Digital neurobehavioral signature and its association with cognitive function and psychological resilience: a cross-sectional study of digital lifestyle patterns and cognitive health

Aim: To investigate the associations between the digital neurobehavioral signature (DNS) score, cognitive function, and psychological resilience among adults, and to explore the potential mediating role of psychological resilience in the association between digital behavioral patterns and cognitive performance. Methods: A cross-sectional study was conducted at Abbasi Shaheed Hospital, Karachi, among 400 adults. DNS was assessed using a composite DNS score derived from screen time, sleep, physical activity, and digital engagement. Cognitive function was measured using the Montreal Cognitive Assessment, while psychological resilience and depressive symptoms were assessed using validated scales. Multivariable regression and mediation analyses were performed to evaluate independent associations and indirect effects. For continuous outcomes, differences across DNS profiles were assessed using one-way ANOVA, followed by Bonferroni-adjusted post-hoc pairwise comparisons when the ANOVA was significant. A p < 0.05 was considered statistically significant. Results: Participants with maladaptive DNS demonstrated significantly lower cognitive performance and psychological resilience compared with those with adaptive profiles, with significant differences confirmed by Bonferroni-adjusted post-hoc pairwise comparisons (p < 0.001). Higher DNS composite scores were independently associated with lower cognitive scores (β = −0.34, p < 0.001). Psychological resilience was positively associated with cognitive function and partially mediated the association between digital behavioral patterns and cognition. Conclusions: These findings suggest that the exploratory DNS composite behavioral index is associated with cognitive function and psychological resilience and may provide a framework for investigating relationships between digital lifestyle behaviors and neurocognitive and psychological outcomes.