Internet use and depression among older adults

Internet access during COVID-19 and depressive symptoms in middle-aged and older adults: Evidence from a quasi-experimental study in China

BACKGROUND

Amid the COVID-19 pandemic, the mental health of middle-aged and older adults has become an increasing concern, and the role of the internet in addressing this public health crisis has drawn the attention of researchers. This study evaluated the impact of internet access during COVID-19 on depressive symptoms among middle-aged and older adults.

METHODS

Data were derived from China Health and Retirement Longitudinal Study (CHARLS) 2018 and 2020. Difference-in-differences analysis was performed to compare changes in depressive symptoms between the internet users during COVID-19 and those who didn't have access to the internet before and during the pandemic.

RESULTS

We found that internet access during COVID-19 pandemic significantly reduced middle-aged and older adults' depressive symptoms. Further investigation identified the underlying mechanisms through which internet access helps in alleviating depressive symptoms by reducing the likelihood of experiencing negative emotions about COVID-19. Heterogeneity analyses showed that rural residents and middle-aged individuals benefited more from internet access during the pandemic.

CONCLUSIONS

Since internet access can alleviate middle-aged and older adults' depressive symptoms amidst public health crisis, policy makers should focus on enhancing their access to the internet.

Does Internet use improve the physical and mental health of older adults in China? A study based on the digital divide theory

In the digital era, increasingly more Chinese older adults have become Internet users, but the digital divide deeply affects their health. Based on the China Longitudinal Aging Social Survey, the influence of Internet use on older adults' physical and mental health are examined. It is found that digital access, online socializing and information/knowledge acquisition improve older adults' physical and mental health, while Internet skills can hardly influence their health. Social connection and adaptation are two important channels through which Internet use improves older adults' health. Younger and better-educated older adults gain more health benefits from Internet access, but online socializing and economic activities show stronger positive health effects in less-educated older adults. Narrowing the digital divide and promoting digital cohesion are important for the health of older population, so the health and pensions sector and geriatric nursing providers should help this group integrate into digital life to improve their health.

How did COVID-19 pandemic affect the older adults' needs for robot technologies in Japan?: comparison of participatory design workshops during versus after the COVID-19 pandemic

Social technology can improve the quality of social lives of older adults (OAs) and mitigate negative mental and physical health outcomes. When people engage with technology, they can do so to stimulate social interaction (stimulation hypothesis) or disengage from their real world (disengagement hypothesis), according to Nowland et al.'s model of the relationship between social Internet use and loneliness. External events, such as large periods of social isolation like during the COVID-19 pandemic, can also affect whether people use technology in line with the stimulation or disengagement hypothesis. We examined how the COVID-19 pandemic affected the social challenges OAs faced and their expectations for robot technology to solve their challenges. We conducted two participatory design (PD) workshops with OAs during and after the COVID-19 pandemic. During the pandemic, OAs' primary concern was distanced communication with family members, with a prevalent desire to assist them through technology. They also wanted to share experiences socially, as such OA's attitude toward technology could be explained mostly by the stimulation hypothesis. However, after COVID-19 the pandemic, their focus shifted towards their own wellbeing. Social isolation and loneliness were already significant issues for OAs, and these were exacerbated by the COVID-19 pandemic. Therefore, such OAs' attitudes toward technology after the pandemic could be explained mostly by the disengagement hypothesis. This clearly reflect the OA's current situation that they have been getting further digitally excluded due to rapid technological development during the pandemic. Both during and after the pandemic, OAs found it important to have technologies that were easy to use, which would reduce their digital exclusion. After the pandemic, we found this especially in relation to newly developed technologies meant to help people keep at a distance. To effectively integrate these technologies and avoid excluding large parts of the population, society must address the social challenges faced by OAs.

The Benefits of Technology for Engaging Aging Adults: Findings From the PRISM 2.0 Trial

Background and Objectives

Technology has potential for providing support for aging adults. This study evaluated the Personal Reminder Information and Social Management 2.0 (PRISM 2.0) software, in terms of enhancing social engagement and quality of life, and decreasing loneliness among older adults.

Research Design and Methods

The randomized field trial conducted in diverse living contexts (rural locations, senior housing, and assisted living communities [ALC]). Two hundred and forty-five adults, aged 64 to 99 years, were randomly assigned to the PRISM 2.0 (integrated software system designed for aging through an iterative design process) or a Standard Tablet (without PRISM) Control condition, where participants received the same amount of contact and training as those in the PRISM 2.0 condition. Primary outcomes included measures of loneliness, social support, social connectedness, and quality of life. Secondary outcomes included measures of social isolation, mobile device proficiency, and technology readiness. Data were collected at baseline and 6 and 9 months postrandomization. This article focuses on the 6-month outcomes due to coronavirus disease 2019-related data challenges at 9 months.

Results

Contrary to our hypothesis, participants in rural locations and senior housing in both conditions reported less loneliness and social isolation, and greater social support and quality of life at 6 months, and an increase in mobile device proficiency. Participants in the ALCs in both conditions also evidenced an increase in mobile device proficiency. Improvements in quality of life and health-related quality of life were associated with decreases in loneliness.

Discussion and Implications

This study provides compelling evidence about the benefits of technology for older adults in terms of enhancing social outcomes and quality of life. However, the findings also underscore that for technology applications to be successful, they need to be adapted to the abilities and needs of the user group and instructional support needs to be provided.

Clinical Trials Registration #

NCT03116399.

Assessing the Impact of Internet Skills on Depressive Symptoms Among Chinese Middle-Aged and Older Adults: Cross-Sectional Instrumental Variables Analysis

Background

The potential benefits of IT for the well-being of older adults have been widely anticipated. However, findings regarding the impact of internet use on depressive symptoms are inconsistent. As a result of IT's exponential growth, internet skills have supplanted internet access as the source of the digital divide.

Objective

This study evaluates the effect of internet skills on depressive symptoms through an instrumental variables (IV) approach.

Methods

Data from the China Health and Retirement Longitudinal Study's wave 4 (2018) were used. This included 16,949 community residents aged 45 years and older. To overcome the endogeneity issue, we used an IV approach.

Results

Our results reveal the emergence of a second-level digital divide, the disparity in internet skills, among Chinese middle-aged and older adults. Liner regression suggests that a 1% increase in internet skills is associated with a 0.037% decrease in depressive symptoms (β=-.037, SE 0.009), which underestimates the causal effect. As expected, internet skills are an endogenous variable (F test P value <.001). IV regressions indicate that a 1% increase in internet skills reduces 1.135% (SE 0.471) to 1.741% (SE 0.297) of depressive symptoms. These 2 IV are neither weak (F-1=16.7 and 28.5; both >10) nor endogenous (Wu-Hausman test P value of .10; >.05 or >.01).

Conclusions

Better mental health is predicted through improved and higher internet skills. Consequently, residents and policy makers in China should focus on bridging the digital divide in internet skills among middle-aged and older adults.

The Effect of Social Media Forwarding on Subjective Well-Being in Chinese Older Adults: A Moderated Mediation Model

Purpose

In the intersection of the aging and information era, the development of digital aging significantly influences the well-being of older individuals. Given the divergent findings in various studies exploring the effects of social media use on mental health, this study specifically examined the impact of forwarding, a prevalent social media behavior among older individuals, focusing on the effects of use intensity on their subjective well-being (SWB) and the specific mechanisms involved.

Materials and Methods

A total of 323 Chinese older adults completed the questionnaire. SPSS along with Hayes Process Models 4 and 7 was employed to test the hypotheses.

Results

The results indicated that social media forwarding intensity significantly and positively predicted SWB of older adults. This association was partially mediated by perceived social support (PSS) and self-esteem. Gender served as a moderator, highlighting that the positive predictive effects of forwarding intensity on PSS and self-esteem were more pronounced for older men than for older women. Further, the findings confirmed the existence of the moderated mediating effect such that the impact of forwarding on SWB was mediated through both PSS and self-esteem for older men, while, for older women, it was solely mediated by PSS.

