Associations of television viewing and computer use with cognitive performance in older adults: A cross-sectional NHANES study

Background Television (TV) viewing and computer use may differentially affect cognitive function in older adults. However, evidence on domain-specific and nonlinear associations is limited. Objective To examine the associations of TV viewing and computer use with domain-specific cognitive function in older adults, and to explore potential nonlinear relationships. Methods We analyzed 2554 adults aged ≥60 years from NHANES 2011–2014. Daily TV and computer use were self-reported. Cognitive function was assessed by Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Word Learning, Digit Symbol Substitution Test (DSST), and Animal Fluency Test (AFT). Weighted linear regression models adjusted for demographic, lifestyle, and health-related covariates. Subgroup, sensitivity, and restricted cubic spline (RCS) analyses were performed. Results Longer TV viewing was associated with lower cognition, particularly AFT (Model 3: β = –0.37, 95% CI −0.62 to −0.12, p FDR = 0.035). Computer use was positively associated with DSST (β = 0.85, 95% CI 0.26 to 1.40, p FDR = 0.030), with smaller positive associations observed for CERAD. RCS analyses indicated a nonlinear association for computer use, with peak cognitive benefits at approximately two hours per day, while TV viewing showed a linear negative relationship. Associations were robust across age, sex, and race subgroups and in sensitivity analyses. Conclusions In older adults, longer TV viewing was associated with lower verbal fluency, whereas moderate computer use was associated with better processing speed. A non-linear association was observed for computer use, with benefits peaking at around 2 h per day.