Digital exclusion was associated with higher odds of frailty and faster frailty progression among older adults across multiple international cohorts, and transitioning from digital exclusion to digital inclusion was linked to lower odds of frailty.
Digital exclusion was significantly associated with higher odds of frailty in three of four international cohort studies examined.
Digital exclusion was associated with faster frailty progression in two of the four cohort studies.
Transitioning from digital exclusion to digital inclusion was associated with significantly lower odds of frailty compared with persistent digital exclusion.
A considerable proportion of older adults across all four cohorts still experienced digital exclusion during the study period.
The association between digital exclusion and frailty was strongest in the Chinese cohort (CHARLS), with an odds ratio nearly twice that observed in the US and English cohorts.
This research suggests that older adults who do not use the internet — referred to as being 'digitally excluded' — are more likely to be frail and to become frail more quickly over time. The study drew on data from over 37,000 older adults across four countries (China, the United States, England, and Mexico) and tracked them over multiple years. In three of the four countries studied, people who did not use the internet had meaningfully higher odds of being frail, with the strongest association found in China, where digitally excluded older adults had nearly three times the odds of frailty compared to internet users. The study also found that digital exclusion was linked to faster worsening of frailty over time in China and England. Importantly, older adults who started out digitally excluded but later began using the internet showed lower odds of frailty compared to those who remained excluded throughout the study period. This suggests that gaining access to and use of digital technology may be relevant to maintaining health in older age, though the study cannot prove that internet use directly causes better health outcomes. This research highlights digital exclusion as a meaningful social factor connected to physical health decline in older adults around the world. The findings suggest that efforts to improve digital access and digital literacy among older people — such as providing internet access, affordable devices, and training — may be worth considering as part of broader strategies to support healthy ageing and reduce health inequalities.
Wang H, Sun R, Yan B, Wei Y, Wu Y, Ling F, et al.. (2026). Digital exclusion and frailty among older adults: findings from four longitudinal cohort studies.. Age and ageing. https://doi.org/10.1093/ageing/afag133