Conclusion

This study revealed the positive impact of forwarding, a user-friendly social media function, on the well-being of older adults and elucidated the specific mechanisms through a moderated mediation model. In light of these findings, we propose customizing the development of age-friendly social media functions to address the diverse psychological needs of older adults, taking into account gender differences. These findings may offer valuable insights for constructing digital age-friendly platforms and fostering active aging development.

Connecting through clicks: A longitudinal examination of internet use and depressive symptoms among middle- and old-aged Chinese

AIM

While prior investigations into the influence of internet engagement on depressive symptoms in middle-aged and older individuals have largely been favorable, concerns persist. Some research posits that internet use may detract from direct interpersonal interactions, elevating depression risks. Here, we scrutinize these contrasting views, endeavoring to delineate the relationship between internet use, social participation, and the ensuing depressive manifestations.

METHODS

We analyzed nationally representative data from three consecutive waves (2013-T1, 2015-T2, 2018-T3) of the China Health and Retirement Longitudinal Study survey. Measures of social participation encompassed formal social participation (i.e., attending clubs for mahjong, chess, sports, or other activities; participation in community organizations, volunteering, or enrolling in training courses) and informal social participation (i.e., interactions with friends or extending assistance to relatives, friends, or neighbors). Structural equation modeling was used to evaluate a focused longitudinal mediation model.

RESULTS

Our dataset comprised 13 671 individuals aged 45 years or older. Baseline internet use was associated with a decrease in depressive symptoms by T3 (c '  = -0.143, SE = 0.055). The longitudinal association between internet use and the alleviation of depressive symptoms was partially mediated by enhanced formal social participation (indirect effecta 1 × b 1  = -0.023, SE = 0.011).

CONCLUSIONS

For developing nations such as China, grappling with a rapidly aging demographic and scarce mental health infrastructure, pioneering initiatives that merge digital and formal social participation might be a valuable component in a multifaceted approach to alleviate late-life depression. Geriatr Gerontol Int 2024; 24: 218-224.

The relationship between Internet use and loneliness of middle-aged and older adult people: the moderating effect of residence

Objectives

The proportion of middle-aged and older adult people exposed to the Internet continues to grow. Internet use may have an impact on the mental health of the older adult, especially loneliness. This study analyzed the relationship between Internet use and presence of loneliness.

Methods

A total of 550 person aged 45 years and above were randomly selected from a province in eastern China at the end of 2022. The outcome variable was presence of loneliness, as measured by self-report. Descriptive analysis, chi-square test and binary logistic analysis were used to analyze the data.

Results

58.3% of respondents use the Internet. Internet use could reduce the possible of reported loneliness in middle-aged and older adult people (OR = 0.652, 95%CI: 0.465, 0.940), and residence played a moderating role in the relationship between them. Middle-aged and older adults who used the Internet for 1-3 h (OR = 0.464, 95%CI: 0.275, 0.784) and 3-5 h (OR = 0.484, 95%CI: 0.247, 0.946) were less likely to felt lonely than those who used the Internet for less than 1 h per day. In addition, middle-aged and older adult people using the Internet to contact relatives and friends (OR = 0.488, 95%CI:0.292, 0.818), read the news (OR = 0.485, 95%CI:0.277, 0.848), assets management (OR = 0.297, 95%CI:0.109, 0.818) were less likely to report loneliness, while those who made online payment (OR = 3.101, 95%CI:1.413, 6.807) were more likely to report loneliness.

Conclusion

There is a significant negative correlation between Internet use and presence of loneliness, but different Internet duration and content have different effects on loneliness in middle-aged and older adult people. We should pay attention to the impact of Internet use on loneliness in middle-aged and older adult people.

The moderating effect of intergenerational relationships on the association between Internet engagement and mental well-being

OBJECTIVE

This study examined the moderating effect of intergenerational relationships on the association between Internet engagement and older Chinese adults' mental well-being and whether this relationship and the moderating role of intergenerational relationships differs by age.

METHODS

We collected survey data from 1,162 participants aged 60 and older. Using the Satisfaction with Life Scale (SWLS) to measure life satisfaction, the Chinese version of the De Jong Gierveld Loneliness Scale to evaluate loneliness, and the Intergenerational Relationship Quality Scale for Aging Chinese Parents (IRQS-AP) to assess intergenerational relationship quality. Two-stage least squares regression with interaction terms was used to examine the moderating effect of intergenerational relationships on the association between Internet engagement and mental well-being in different age groups.

RESULTS

Higher levels of Internet engagement were significantly associated with better life satisfaction and lower loneliness in older adults, particularly for the young-old. Furthermore, the positive association between Internet engagement and mental well-being was stronger for older adults with conflicted or detached intergenerational relationships.

CONCLUSIONS

Encouraging and training older adults to use the Internet to shrink the digital divide, developing a sound Internet infrastructure, providing low-cost Internet services, particularly for the young-old with conflicted or detached intergenerational relationships, and the old-old.

The structural characteristics of the lifestyle among older adults and its impact on the health in China

Objective

Enhancing overall health remains a primary global objective, with lifestyle being a crucial factor impacting the health status among older adults. This study focuses on the lifestyle of Chinese older adults, systematically exploring the evolution and characteristics of their lifestyle and investigating its impact on their health.

Methods

Utilizing panel data from the Chinese Longitudinal Health Longevity Survey (CLHLS) from 2008, 2011, 2014, and 2018, we adopted 15 indicators reflecting older adults' lifestyle. Latent class analysis and ordinary least square regression were used to uncover the structural nuances of the Chinese older adults' lifestyle and its effects on health.

Results

The study identifies three distinct lifestyle categories for the older adults: relatively positive, mixed, and relatively negative. It reveals that the Chinese older adults do not predominantly adopt a positive lifestyle, and this trend persisted from 2008 to 2018. Each improvement in lifestyle category significantly boosts the older adults' physical health, mental health, and self-assessed health by 11.2%, 3.6%, and 17.1%, respectively.

Conclusion

To attain the strategic aim of healthy aging, efforts should prioritize encouraging the older adults to adopt a positive lifestyle, enhance the geriatric health service system, and promote an intelligent lifestyle management model.

Association between internet use and depressive symptoms among older adults: mediating role of daytime napping and moderating role of productive engagement

OBJECTIVES

This study investigated the mediating role of daytime napping in the relationship between internet use and depressive symptoms among older adults. Further the moderating effect of productive engagement was assessed on the linkage between internet use and depressive symptoms.

METHODS

We surveyed 956 Chinese community-dwelling older adults. Respondents reported their internet use for different purposes (social, informational, and instrumental use), rated their levels of depressive symptoms and of daytime napping, and reported different types of/overall productive engagement. We conducted mediation and moderation analyses to test the potential pathways of associations among those factors.

RESULTS

Daytime napping mediated the association between social and informational internet use and depressive symptoms. Family caregiving, sporting activities, and overall productive engagement each moderated the relationship between internet use and depressive symptoms.

CONCLUSION

Internet use can increase the risk of depressive symptoms in older adults by increasing daytime napping. However, the benefits of internet use can be particularly salient for those who have a low level of productive engagement. The findings have implications for policies and practices that are designed to help older adults access the internet to enhance well-being.

"If you weren't connected to the Internet, you were not alive": experience of using social technology during COVID-19 in adults 50

Introduction

Loneliness and social isolation reduce physical and mental wellbeing. Older adults are particularly prone to social isolation due to decreased connection with previous social networks such as at workplaces. Social technology can decrease loneliness and improve wellbeing. The COVID-19 pandemic prompted quarantine and social distancing for many people, creating a context of widespread social isolation.

