ArticleResearch square2026
Digital Exclusion and Sleep Problems in Middle-Aged and Older Adults: A Multi-Cohort Cross-National Study.
Article in Research square, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
4 authors.
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Abstract
Digital exclusion has been recognised as a social determinant of health, but its prospective relationship with sleep in international ageing cohorts is unknown. We analysed harmonised individual-level data from the Health and Retirement Study (HRS; USA, n = 13,876), the China Health and Retirement Longitudinal Study (CHARLS; n = 12,131) and the Survey of Health, Ageing and Retirement in Europe (SHARE; n = 65,530). Digital exclusion and sleep were measured using cohort-specific indicators: email/internet non-use (HRS), online social-networking non-use (CHARLS) and internet/email non-use (SHARE); sleep outcomes were symptom-based (HRS), duration/restlessness-based (CHARLS) and medication-based (SHARE). Progressive logistic regression, lagged longitudinal models (wave T exposure, wave T + 1 outcome), and temporally ordered mediation (depressive-symptom pathway) were applied. In lagged longitudinal analyses, digital exclusion was associated with subsequent sleep problems in CHARLS (OR 1.47, 95% CI 1.18-1.83) and SHARE (OR 1.79, 95% CI 1.53-2.09); the HRS association was non-significant (OR 1.08, 95% CI 0.98-1.19). Between-cohort heterogeneity was very high (I
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