～794 40441.7613.622.69
≥801 41713.4411.933.56
文化程度小学以下2 25921.4212.703.20188.24<0.001
小学4 40841.8013.722.71
初中2 68825.4914.292.30
高中及以上1 19111.2914.532.06
婚姻状况无配偶2 53624.0512.993.18-14.11<0.001
有配偶8 01075.9513.972.53
居住地农村4 68744.4413.522.87-7.10<0.001
城镇5 85955.5613.912.61
经济水平低1 18911.2713.123.0734.58<0.001
中7 46570.7913.802.70
高1 89217.9413.862.60
吸烟否7 60172.0713.732.73-0.470.636
是2 94527.9313.762.75
BMI正常6 83564.8113.752.769.87<0.001
偏轻4824.5713.263.01
超重2 87827.2913.832.62
肥胖3513.3313.252.66
ADL正常9 09686.2514.032.49319.85<0.001
轻度失能9348.8612.502.85
中度失能1861.7611.503.39
重度失能3303.1310.514.29
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一般特征分布及单因素分析结果

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变量分组人数百分比（%）认知功能得分t/F值P值
均值标准差
全体老年人无10 546100.0013.742.73
互联网使用否7 55971.6813.342.91-29.48<0.001
是2 98728.3214.751.86
性别女5 16348.9613.612.81-4.72<0.001
男5 38351.0413.862.65
年龄（岁）60～694 72544.8014.382.18486.82<0.001
70～794 40441.7613.622.69
≥801 41713.4411.933.56
文化程度小学以下2 25921.4212.703.20188.24<0.001
小学4 40841.8013.722.71
初中2 68825.4914.292.30
高中及以上1 19111.2914.532.06
婚姻状况无配偶2 53624.0512.993.18-14.11<0.001
有配偶8 01075.9513.972.53
居住地农村4 68744.4413.522.87-7.10<0.001
城镇5 85955.5613.912.61
经济水平低1 18911.2713.123.0734.58<0.001
中7 46570.7913.802.70
高1 89217.9413.862.60
吸烟否7 60172.0713.732.73-0.470.636
是2 94527.9313.762.75
BMI正常6 83564.8113.752.769.87<0.001
偏轻4824.5713.263.01
超重2 87827.2913.832.62
肥胖3513.3313.252.66
ADL正常9 09686.2514.032.49319.85<0.001
轻度失能9348.8612.502.85
中度失能1861.7611.503.39
重度失能3303.1310.514.29
), ArticleFig(id=1241678310971855197, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522925170389004, language=EN, label=Table 3, caption=

Results of multivariate linear regression

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变量分组模型一模型二
βt值P值βt值P值
互联网使用否11
是0.23（1.297～1.522）24.53<0.0010.12（0.608～0.845）12.01<0.001
性别女1
男0.00（-0.076～0.120）0.440.662
年龄（岁）60～691
70～79-0.06（-0.442～-0.228）-6.15<0.001
≥80-0.16（-1.481～-1.150）-15.57<0.001
文化程度小学以下1
小学0.13（0.575～0.833）10.68<0.001
初中0.15（0.773～1.078）11.91<0.001
高中及以上0.12（0.873～1.258）10.85<0.001
婚姻状况无配偶1
有配偶0.04（0.167～0.402）4.74<0.001
居住地农村1
城镇0.00（-0.085～0.123）0.360.716
经济水平低1
中0.10（0.449～0.754）7.75<0.001
高0.07（0.316～0.677）5.40<0.001
BMI正常1
偏轻-0.01（-0.399～0.061）-1.440.150
超重-0.01（-0.145～0.074）-0.630.528
肥胖-0.02（-0.593～-0.054）-2.350.019
ADL正常1
轻度失能-0.12（-1.367～-1.025）-13.70<0.001
中度失能-0.08（-2.050～-1.318）-9.02<0.001
重度失能-0.17（-2.909～-2.347）-18.34<0.001
R20.050.18
), ArticleFig(id=1241678311651332461, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522925170389004, language=CN, label=表3, caption=