Method

In the current study, we interviewed middle-aged and older adults' (n = 20) about their use of social technology when social isolation was common: during the early part of the pandemic while social isolation and masking were still required in the United States, between August 2020 and June 2021.We analyzed the data using three-phase coding. We compare our results against the model of the bidirectional and dynamic relationship between social internet use and loneliness.

Results

We found that during the COVID-19 pandemic, our participants experienced decreased social interaction and moved toward online interaction. Participant use of social technology supported the stimulation hypothesis - that is, they used it to maintain existing relationships and social connection. The findings also add novel evidence that the stimulation hypothesis endures for older adults during enforced isolation (in this case due to the COVID- 19 pandemic).

Discussion

Based on our data, we also propose adding the presence or realism of connection via social technology as a main factor to the model and engaging with construal level theory of social presence to fill in critical variables of this relationship. We further find that digital exclusion acts as a barrier to obtaining benefits from stimulation via social technology and recommend that further research examined digital exclusion in relation to the bidirectional and dynamic model. Finally, we discuss recommendations for improving social technology to benefit middle-aged and older adults.

Multidimensional Internet Use, Social Participation, and Depression Among Middle-Aged and Elderly Chinese Individuals: Nationwide Cross-Sectional Study

BACKGROUND

There is growing evidence that the internet has beneficial effects on the mental health of middle-aged and older people (≥45 years), but the evidence is inconclusive, and the underlying mechanisms are less known.

OBJECTIVE

This study aims to explore the relationship between multidimensional (devices, frequency, and purpose) internet use and depression in middle-aged and elderly Chinese, as well as the mediating effect of social participation. Moreover, this study will explore the moderating effect of the regional informatization development level (RIDL) on the relationships between individual internet use, social participation, and depression.

METHODS

Data on 17,676 participants aged 45 years or older were obtained from the China Health and Retirement Longitudinal Study (CHARLS) 2018 data set. The 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10) was used to identify the presence of depression. Logistic regression was used to explore the relationship between each dimension of internet use and depression. Multiple linear regression was used to explore the mediating effect of social participation and the moderating effect of the RIDL.

RESULTS

The results showed that 28.33% (5008/17,676) of the total population had depression. In terms of regional subgroups, respondents living in the western region exhibited the highest proportion of depression (2041/5884, 34.69%). Internet use was negatively associated with depression (odds ratio 0.613, 95% CI 0.542-0.692; P<.001). Various dimensions of internet use positively contributed to individual social participation and reduced individual depression (devices: β=-.170, 95% CI -0.209 to -0.127; frequency: β=-.065, 95% CI -0.081 to -0.047; and purpose: β=-.043, 95% CI -0.053 to -0.031). In addition, the RIDL weakened the relationship between individual-level internet use and social participation (internet use: F74.12,9.82=7.55, P<.001; devices: F51.65/9.88=5.23, P=.005; frequency: F66.74/10.08=6.62, P=.001; and purpose: F66.52/9.78=6.80, P=.001), and negatively moderated the relationship between the frequency of internet use and depression (frequency: F662.67/188.79=3.51, P=.03).

CONCLUSIONS

This study found that different dimensions of internet use are associated with lower levels of depression. Social participation partially mediates the association between multidimensional internet use and depression in the eastern, central, and western regions, respectively. Additionally, the RIDL helps individuals further their internet use and social participation, reducing the impact of depression. However, this effect weakens sequentially from the western region to the central region and then to the eastern region.

The longitudinal associations between perceived importance of the internet and depressive symptoms among a sample of Chinese adults

Objective

The aim of this study is to examine the extent to which individuals' cognitive evaluation of the importance of the Internet is associated with depressive symptoms, and in what ways.

Methods

This study utilized a sample of 4,100 participants from the fourth (2016), fifth (2018), and sixth (2020) waves of the China Family Panel Studies. Structural equation modeling was employed for data analysis.

Result

The findings of this study reveal that individuals' cognitive evaluation of the importance of the Internet in 2016 was positively linked with the frequency of Internet use and subjective socioeconomic status in 2018. Furthermore, the frequency of Internet use and subjective socioeconomic status in 2018 were found to be negatively associated with depressive symptoms in 2020. These results indicate that the perceived importance of the Internet has an indirect effect on depressive symptoms through the identified pathway.

Conclusion

The present findings contribute to the existing literature by highlighting the importance of individuals' perceived importance of the internet as a significant factor that influences depressive symptoms. The results suggest that policy makers should take actions to increase public awareness of the importance of the Internet in the digital era, and to ensure equitable access to the internet, thus facilitating convenient internet use and helping individuals adapt to the digital age.

Refined Analysis of Older eHealth Users From an Agency Perspective: Quantitative Telephone Interview Study

BACKGROUND

Most studies on the eHealth divide among older people have compared users to nonusers and found that age, gender, and education were associated with eHealth misuse. They assumed that these characteristics were structural barriers to eHealth adoption. Furthermore, eHealth practices have been examined in a narrow and incomplete way, and the studies disagree about the association between health conditions and eHealth use. Using a more dynamic theoretical lens, we investigated the potential motivations driving older adults' agential adoption of eHealth practices despite their advanced age.

OBJECTIVE

This study aimed to obtain a complete and detailed description of eHealth uses among older adults; examine whether demographic characteristics such as age, gender, and education (previously related to eHealth misuse) are still associated with the various eHealth clusters; and determine whether contextual factors such as changes in the health condition of older eHealth users or their loved ones are associated with older adult eHealth use.

METHODS

We conducted a 30-minute telephone interview with a representative sample of 442 Israeli adults (aged ≥50 years) with a sampling error of 2.04%. The interviews were conducted in Hebrew, Arabic, and Russian. Using factor analysis with 21 eHealth use questions, we identified 4 eHealth clusters: instrumental and administrative information seeking, information sharing, seeking information from peers, and web-based self-tracking. In addition to age, gender, education, internet experience, frequency of internet use, perceived eHealth literacy, and self-rated health, we asked respondents to indicate how much they had used offline health services because of a health crisis in the past year.

RESULTS

We found differences in the number of older eHealth users in the various clusters. They used instrumental and administrative information (420/442, 95%) and obtained information from peers (348/442, 78.7%) the most; followed by web-based self-tracking related to health issues (305/442, 69%), and only a few (52/442, 11.3%) uploaded and shared health information on the web. When controlling for personal attributes, age, gender, and education were no longer predictors of eHealth use, nor was a chronic ailment. Instead, internet experience, frequency of internet use, and perceived eHealth literacy were associated with 3 eHealth clusters. Looking for health information for family and friends predicted all 4 eHealth clusters.

CONCLUSIONS

Many older adults can overcome structural barriers such as age, gender, and education. The change in their or their loved ones' circumstances encouraged them to make deliberate efforts to embrace the new practices expected from today's patients. Seeking health information for family and friends and dealing with unexpected health crises motivates them to use eHealth. We suggest that health professionals ignore their tendency to label older people as nonusers and encourage them to benefit from using eHealth and overcome stereotypical ways of perceiving these patients.

Development of a scale for capturing psychological aspects of physical-digital integration: relationships with psychosocial functioning and facial emotion recognition

The present work aims at developing a scale for the assessment of a construct that we called "physical-digital integration", which refers to the tendency of some individuals not to perceive a clear differentiation between feelings and perceptions that pertain to the physical or digital environment. The construct is articulated in four facets: identity, social relationships, time-space perception, and sensory perception. Data from a sample of 369 participants were collected to evaluate factor structure (unidimensional model, bifactor model, correlated four-factor model), internal consistency (Cronbach's α, McDonald's ω), and correlations of the physical-digital integration scale with other measures. Results showed that the scale is valid and internally consistent, and that both the total score and the scores at its four subscales are worthy of consideration. The physical-digital integration scores were found to be differently associated with digital and non-digital behaviors, individuals' ability to read emotions in the facial expressions of others, and indicators of psychosocial functioning (anxiety, depression, and satisfaction with social relationships). The paper proposes a new measure whose scores are associated with several variables that may have relevant consequences at both individual and social levels.

