Technology literacy and access to digital resources for remote assessment among adults enrolled in Alzheimer's disease research

Background: The SARS-CoV-2 pandemic accelerated development of innovative methods for conducting research remotely via digital technologies. However, few studies have examined participant technological literacy skills or access as key social determinants of brain health in aging populations at risk of Alzheimer's disease and other dementias.

Objective: To identify associations of sociodemographic and clinical characteristics, cognitive status and geolocation with digital technology access and skill within dementia research cohorts.

Methods: A self-administered questionnaire surveyed digital access and literacy skills in persons enrolled across various studies conducted at Emory Goizueta Alzheimer's Disease Research Center. We investigated cognitive and sociodemographic characteristics, and neighborhood disadvantage related to these digital attributes.

Results: Of 1860 participants (mean age: 65.3 years (SD:11.4)) surveyed, 71.6% were women, 87.1% Whites, 10.4% African Americans, and 46.9% had postgraduate-level education. Most participants had access to digital devices: desktop (53.7%), laptop (81.6%), tablet (71.6%), smartphone (94.6%), internet (82.0%), or videoconferencing (95.5%). Cognitively unimpaired participants had higher odds of digital access (OR:3.75; 95% CI:2.45-5.73) and skill (OR:1.22; 95% CI:1.14-1.30). Although Whites were likelier to have access (OR:1.36; 95% CI:1.01-1.82) than African Americans, no differences were found in skill between the two groups. Living in more disadvantaged neighborhoods was significantly associated with lower technology skills (OR:0.86; 95% CI:0.82-0.91).

Conclusions: Cognitive impairment, race, and neighborhood socioeconomic disadvantage are significant barriers which limit digital access and skill. Improving digital knowledge, skill-building, and geographic access may encourage research participation especially in geographically remote or disadvantaged areas and help narrow sociodemographic and racial disparities existing in dementia research.