多元线性回归结果

, figureFileSmall=null, figureFileBig=null, tableContent=
变量分组模型一模型二
βt值P值βt值P值
互联网使用否11
是0.23（1.297～1.522）24.53<0.0010.12（0.608～0.845）12.01<0.001
性别女1
男0.00（-0.076～0.120）0.440.662
年龄（岁）60～691
70～79-0.06（-0.442～-0.228）-6.15<0.001
≥80-0.16（-1.481～-1.150）-15.57<0.001
文化程度小学以下1
小学0.13（0.575～0.833）10.68<0.001
初中0.15（0.773～1.078）11.91<0.001
高中及以上0.12（0.873～1.258）10.85<0.001
婚姻状况无配偶1
有配偶0.04（0.167～0.402）4.74<0.001
居住地农村1
城镇0.00（-0.085～0.123）0.360.716
经济水平低1
中0.10（0.449～0.754）7.75<0.001
高0.07（0.316～0.677）5.40<0.001
BMI正常1
偏轻-0.01（-0.399～0.061）-1.440.150
超重-0.01（-0.145～0.074）-0.630.528
肥胖-0.02（-0.593～-0.054）-2.350.019
ADL正常1
轻度失能-0.12（-1.367～-1.025）-13.70<0.001
中度失能-0.08（-2.050～-1.318）-9.02<0.001
重度失能-0.17（-2.909～-2.347）-18.34<0.001
R20.050.18
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互联网使用对我国老年人认知功能的影响研究
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朱欣叶 , 钱爱兵
现代预防医学 | 健康与社会行为 2024,51(5): 883-887
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现代预防医学 | 健康与社会行为 2024, 51(5): 883-887
互联网使用对我国老年人认知功能的影响研究
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朱欣叶, 钱爱兵
作者信息
  • 南京中医药大学卫生经济管理学院，江苏 南京 210023

    • 朱欣叶（1999—），女，硕士在读，研究方向：老年健康、卫生政策

通讯作者:

钱爱兵，E-mail:
A study on the influence of internet use on the cognitive function of the elderly in China
Xin-ye ZHU, Ai-bing QIAN
Affiliations
  • School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, China
出版时间: 2024-03-10 doi: 10.20043/j.cnki.MPM.202309486
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摘要
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目的

分析我国老年人的认知功能现状以及互联网使用对老年人认知功能的影响。

方法

将10 546名60岁及以上老年人纳入研究范围，运用t检验法和方差分析法分析不同特征老年群体的认知功能差异，运用多元线性回归模型探究互联网使用对老年人认知功能的影响。

结果

共有2 987位老年人使用互联网，约占总人数的28.32%；使用互联网的老年人认知功能平均得分为（14.75±1.86）分，没有使用过互联网的老年人人认知功能平均得分为（13.34±2.91）分，两者差异具有统计学意义（t=-29.48，P<0.001）；互联网使用与老年人认知功能相关（β=0.12，95%CI：0.608～0.845，P<0.001），使用互联网的老年人认知功能更好。

结论

互联网使用会对老年人认知功能产生影响，建议采取针对性措施来改善老年人的认知功能。

老年人  /  互联网使用  /  认知功能
Objective

To analyze the current situation of cognitive function of the elderly in China and the influence of internet use on the cognitive function of the elderly.

Methods

In total 10 546 people aged 60 and above were included in the study. The t-test and variance analysis were used to analyze the differences of cognitive function among elderly groups with different characteristics. Multiple linear regression model was used to explore the effect of internet use on the cognitive function of the elderly.

Results

A total of 2 987 elderly people used the internet, accounting for 28.32% of the total, and the average score of cognitive function of the elderly who used the internet was 14.75±1.86. The average score of cognitive function of the elderly who had not used the internet was 13.34±2.91. There was a significant difference between the two groups (t=-29.48, P < 0.001). The use of the internet was related to the cognitive function of the elderly (β = 0.12, 95%CI: 0.608-0.845, P < 0.001), and the cognitive function of the elderly who used the Internet was better.

Conclusion

Internet use has an impact on the cognitive function of the elderly, and it is suggested that targeted measures be taken to improve the cognitive function of the elderly.