Internet use and depressive symptoms among Chinese older adults: Two sides of internet use

Objective

To explore the relationship between internet use which includes time spent on the internet, internet skills, types of online activities, and depressive symptoms in older adults.

Methods

We used 2020 China Family Panel Studies (CFPS) data with 3,171 older adults aged 60 years. Depression symptoms were measured with the Center for Epidemiologic Studies Depression (CES-D), and internet use was measured by time spent on the internet, internet skills, and types of online activities. Multiple linear regression models were used to explore the relationship between internet use and depressive symptoms in older adults.

Results

Longer time spent on the internet was associated with higher scores of depressive symptoms (β = 0.14). Higher internet skills were associated with lower scores of depressive symptoms (β = −0.42). Watching short-form videos (β = 1.34) was associated with higher depressive symptom scores, and the use of the WeChat function (β = −0.96) was associated with lower depressive symptom scores, while online games and online shopping were not significant.

Conclusion

The effect of internet use on depressive symptoms in older adults is a double-edged sword. Controlling the time spent on the internet, improving internet skills, and guiding specific a type of online activities in older adults can improve depressive symptoms through rational use.

Internet access, support, usage divides, and depressive symptoms among older adults in China: A nationally representative cross-sectional study

OBJECTIVE

This study examines the associations between multiple sub-dimensions of the digital divide, including Internet access, support, usage divides, and depressive symptoms among older adults as well as the potential moderating effects of rural/urban status on these associations in China.

METHODS

Data were obtained from the 2018 China Longitudinal Aging Social Survey, which provided a nationally representative sample of 11,418 participants aged 60 years and older. Multivariate linear regression models were used to analyze the associations between digital divide and depressive symptoms. The moderating role of rural/urban status was tested based on the interaction terms.

RESULTS

After controlling for the covariates, access to Internet devices, support for Internet use from family, and using the Internet for communication, entertainment, or as instruments, were found to be significantly associated with a lower level of depressive symptoms (P < 0.05), and compared with no access to the Internet, accessing and using the Internet was significantly related to decreased depressive risks (P < 0.001), whereas access to the Internet with non-use was not statistically significant. Additionally, the associations between multidimensional aspects of the digital divide and depressive symptoms were moderated by rural/urban status, with these associations being significantly stronger among rural older adults (P < 0.05).

CONCLUSIONS

This study highlights the importance of assessing the associations between digital divide and depressive symptoms from the multidimensional perspectives of access, support, and usage. Policy interventions targeting various aspects of the digital divide should be implemented to ensure active Internet engagement among older adults, especially those living in rural areas.

The impact of internet use on health status among older adults in China: The mediating role of social support

Background

With the popularization of the Internet, the use of the Internet is becoming more and more important in the daily life of older adults. However, previous research mainly focuses on Internet use and health in general, and the mechanism of this effect remains to be studied. To bridge this gap, this study aims to explore the mediational effects of social support between Internet use and health among older adults in China.

Methods

The data used in this article are from the 2021 Chinese General Social Survey (CGSS). Social support is divided into two aspects and four dimensions: informal social support (relatives support, friends support, neighbors support) and formal social support (social insurance). This article uses the nested multivariate OLS regression models to analyze the impact of Internet use on health. Furthermore, Finally, SPSS macro PROCESS is applied to test their mediation effects.

Results

Informal social support positively influenced the health status among older adults, while formal social support did not. Among the three types of informal social support, relatives support and friends support significantly affected health status among Chinese older adults. Regarding social support differences between urban and rural areas, it was found that relatives support is a positively significant factor for rural older adults, while friends support is significant for urban older adults.

Conclusions

Since Internet use has many ways of impacting health status, social support only plays a partial mediating role in this study. It recommends that the government should take compelling measures to encourage and promote the use of the Internet among older adults and obtain various social support to improve their health status.

The contribution of the smartphone use to reducing depressive symptoms of Chinese older adults: The mediating effect of social participation

Background

Depression is a prevalent mental health disorder. Although Internet use has been associated with depression, there is limited data on the association between smartphone use and depressive symptoms. The present study aimed to investigate the relationship between smartphone use and depressive symptoms among older individuals in China.

Methods

5,244 Chinese older individuals over the age of 60 were selected as the sample from the China Longitudinal Aging Social Survey (CLASS) 2018 dataset. The dependent variable "depression symptoms" was measured using the 9-item Center for Epidemiologic Studies-Depression (CES-D) scale. The study employed multiple linear regression to investigate the relationship between smartphone use (independent variable) and depressive symptoms in older people. Thorough analyses of robustness, sensitivity, and heterogeneity were conducted to ensure the robustness and sensitivity of the findings. Additionally, mediating effect analysis was performed to elucidate the mechanism through which the dependent and independent variables were related.

Results

Empirical study indicated that smartphone use had a negative impact on depressive symptoms among older adults, specifically leading to a reduction in such symptoms. The above-mentioned result was verified through endogenous and robustness tests. The heterogeneity analysis revealed that older individuals aged 70 years and above, male, and residing in urban areas exhibited a stronger association between smartphone use and depressive symptoms. Furthermore, the mediating effect model indicated that political participation, voluntary participation, and active leisure participation mediated the relationship between smartphone use and lower levels of depression symptoms among the older adults. However, passive leisure participation had a suppressing effect on the relationship between smartphone use and reduced depressive symptoms among the older adults.

Limitations

The causal relationship between variables required further investigation with a longitudinal design.

Conclusion

These findings suggested that smartphone use may be considered an intervention to reduce depression symptoms among older people by increasing levels of political participation, voluntary participation, and active leisure participation.

Internet use and depression among Chinese older adults: The mediating effect of interpersonal relationship

The number of elderly Internet users has increased significantly in the past few years, and the Internet has greatly changed the way that older adults access information and communicate. Generally, those who regularly use the Internet may expand their range of interpersonal interactions, which has positive effects on their health. Depression is the leading cause of ill health, and is closely related to people's mental health. We sought to investigate whether internet use help reduce depression level among older adults. Using data from the 2020 China Family Panel Studies (CFPS), a total of 4,714 respondents were included to explore the effects of Internet use on the elderly's depression levels in China, along with the mediating role of interpersonal relationship in the above relationship. Regression results indicated that Internet use significantly reduced depression levels among the elderly. Further analysis showed that different Internet usage had different effects on depression among the elderly. Wechat chatting, video browsing, and online shopping were positively correlated with lower levels of depression. However, playing online games and online learning did not predict reduced levels of depression. Moreover, interpersonal relationship mediated the relationship between Internet use and depression levels. Internet use was associated with a higher level of interpersonal relationship, which in turn reduced depression levels in older adults. Regarding gender and regional differences, the coefficient of Internet use for urban older adults was significantly negative at 0.001 level, while it was not significant for rural older adults. A mediating effect of interpersonal relationship between Internet use and depression levels was only found for male elderly. To reduce the level of depression and promote mental health in the course of aging, Internet use and the improvement of interpersonal relationships merit special attention.

The association between internet use and depression among older adults in China: The mediating role of social networks

Objective

In the aging world, the depression of older adults has aroused great concern. It brings detrimental side effects to old adults and the sustainability of society. The information and communication technologies have reshaped how people live among which the Internet has gained much popularity in the senior community. This study aims to explore the association between Internet use and depression in older adults.

Methods

This study applied a representative national dataset (China Longitudinal Aging Social Survey, CLASS 2018) to examine by conducting regression analysis. Inspired by the social capital theory, we further examined the mediating role of general social networks (as a general concept) and specific networks (family and friend networks) in reducing depression. All calculations and analyses were conducted by STATA.

