Ten-year trends of the digital divides and its effect on healthy aging among older adults in China from 2011 to 2020.

We examined decade-long trends in digital divides and their causal impact on healthy aging among older adults in China. Using five waves of nationally representative data from the China Health and Retirement Longitudinal Study (2011-2020; n = 46,674, aged ≥60), we applied instrumental variable method with two-way fixed effects to address endogeneity. From 2011 to 2020, digital access divide declined from 88.0% to 47.3%, and digital usage divide from 99.0% to 75.7% (P for trend < 0.001). However, both divides were significantly associated with poorer healthy aging outcomes across physical, cognitive, emotional, and social domains. The digital access divide was linked to increased functional limitations, multimorbidity, cognitive impairment, depressive symptoms, social isolation, and lower overall healthy aging index. The digital usage divide showed the same pattern. Subgroup analyses revealed heterogeneity by urban-rural residence, sex, economic level, marital status, education level, and region.