Elderly  /  Internet use  /  Cognitive function
朱欣叶, 钱爱兵. 互联网使用对我国老年人认知功能的影响研究. 现代预防医学, 2024 , 51 (5) : 883 -887 . DOI: 10.20043/j.cnki.MPM.202309486
Xin-ye ZHU, Ai-bing QIAN. A study on the influence of internet use on the cognitive function of the elderly in China[J]. Modern Preventive Medicine, 2024 , 51 (5) : 883 -887 . DOI: 10.20043/j.cnki.MPM.202309486
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第七次人口普查数据显示，60岁及以上老年人口占比为18.7%，较第六次人口普查增加了5.44个百分点，我国人口老龄化问题逐渐严重[1]。认知功能下降是衰老的常见表现[2]，同时也是阿尔兹海默病的初期典型特征[3]，相关研究显示我国60岁以上患有阿尔茨海默病和相关痴呆症的老年人占比在5%～30%[4]。由于认知功能下降的可逆性较低，患者需接受持续性的治疗和照护，这会使其自身及家庭承受巨大的经济压力[5-6]。随着互联网的快速发展，尽管已有部分学者开始关注互联网使用对老年人认知功能的影响[7-10]，但现有研究尚缺乏基于大样本数据的实证分析。基于此，本研究选用中国老年社会追踪调查（China Longitudinal Aging Social Survey，CLASS）2020年数据，探究我国老年人的认知功能现状以及互联网使用对我国老年人认知功能的影响，以期在人口老龄化趋势下寻找缓解我国老年人认知功能衰退的办法。
1　资料与方法
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1.1　数据来源
数据来源于2020年CLASS，该调查在我国28个省、市、自治区内进行，旨在收集老年人的个人基本信息、社会经济状况、身心健康情况等。2020年CLASS的原始样本量为11 398人，在剔除认知功能得分缺失的样本后，最终纳入分析的样本量为10 546人。
1.2　变量选择
1.2.1　被解释变量
本研究的被解释变量为老年人的认知功能。CLASS问卷使用创建于1975年的简易精神状态量表（mini-mental state examination，MMSE）测量老年人的认知功能[11]。参考已有研究[12-13]，用MMSE量表得分表示老年人的认知功能，总得分区间为0～16，分数越高表明老年人的认知功能越好。
1.2.2　解释变量
本研究的解释变量为老年人的互联网使用情况。参考已有研究[14-15]，根据CLASS问卷中“您上网吗?”这一问题，将从不上网定义为不使用互联网，取值为0，反之为1。
1.2.3　控制变量
本研究的控制变量包括个人特征因素和健康状况因素。参考已有研究[12-13,16-18]，个人特征因素选取性别、年龄、文化程度、婚姻状况、居住地和经济水平，健康状况因素选取吸烟、身体质量指数（body mass index，BMI）和日常生活活动能力（activity of daily living，ADL）。变量的具体赋值方式见表1。
1.3　研究方法
本研究使用SPSS 26.0软件进行数据处理与分析。描述性分析中，计量资料用（均值±标准差）表示，计数资料用频数和比例表示；单因素分析中，两组均数的比较采用独立样本t检验，多组均数的比较采用单因素方差分析；多因素分析中，使用多元线性回归模型探究互联网使用对我国老年人认知功能的影响，检验水准α=0.05。
2　结果
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2.1　基本情况
在10 546位老年人中，有2 987位老年人使用互联网，占比为28.32%。在性别分布上，男性老年人占51.04%，略高于女性老年人。在年龄分布上，80岁以上的老年人占13.44%。在文化程度分布上，63.22%的老年人文化程度在初中以下。在婚姻状况分布上，75.95%的老年人有配偶。在居住地分布上，城镇老年人占55.56%，高于农村老年人。在经济水平分布上，经济水平居中的老年人占比最高，为70.79%。在健康状况分布上，72.07%的老年人不吸烟，64.81%的老年人BMI正常，86.25%的老年人ADL正常。见表2。
2.2　不同特征老年人的认知功能情况
在本研究中，全体老年人的认知功能平均得分为（13.74±2.73）分。其中，使用互联网的老年人认知功能平均得分高于未使用过互联网的老年人，两者存在差异。男性老年人的认知功能平均得分略高于女性老年人，两者存在差异。年龄与老年人的认知功能有关，年龄在80岁以上老年人的认知功能平均得分比60～69岁老年人低2.45分。文化程度与老年人的认知功能有关，文化程度在高中及以上老年人的认知功能平均得分比文化程度在小学以下老年人高1.83分。有配偶老年人的认知功能平均得分高于无配偶老年人，两者存在差异。居住在城镇老年人的认知功能平均得分略高于居住在农村老年人，两者存在差异。经济水平与老年人的认知功能有关，经济水平较高老年人的认知功能平均得分比经济水平较低老年人高0.74分。老年人是否吸烟与认知功能无关，但BMI与ADL均与认知功能相关。见表2。