Results

(a) Internet use significantly reduces depressive symptoms among Chinese older adults; (b) internet use enhances social network support for Chinese older adults; and (c) social networks in general and family networks and friend networks in specific all play a mediating role between internet use and depression symptoms.

Conclusion

This work proved that internet use could reduce depression levels in older adults in China, and social networks, including family networks and friend networks, have a mediation role in the relationship between internet use and depression in older adults in China. Combined with the Chinese social context, we explained that the existence of an empty-nest elderly community in Chinese society and the emphasis on kinship in Chinese tradition may be the reasons. Based on the main findings, tailor-made suggestions for addressing depression issues among older adults were discussed.

A U-Shaped Association between Internet Use and Depression in China

Objectives: In this research, we aimed to investigate the relationship between Internet use and depression levels among Chinese residents. Methods: We conducted a cross-sectional study to analyze adults ≥ 18 years old in China using China Family Panel Studies (CFPS) 2018 data. Results: The sample included 23,258 participants. Overall, Internet users presented lower levels of depression compared to non-Internet users. The analysis of the Internet user group showed a U-shaped relationship between the length of free time Internet use and the depression index. Moderate Internet use was significantly associated with a decrease in the depression index after 11 hours per week, Internet use was significantly associated with an increase in the depression index. Analysis of socio-demographic characteristics revealed significant differences in depression indices between urban and rural areas, and between different age, gender, education level, socio-economic status, and health level groups (p<.001). Conclusion: There is a need to increase the popularity of the Internet. Internet users should control the length of their Internet use to more rational levels. In the process of large-scale prevention and treatment of depression, it is necessary to pay attention to the differences in depression levels between groups to target solutions.

Health IT in our daily life: impact of mobile phone use on the emotions and compliance of diabetes patients

Purpose

Leveraging information technology (IT) to improve the treatment and support of patients is a widely studied topic in healthcare. For chronic diseases, such as diabetes, the use of information technology is even more important since its effect extends from a clinic environment to patients’ daily life. The purpose of this paper is to investigate the impacts of one widely adopted information technology, the mobile phone, on diabetes treatment, specifically on the complicated process of patients’ health, emotions and compliance.

Design/methodology/approach

We leverage a unique longitudinal dataset on diabetes patients’ health status in rural areas of China to study the problem. We also cross-link the dataset with mobile carrier data to further differentiate mobile phone use to phone calls and network use. To address the endogeneity concerns, we apply PSM and a series of instrument variables.

Findings

We identify clear evidence that mobile phone use can significantly improve patients’ emotions and compliance, where the effect is generally larger on patients in worse health conditions. While mobile phone calls clearly benefit diabetes patients, we do notice that mobile phone network use has a negative moderating effect with patients’ health condition on improving compliance.

Originality/value

This study not only enriches our theoretical understanding of the role of mobile phones in diabetes management, it also shows the economic benefit of promoting patients’ use of mobile phones, which should be considered by medical care providers and medical policymakers.

Building Digital Literacy in Older Adults of Low Socioeconomic Status in Singapore (Project Wire Up): Nonrandomized Controlled Trial

BACKGROUND

In a rapidly digitalizing world, the inability of older adults to leverage digital technology has been associated with weaker social connections and poorer health outcomes. Despite the widespread digital adoption in Singapore, older adults, especially those of lower socioeconomic status (SES), still face difficulties in adopting information and communications technology and are typically digitally excluded.

OBJECTIVE

We aimed to examine the impact of the volunteer-led, one-on-one, and home-based digital literacy program on digital literacy and health-related outcomes such as self-reported loneliness, social connectedness, quality of life, and well-being for older adults of low SES.

METHODS

A nonrandomized controlled study was carried out in Singapore between July 2020 and November 2021 involving 138 digitally excluded community-dwelling older adults aged ≥55 years and of lower SES. Older adults awaiting participation in the program served as controls. Older adults under the intervention were equipped with a smartphone and cellular data, underwent fortnightly to monthly digital literacy training with volunteers to learn digital skills, and digitally connected to their existing social networks. Primary outcome was the improvement in self-reported digital literacy. Secondary outcomes included improvements in University of California, Los Angeles 3-item loneliness scale, Lubben Social Network Scale-6, EQ-5D-3L and EQ visual analogue scale scores, and Personal Wellbeing Score.

RESULTS

There were significant improvements in digital literacy scores in the intervention group as compared to controls (mean difference 2.28, 95% CI 1.37-3.20; P<.001). Through multiple linear regression analyses, this difference in digital literacy scores remained independently associated with group membership after adjusting for differences in baseline scores, age, gender, education, living arrangement, housing type, and baseline social connectivity and loneliness status. There was no statistically significant difference in University of California, Los Angeles 3-item loneliness scale, Lubben Social Network Scale-6, Personal Wellbeing Score, or EQ-5D Utility and visual analogue scale score.

CONCLUSIONS

This study adds to the growing research on digital inclusion by showing that a volunteer-led, one-on-one, and home-based digital literacy program contributed to increase digital literacy in older adults of low SES. Future studies should look into developing more older adult-friendly digital spaces and technology design to encourage continued digital adoption in older adults and, eventually, impact health-related outcomes.

Internet use and health status among older adults: The mediating role of social participation

Background

The acceleration of population aging and the arrival of the informatization make more and more older adults use the Internet, and its use is having an impact on their health. However, the relationship between internet use and the health of older adults and the mechanism of the effect of internet use on the health are not very clear.

Methods

Multiple linear regression models to explore the correlation between internet use and health status in the 3,141 individuals aged ≥60 years were used. Propensity score matching (PSM) method was used to test the robustness of the regression results. In addition, sequential recursive models was used to examine the mediating effect of social participation on the relationship between internet use and health status.

Results and discussion

We found a significant positive relationship between internet use and health status, and social participation mediated the relationship between internet use and health status. In addition, the effect of internet use on health status was different among older adults in rural and urban areas.

Conclusions

The development and application of internet products adapted to the development of an aging society should be accelerated to meet their needs for continued socialization. The forms and activities of social participation for the elderly groups should be enriched and public service internet usage training seminars should be conducted to improve internet skills.

The impact of mobile Internet use on mental distress among Chinese adults during the COVID-19 pandemic

With the rapid development of digital technology, mobile Internet use is increasing in popularity in China. Previous studies have shown that mobile Internet use has a positive or negative effect on mental distress. Using CFPS2020 data, this paper finds that mobile Internet use significantly alleviates mental distress in Chinese adults. Heterogeneity analysis indicates that mobile Internet use can significantly alleviate mental distress among adults between the ages of 30 and 70, without a bachelor's degree or residing outside the province of Hubei. Furthermore, mobile Internet use significantly reduces mental distress through two mediators: trust and happiness. It also shows that watching short videos or learning online is associated with reduced mental distress, as opposed to online shopping, chatting, or playing games. However, the mental distress of new mobile Internet users in 2020 has not been alleviated. This paper enriches the relevant theoretical research and provides a practical reference for using the mobile Internet to ease mental distress during epidemics.

The relationship between gender, marital status and depression among Chinese middle-aged and older people: Mediation by subjective well-being and moderation by degree of digitization

The purposes of this study were to investigate the effects of gender and marital status on depression among middle-aged and older people in China, and to explore the mediating effect of subjective well-being and the moderating effect of degree of digitization in the relationship between subjective well-being and depression. A total of 15,586 Chinese middle-aged and older people (≥ 45 years old) were included in the study using data from the 2018 China Health and Retirement Longitudinal Survey (CHARLS). T-test, ANOVA, hierarchical regression and Bootstrap methods were adopted to test the mediating role of subjective well-being and the moderating role of degree of digitization. The results showed that middle-aged and older women were more likely to suffer from depression than men, and married middle-aged and older people were less likely to be depressed than those who were separated or divorced, widowed and never married. Subjective well-being partially mediated the relationship between gender and depression, and masked the relationship between marital status and depression, and all five dimensions it contains also played a mediating role. Degree of digitization moderated the effect of subjective well-being on depression. Simple slope tests indicated that the effect of subjective well-being on depression increased as degree of digitization increased. In conclusion, to address the mental health problems of middle-aged and older people brought about by the ageing and digital society, we should start by improving their subjective well-being and promoting their integration into the digital society.

