It's a prospective cohort study. That means, a group of people were followed over a long period. The temporal association means that some manifestations of reverse causality can be excluded. In other words, it is not the case that people with observable dementia mistakenly rated their screen time as higher.
What the study could not exclude is the possibility that people who reported high screen use during the exposure period already had some kind of unmeasured brain damage, what the paper calls "prodromal" dementia.
The most likely explanation of these data is not that screen time causes dementia directly. Excessive screen time probably correlates with the sedentary and isolated lifestyles that are known to influence cardiovascular and mental health.
What is novel and interesting is that you wouldn't necessarily expect moderate computer use would have a protective effect.
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