2.3　互联网使用对老年人认知功能的影响
本研究以老年人的认知功能得分为被解释变量，以互联网使用为解释变量，分两个模型进行多元线性回归分析。模型一仅纳入互联网使用，结果表明，使用互联网老年人的认知功能更好（β=0.23，P<0.001）。模型二在模型一的基础上加入个人特征因素和健康状况因素，结果显示，有了显著提升，说明模型二的拟合效果更好。在控制了相关变量后，互联网使用仍对老年人认知功能具有显著正向影响（β=0.12，P<0.001）。此外，老年人认知功能的影响因素还包括年龄、文化程度、婚姻状况、经济水平、BMI、ADL等。见表3。
3　讨论
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本研究基于2020年CLASS数据的全国抽样样本，对我国60岁及以上老年人的认知功能现状进行了分析，并探究了互联网使用对其认知功能的影响。在本研究中，老年人的认知功能得分为（13.74±2.73）分，明显高于2014年CLASS数据计算的（13.0±3.1）分[12]和2018年CLASS数据计算的（13.31±3.09）分[13]。Zhang等[19]学者研究发现我国老年人的认识功能平均得分在2005—2014年期间呈现下降趋势，而在2014年之后，其认识功能平均得分呈现上升趋势。这可能归因于近年来我国对老年人认知状况的重视，例如《“十三五”健康老龄化规划重点任务分工》提出要推广老年痴呆防治适宜技术；《探索老年痴呆防治特色服务工作方案》强调要普及老年痴呆防治知识。尽管我国老年人的认知功能有所提升，但整体形势仍然严峻，截至2020年我国痴呆症患者的数量大约在600～800万，这一数字预计于2040年将增加至2 250万[13]。
本研究发现使用互联网老年人的认知功能更好，这与已有研究结果相符[20-21]。这可能是由于互联网使用能提高老年人的注意力和反应速度，例如微信等社交媒体的使用需要老年人学习语音信息发送、朋友圈编辑发布等，这种反复的记忆、学习和操作过程会加强老年人大脑皮质之间的联系，通过刺激中枢神经来提升注意力与集中、延迟记忆等认知功能[22]。此外，互联网使用也能在一定程度上解决老年人活动范围受限[23]、信息来源单一[20]等问题，进而有效改善老年人的认知功能。基于此，建议推广互联网在老年群体中的使用，一要营造良好的互联网使用环境，二要开展培训活动教会老年人使用智能技术获取线上服务，三要加强研发老年友好型终端产品。
本研究还发现年龄、文化程度、婚姻状况、经济水平、ADL等因素也会影响老年人的认知功能。在年龄方面，年龄增加会导致脑白质降低，这会损伤老年人的信息加工处理能力，进而影响其认知功能[18]。在文化程度方面，文化程度较高的老年人更加具备健康投资意识和能力[24]，这对老年人的认知功能起到保护作用。在婚姻状况方面，有配偶老年人的认知功能更强，原因可能是配偶的陪伴能有效缓解孤独感，从而对认知功能产生促进作用，这与韦慧燕等[25]学者的研究结果一致。在经济水平方面，经济水平较高的老年人能够获得更丰富的医疗保健资源和日常娱乐活动[18]，这可以有效提高其认知功能。在ADL方面，ADL与老年人认知功能的关系在以往研究中已被证实[26]，这可能是由于日常生活活动能力受损会限制老年人的活动范围，导致其与外界的交流变少，进一步降低其认知功能。
本研究仍存在一些局限性。首先，本研究选用的是截面数据，难以确定因果关系；其次，本研究将是否使用互联网作为解释变量，未深入探讨不同类型的互联网使用（如社交软件、影音、游戏等）对老年人认知功能的影响；最后，由于CLASS数据库使用的是简化版的MMSE量表，难以准确判断老年人的认知功能是否存在障碍，故本研究选用MMSE量表得分来衡量老年人的认知功能。
基金
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  • 国家社会科学基金资助项目(20BTQ053)
文献
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2024年第51卷第5期
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doi: 10.20043/j.cnki.MPM.202309486
  • 接收时间：2023-09-26
  • 首发时间：2026-03-19
  • 出版时间：2024-03-10
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  • 收稿日期：2023-09-26
基金
国家社会科学基金资助项目(20BTQ053)
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    南京中医药大学卫生经济管理学院，江苏 南京 210023

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