The role of internet use in the relationship between occupational status and depression

BACKGROUND

The emerging information and communications technology (ICT) and society 5.0 have integrated digital innovation and imaginative creativity to solve social problems and create social value in an aging society. Especially in China, the penetration rate of internet use has become more prominent. Nevertheless, the role of internet use in the relationship between occupational status and depression remains unknown. The purpose of this study was to estimate how internet use moderates the relationship between occupational status and depression in a sample of older adults in China.

METHODS

A cross-sectional design was used to assess the relationship between occupational status, internet use and depression. This study employed data from the Chinese General Social Survey (CGSS) conducted in 2017. The full sample size of this study is 2,403. OLS regression was adopted to explore the correlation between occupational status and depression and the moderating role of internet use. Meanwhile, a heterogeneity analysis based on residence registration was implemented to explore the difference between rural and urban sample groups.

RESULTS

The findings suggested that higher occupational status was related to lower depression level. By playing an inhibitory moderating role between the association of occupational status and depression, internet use and occupational status formed a substituting effect. Meanwhile, the above moderating effect was only significant in urban group and insignificant in rural group. Besides, being male and having higher social class were significantly and negatively correlated with depression.

CONCLUSION

This study began with the theory of social stratification and social mobility, added the theory of social capital, constructed an analytical framework of regulatory effect, put forward two basic assumptions, selected measurement indicators taking into account Chinese cultural factors, and conducted empirical tests using authoritative statistical software and national representative data, providing a new theoretical contribution to our understanding of the impact of occupational status and depression in developing countries.

The Effects of Online Social Interactions on Life Satisfaction of Older Chinese Adults: New Insights Based on a Longitudinal Approach

Population aging and digitalization have become universal phenomena. Over the past two decades, digital inclusion has started to play a crucial role in supporting successful aging. Based on a nationally representative sample of around 5200 older adults in China over the period of 2014-2018, we explore the effects of online social interactions (OSIs) on the life satisfaction of older adults. We find that OSIs can improve the levels of life satisfaction of older Chinese adults. Estimates from fixed effect and cross-lagged structural equation models further suggest that OSIs work by increasing physical activities, healthy time allocation, interpersonal trust, and informal social engagement and reducing loneliness. We also find that OSIs narrow the social inequality in life satisfaction across groups from rural-urban areas and groups with different social statuses. Moreover, a comparison among different online engagements shows that not all online activities positively affect older adults' life satisfaction. Different online activities have varying effects. Our results highlight that public digital interventions focusing on social functions can benefit the lives of older adults.

Leisure, Mental Health, and Life Satisfaction among Older Adults with Mild Cognitive Impairment

Objectives: Little research has investigated the relationship between types of leisure activities and mental health outcomes among older adults with mild cognitive impairment (MCI). The purpose of this study was to investigate how certain leisure activities are associated with life satisfaction, anxiety, loneliness, happiness, and positive and negative affect. Methods: In this study, we used the 2020 Health and Retirement Study Core Early data and conducted a hierarchical regression analysis to investigate the different effects of the 3 types of leisure activities on the mental health of older adults with MCI (N=901). Results: We found that leisure-time physical activity was the strongest predictor of enhanced life satisfaction, positive affect, and happiness, and reduced anxiety and loneliness. In addition, sedentary leisure was associated with reduced anxiety and loneliness and increased happiness. Conclusions: These findings suggest that engagement in leisure-time physical activity and sedentary leisure can be instrumental in promoting the life satisfaction and mental health of older adults with mild cognitive impairment.

Social networking site usage: A systematic review of its relationship with social isolation, loneliness, and depression among older adults

OBJECTIVE

Older adults, age ≥ 60 years, are at risk of depression, which is aggravated by loneliness and social isolation. The use of social networking sites (SNS) has been reported to be beneficial to help people stay in touch with their families and communities. The purpose of this study was to examine the relationship between SNS usage and social isolation, loneliness, and depression among older adults.

METHODS

The online electronic search for literature was conducted up to June 2020 using three databases and searching from reference lists to find potential studies. The inclusion criteria were based on three main study characteristics: (i) a study population of adults age ≥ 60 years, (ii) examine SNS usage, and (iii) report depression or loneliness or social isolation as outcomes.

RESULTS

Fifteen articles were included: ten observational and five experimental studies. Five studies focused on depression and five studies on loneliness/social isolation, while five studies reported on both outcomes. Among observational studies, there was some evidence that SNS usage was associated with lower levels of depression and loneliness scores, but a very limited number of experimental studies were able to obtain similar results. For social isolation, no study found significant associations between SNS usage and lower levels of social isolation.

CONCLUSIONS

This review found very limited evidence, especially from experimental studies, to support associations between SNS use with depression, loneliness, and social isolation among older adults. More studies are needed to enhance understanding to make valid conclusions.

The systematic review was registered in the PROSPERO database on 10 April 2019 and updated in July 2020 (CRD42019125267).

Association between internet use and successful aging of older Chinese women: a cross-sectional study

BACKGROUND

The internet has become ubiquitous in contemporary human life. However, little is known about the association between internet use and older people's aging process, especially that of older women.

METHODS

Using the nationally representative dataset of the China Longitudinal Aging Social Survey 2016, we examined the relationship between internet usage and the successful aging of older Chinese women. The sample in this study consisted of 2713 respondents with an average age of 69.963 years. Successful aging was defined as no major diseases, no disability, high cognitive functioning, high physical functioning, and active engagement with life. Older women's internet use behavior was represented by internet use frequency. Probit and instrumental variable models were employed to test the association between internet use frequency and successful aging of older women. The Karlson/Holm/Breen (KHB) mediation analysis was used to estimate the mediating effect of social capital on the relationship between internet use frequency and older women's successful aging.

RESULTS

Using a probit model (coefficient = 0.030, p < 0.001) and an instrumental variable probit model (coefficient = 0.287, p < 0.001), it was found that a successful aging status was significantly correlated with an increase in internet use frequency. The functional mechanism analysis suggested that social capital partially mediated the overall association between internet use frequency and successful aging.

CONCLUSIONS

This study suggests that the more frequently older Chinese women use the internet, the greater the possibility of successful aging. Our findings provide new evidence from China about the determinants of older women's aging process and aid in formulating targeted aging policies for older women in developing countries and regions.

Patterns of Internet Use, and Associations with Loneliness, amongst Middle-Aged and Older Adults during the COVID-19 Pandemic

Loneliness among older adults is a major societal problem with consequences for health and wellbeing; this has been exacerbated by the coronavirus pandemic. The present study investigated associations between internet use, including frequency and type of use, and loneliness in a large UK sample of middle-aged and older adults, aged 55–75 (n = 3500) from the English Longitudinal Study of Ageing (ELSA) cohort study. Our findings indicated a clear relationship between the frequency of internet use and subjective loneliness. Those who used the internet more than once a day reported feeling less lonely than those who used the internet once a week or less. We also found that those who used the internet for e-mail communication were less lonely. However, individuals indicated higher levels of loneliness when the internet was used for information searches about health. Regarding sociodemographic factors underlying internet usage, less frequent use was seen amongst individuals who lived alone, people who were not employed, who had lower education levels, and lower sociodemographic status. Additionally, gender differences were found in the type of internet use: males report using the internet for e-mail communication more than females, while females’ internet use for health-related information searches was higher than in males. In sum, findings suggest that intervention strategies that promote internet access amongst middle-aged and older people could be useful for tackling loneliness and point to the groups within society that should be the focus of such interventions.

Perceived Gap of Age-Friendliness among Community-Dwelling Older Adults: Findings from Malaysia, a Middle-Income Country

Background: The United Nations predicts that the global population aged 65 years or above will double from 703 million in 2019 to 1.5 billion by 2050. In Malaysia, the older population has reached 2.4 million, accounting for nearly 8% of the population. This study aimed to evaluate the perceptions of the elderly on the importance and availability of the age-friendly features in eight domains specified by the Global Network of Age-Friendly City and Communities. Methods: This was a cross-sectional study conducted by structured face-to-face and or telephone interviews. Gap score analysis was performed for 32 items of the 8 age-friendly domains. The gap scores were categorized as follows: 0 = not important OR important and element available; 1 = important but unsure whether the element is available; 2 = important but element not available. The gap scores were then dichotomized into “yes” and “no”, and multivariate logistic regression analysis was subsequently performed. Results: From the 1061 respondents, the housing (55.4%) and transportation (50.7%) domains reported the highest mean perceived gap scores. Out of the 32 elements, the highest mean gap percent scores were observed in elderly priority parking bays (83.8%), home visits by healthcare professionals (78.9%), financial assistance for home modification and purchase (66.3%), and affordable housing options (63.6%). Respondents in the city center reported higher gap scores for modified restrooms, parks, volunteer activities, and the internet; respondents in the non-city center reported higher gap scores for nursing homes, healthcare professionals, and cultural celebrations. Age, location, marital status, income, duration of stay, physical exercise, internet access, and intention to continue working were found to be associated with a higher perceived gap in specific domains. Conclusion: The most significant unmet needs were detected in the housing, transportation, and employment opportunities domains. Considerable disparities in the perceived gap were detected between the older population in the city center and non-city center. To address shortcomings in the local age-friendly setting, coordinated municipal policies, political commitment, and benchmarking of existing age-friendly cities are warranted.

Intergenerational family online community and older adults' overall well-being

Purpose

This study aims to evaluate the potential contribution of a membership in an online family community to older adults' overall well-being.

Design/methodology/approach

A total of 427 respondents over the age of 64 participated in the study (M = 74.55, SD = 7.13), answering a survey. To test the contributing of belonging to family online communities (WhatsApp), three hierarchical regression analyses were conducted, with well-being, self-perceptions of aging and loneliness as outcome variables.

Findings

Findings show that belonging to an intergenerational family online community was associated with higher levels of well-being, less loneliness and better self-perceptions of aging, even once demographic characteristics and using social media were controlled for.

Social implications

This study demonstrates the important role that the family online community membership plays in older adults' lives. This has significant implications that may contribute to intergenerational emotional solidarity.

Originality/value

The authors suggest that technology is not per se, but the intergenerational opportunities that technology facilitates that make a difference.

Peer review

The peer review history for this article is available at: https://publons.com/publon/10.1108/OIR-06-2021-0332

Does Mobile Internet Use Affect the Loneliness of Older Chinese Adults? An Instrumental Variable Quantile Analysis

Based on the 2018 China Family Panel Studies (CFPS) data, we empirically analyze the effect, heterogeneity, quantile differences and influencing mechanisms of mobile Internet use on loneliness in the elderly. The study found that the loneliness of the elderly who used mobile Internet was 33.1% lower than that of the elderly who did not use the mobile Internet The study also passed the robustness test. There is heterogeneity in the effect of mobile Internet use on loneliness among the elderly of different ages, educational levels and marital status. Among them, the use of mobile Internet has a significant alleviating effect on the loneliness of the 60-70-year-old elderly, those of junior high school education level and below, and the elderly with a partner. The quantile regression analysis showed that the elderly group with a high level of loneliness benefited more from the use of mobile Internet. Mediation analysis further showed that mobile Internet use can improve parent-child relationship, increase offline interactions with children, and reduce children's tangible support, which we interpret as a potential mechanism for mobile Internet use to alleviate loneliness in the elderly.

Predicting perinatal health outcomes using smartphone-based digital phenotyping and machine learning in a prospective Swedish cohort (Mom2B): study protocol

INTRODUCTION

Perinatal complications, such as perinatal depression and preterm birth, are major causes of morbidity and mortality for the mother and the child. Prediction of high risk can allow for early delivery of existing interventions for prevention. This ongoing study aims to use digital phenotyping data from the Mom2B smartphone application to develop models to predict women at high risk for mental and somatic complications.

METHODS AND ANALYSIS

All Swedish-speaking women over 18 years, who are either pregnant or within 3 months postpartum are eligible to participate by downloading the Mom2B smartphone app. We aim to recruit at least 5000 participants with completed outcome measures. Throughout the pregnancy and within the first year postpartum, both active and passive data are collected via the app in an effort to establish a participant's digital phenotype. Active data collection consists of surveys related to participant background information, mental and physical health, lifestyle, and social circumstances, as well as voice recordings. Participants' general smartphone activity, geographical movement patterns, social media activity and cognitive patterns can be estimated through passive data collection from smartphone sensors and activity logs. The outcomes will be measured using surveys, such as the Edinburgh Postnatal Depression Scale, and through linkage to national registers, from where information on registered clinical diagnoses and received care, including prescribed medication, can be obtained. Advanced machine learning and deep learning techniques will be applied to these multimodal data in order to develop accurate algorithms for the prediction of perinatal depression and preterm birth. In this way, earlier intervention may be possible.

ETHICS AND DISSEMINATION

Ethical approval has been obtained from the Swedish Ethical Review Authority (dnr: 2019/01170, with amendments), and the project fully fulfils the General Data Protection Regulation (GDPR) requirements. All participants provide consent to participate and can withdraw their participation at any time. Results from this project will be disseminated in international peer-reviewed journals and presented in relevant conferences.

Social Capital Mediates the Association between the ICT Usage and Well-Being of Older People in Japan: Implication for a New Design Paradigm

As the population ages, the question of how to prevent isolation among older people and increase their well-being becomes a social issue. It has often been argued that Information and Communication Technology (ICT) usage can be a solution to these challenges, but empirical studies have not shown consistent results. Moreover, there are even fewer studies targeting older people in Japan, which is the most aging country in the world. Therefore, using the psychological comprehensive data of Japanese people aged 60 and over recorded in World Values Survey Wave 7, we conducted a study to clarify the relationship between the ICT usage, social capital, and well-being of older people to make a meaningful contribution to policymakers and the scientific community. As a result of the analysis, it was shown that ICT usage indirectly enhances well-being by increasing social capital. This indicates that for older people, ICT usage does not have a large effect on enhancing well-being, but becomes sufficiently large only through the improvement of social capital. The pros and cons of such modern communication means should be utilized as a reference when considering the development of future communication means and a human coach—a person who supports the use of communication means by older people. In other words, to think about the spread of communication means to community-dwelling older people in the future, it is always necessary to think about technology usage emphasizing the relationship between older people and society.

Health and self-perceived barriers to internet use among older migrants: a population-based study

Background

In older adults, including those with a migrant background, ill health is associated with less internet use. However, it is not known what are the specific self-perceived barriers to internet use among older migrants with different health conditions. The aim of this study was to investigate the associations between different health conditions and self-perceived barriers to internet use among older migrants.

Methods

We used the Care, Health and Ageing of Russian-speaking Minority in Finland (CHARM) study, which is a nationally representative survey of community-dwelling Russian-speaking adults aged ≥50 years living in Finland (N=1082, 57% men, mean age 63.2 years, standard deviation 8.4 years, response rate 36%). Postal survey data were collected in 2019. Health indicators were self-rated health (SRH), depressive symptoms, cognitive functioning, and doctor-diagnosed conditions. Linear regression analyses were used to investigate the associations between health indicators and a summary scale consisting of the following barriers of internet use: (1) internet use is too complicated and hard to learn; (2) having concerns about safety issues; (3) internet use is too expensive; (4) physical limitations hinder the internet use; (5) memory problems hinder the internet use. In addition, the two most commonly reported barriers (the first two) were examined separately using logistic regression analyses. The analyses were adjusted for age, sex, education, marital status, local language proficiency, and income support, and the health conditions, and were performed with weights accounting for the survey design and non-response.

Results

After adjustments, spine/back problems (b=0.13; p=0.049), depressive symptoms (b=0.40; p=0.007), and problems in learning new things (b=0.60; p<0.0005) were associated with higher level of overall barriers to internet use. In addition, a number of health conditions were associated with individual barriers, albeit some health conditions appeared protective.

Conclusions

In general, older migrants with declining health experience more barriers to internet use than their counterparts with better health. To provide better access to healthcare for older adults, including older migrants, rapidly changing devices, software and apps need to be modified and adapted for those with specific health-related needs.

Social Isolation, Cognitive Function, and Depression Among Chinese Older Adults: Examining Internet Use as a Predictor and a Moderator

Objectives

Despite the theoretical and practical interest in Internet use among older adults, evidence examining the impacts of Internet use on late-in-life health is limited. This study examines how Internet use affects depression and cognitive function in older adults and investigates if Internet use moderates the relationship between social isolation and depression/cognitive function.

Method

We performed regression analyses using data came from the second wave of the China Longitudinal Aging Social Survey of 2016. Our final sample featured 8,835 older adults.

Results

The results show 11.4% of Chinese older adults often used the Internet to engage in at least one activity. Internet use was negatively associated with depression, but it was positively related to cognitive function. Socially isolated older adults were more likely to have more depressive symptoms and higher level of cognitive function. There was also an interaction effect between Internet use and social isolation on depression/cognitive function. The negative effect of social isolation was stronger for older adults who used the Internet less. The moderating effect of Internet use was significant for both males and females. However, among those who used the Internet more, the depression levels of socially isolated male participants were much lower than female participants.

Conclusions

Our results reveal the importance of considering Internet use in buffering the negative effects of social isolation and the associated health burdens for aging populations. Recommendations for service practice and future research are discussed.

Effectiveness of Instructional Strategies Designed for Older Adults in Learning Digital Technologies: A Systematic Literature Review

An ageing population is a universal phenomenon experienced worldwide. In parallel with these demographic changes, a significant breakthrough in digital devices has also influenced this digital age. Designing instructional strategies to promote meaningful learning among older adult learners has been a long-standing challenge. To enhance older adults’ life-long learning experiences, implementing instructional strategies in the process through which such adults learn can help to improve effective learning. Despite significant calls for research in this area, there is still insufficient research that systematically reviews the existing literature on older adult learning needs and preferences. Hence, in the present article, a systematic literature review was conducted of the effectiveness of instructional strategies designed for older adult learners through the use of digital technologies. The review was guided by the publication standard, which is ROSES (Reporting Standard for Systematic Evidence Syntheses). This study involves articles selected from two established databases, Web of Science and Scopus. Data from the articles were then analysed using the thematic analysis, which resulted in six main themes: (1) collaborative learning; (2) informal learning setting; (3) teaching aids; (4) pertinence; (5) lesson design; and (6) obtaining and providing feedback. The six main themes produced a further 15 sub-themes. The results from this study make significant contributions in the areas of instructional design and gerontology. The findings from this study highlight several important strategies of teaching digital technology, particularly for older adults, as follows: (1) to enhance instructional design use in teaching digital technology based on the needs and preferences of older adult learners; and (2) to highlight the factors for, and impact of, learning digital technologies among older adults.

Health Consequences of Online Social Capital among Middle-Aged and Older Adults in China

With the rapid development of Internet techniques in China, more and more Chinese middle-aged and older adults have begun to use the Internet for their daily social interactions, and the resulting online social capital may affect their health. Using data from the Chinese General Social Survey of 2017 (n = 7733, aged 45-90 years old), this study investigated the influence of online social capital on the health of middle-aged and older adults in China, and the Heckman sample selection model was used to address potential sample selection bias in Internet use. The results show that number of online contacts significantly improved the physical health of middle-aged and older adults, while the level of depression was significantly reduced by online closeness of non-specific relationships, but more online interactions may slightly increase their depression. Furthermore, more online contacts were associated with elevated physical health among male, rural, less-educated and middle-aged adults, while more online closeness of non-specific relationships was associated with less depression in almost all subgroups. Online social capital can improve the health of middle-aged and older adults in China, so we should help increase older adults' access to the Internet and improve their Internet skills to give full play to the positive health effect of online social capital. However, it should be alert to the negative health consequences caused by excessive Internet use.

Social Relationships and Adaptation in Later Life

Social relations encompass a complex and dynamic set of characteristics that have been shown to distinctly affect health and quality of life across the lifespan and especially in older adulthood. In this chapter we begin with a brief review of several prominent theories of social relations. Next, we consider how social relations can be understood based on the resource they provide (e.g., contact frequency, social support), the relationship they stem from (e.g., friends, family), the strength of the tie (e.g., strong, weak) as well as the means of communication (e.g., offline, online). We briefly summarize how these characteristics have been shown to uniquely influence health and quality of life in older adulthood. Finally, we contemplate potential clinical applications, provide recommendations for the future and offer final concluding comments.

Factors Influencing Intention to Technological Use in Older Adults. The TAM Model Aplication

The use of digital technology by older adults has improved in recent years in response to the need for their functional adaptation to an increasingly technological social context. Understanding this type of technological adaptation has recently become an important field of inquiry in both social and gerontological studies. Working within this framework, the aim of this study is to identify the main determinants that influence the intention of older people to use digital technology in their daily lives, using the Technological Acceptance Model. A study was carried out with the participation of 1155 people over 65 years of age in Spain. Confirmatory Factor Analysis and structural equation models (SEM) were performed. The results show that the TAM is a useful model to explain the intention of older adults to use Digital Technology, showing a high predictive power, highlighting Perceived Usefulness and Perceived Ease of Use as the main predictor variables.

The Digital Divide and Active Aging in China

With the rapid development of society, especially the advent of intelligent technology of life services, the ability of the elderly to adapt to modern digital life is getting weaker and weaker, the dilemma of the “digital divide” for the elderly has aroused heated public debate. In the era of aging and information superposition, in-depth study of the multi-dimensional impact of the digital divide on the elderly has become an effective content of China’s active aging strategy. Based on the micro-data of the Chinese General Social Survey in 2017, this paper uses the entropy right method to construct the digital divide index system for the elderly over 60 years of age from the perspective of essential equipment, Internet utilization degree, and Basic Internet usage skills. At the same time, this paper constructs China’s comprehensive index of active aging from three aspects: health, social participation, and guarantee of the elderly, to study the impact of the digital divide on China’s active aging. The following conclusions have been drawn: the digital divide among the elderly significantly inhibits China’s active aging. The digital divide reduces the level of physical and mental health and social participation of older persons and inhibits the level of guarantee of older persons, thus impeding their active aging. In addition, it also reduces the overall life satisfaction of the elderly. The use of the Internet, skills, and other digital technology abilities of the elderly have effectively promoted active aging. The more Internet access devices older people have, the higher their level of social participation. The higher the Internet frequency of the elderly, the healthier the body and mind. Furthermore, the greater the level of physical and mental health and social participation of older groups who use online payments. The digital divide among the elderly inhibits the process of China’s active aging, and the unique course and stage characteristics of the development of the aging of the Chinese population require us to pay full attention to the relationship between the digital divide and active aging and how to construct a “digital-friendly” aging system is an essential issue for China’s social development to consider.