Variety, frequency, and type of Internet use and its association with risk of depression in middle- and older-aged Chinese: A cross-sectional study

Internet use, physical activity and depressive symptoms in older adults: A cross-lagged panel analysis

BACKGROUND

Existing cross-sectional studies suggest a strong positive association between Internet use, physical activity, and mental health in older adults; however, longitudinal studies reporting the relationship between Internet use, physical activity, and levels of depressive symptoms in older adults are lacking. This study aimed to examine the bidirectional relationship between Internet use and depressive symptoms in older adults and its underlying mechanisms.

METHODS

We used two waves of follow-up data (2016 and 2018) from the China Family Panel Studies, including 5837 participants aged 60 years or above. The bidirectional relationship between Internet usage time and depressive symptoms was examined using a cross-lagged model. The mediating role of physical exercise was examined using a half-longitudinal mediation model.

RESULTS

The results revealed a bidirectional relationship between Internet use time, frequency of physical activity, and depressive symptoms. Longer Internet use predicted lower levels of depressive symptoms, and the frequency of physical activity mediated the longitudinal relationship between Internet use and depressive symptoms in older adults.

LIMITATIONS

First, our study used self-report-based variables. Second, our study did not obtain the specific timing of the application of various functions of the Internet and the intensity of physical activity among older adults. Finally, based on the availability of data, our study involved only two waves of data. This may not be sufficient for a full longitudinal mediation effect test.

CONCLUSIONS

Internet use and depressive symptoms were interrelated over time among older adults. The frequency of physical activity was a mediator of Internet use and depressive symptoms. This underscores the importance of Internet-based technologies to enable healthy living and prevent depression and loneliness in older adults.

Classification of high-risk depressed mood groups in cancer patients based on Health Ecology Model

BACKGROUND

Depressed mood affects a significant number of patients with cancer, and can impair their quality of life and interfere with successful treatment. Our study aims to create a predictive model for identifying high-risk groups of depressed mood in cancer patients, offering a theoretical support for preventing depressed mood in these individuals.

METHODS

The China Health and Retirement Longitudinal Study (CHARLS) provided the data for this research, which used CES-D as a tool to identify individuals with depressed mood. Influencing factors of depressed mood in cancer patients was analyzed using a binary logistic regression model. Using the Harvard Cancer Index, we classified the high-risk patients for depressed mood.

RESULTS

In present study, 52.96 % of cancer patients met criteria for depressed mood based on the CES-D. Significant correlations were found between depressed mood and factors such as gender, self-rated health, sleep duration, exercise, satisfaction with family, residence, education, life satisfaction, and medical insurance. Utilizing the Harvard Cancer Index, we classified patients into five risk levels for depressed mood, revealing a significant variation in the number of depressive patients across these levels (x2=99.82, P < 0.05). Notably, the incidence of depressed mood increased with the risk level among cancer patients (x2=103.40, P < 0.05).

LIMITATIONS

Lack of data on tumor typing and subgroups makes it unlikely to explore the specifics of depressed mood in patients with various types of cancer.

CONCLUSION

The determinants of depressed mood in cancer patients are multi-dimensional. The Harvard Cancer Index may be helpful in identifying high-risk populations.

Does internet use benefit the mental health of older adults? Empirical evidence from the China health and retirement longitudinal study

The mental health (MH) of older adults is a prominent public health concern. However, research regarding the impact of emerging Internet use on MH among older adults remains limited, particularly in transitional economies experiencing a rapidly aging population such as China. Thus, to address this research gap, this study uses data from the 2013-2018 waves of the China Health and Retirement Longitudinal Study. To investigate the causal relationship between Internet use and MH among older adults and explore the underlying channels through which this relationship operates. The results reveal a notable positive association between Internet use and MH among older adults. Furthermore, the study highlights social interaction, social trust, traveling expenses, and healthy habits as crucial channels through which Internet use can impact MH among older adults. The analysis also reveals how Internet use demonstrates a stronger positive effect on older individuals who have fewer chronic diseases and live with their offspring compared with their counterparts. These findings have significant policy implications, which thus emphasizes the need to enhance Internet use among older adults as a means of improving their MH.

Association between home and community-based services utilization and self-rated health among Chinese older adults with chronic diseases: evidence from the 2018 China Health and Retirement Longitudinal Study

BACKGROUND

As global aging intensifies, older adults with chronic diseases are of increasing concern. Home and community-based services (HCBSs) have been proven to promote self-rated health (SRH) in older adults, but no research explored the associations between the use of overall HCBSs, three different types of HCBSs (health care, daily care, and social support services) and SRH among older adults with chronic diseases. Consequently, this study applies a national publicly available database to examine these associations among older adults with chronic diseases.

METHODS

8,623 older adults with chronic diseases (≥ 60 years old) were included in this study. SRH was evaluated applying a concise question with a 1 - 5 scale. HCBSs utilization was assessed through the question, "What kind of HCBSs were used in the community?". Univariate general linear regression models aimed to compare the mean values of SRH in terms of HCBSs utilization in each group. This study is a cross-sectional study design and the relationship between HCBSs utilization and SRH was assessed by multilevel linear regression.

RESULTS

The mean score for SRH among the respondents was 3.19, of whom 20.55% used one or more HCBSs, 19.47% utilized health care services, 2.44% utilized social support services, and only 0.55% utilized daily care services. The use of HCBSs was found to be linked to SRH among older adults with chronic diseases (β = 0.085, SE = 0.025, p < 0.001). SRH among older adults with chronic diseases was strongly linked to the use of health care and social support services (β = 0.068, SE = 0.025, p < 0.001; β = 0.239, SE = 0.063, p < 0.001, respectively). However, there was no significant association between the use of daily care services and SRH among older adults with chronic diseases.

CONCLUSION

This study revealed that HCBSs utilization was positively and significantly linked to SRH in Chinese older adults with chronic diseases. Furthermore, this study supposes the low utilization of social support and daily care services may be due to a mismatch between supply and demand. The government should offer the targeted HCBSs for older adults with chronic diseases according to their unique features to enhance their health status.

Internet accessibility and incident depressive symptoms in middle aged and older adults in China: A national longitudinal cohort study

BACKGROUND

With the rapid development of the Internet over the past ten years, its widespread applications and accessibility may cause dynamic changes in the association between internet use and depressive symptoms.

OBJECTIVE

We aim to explore the association between internet accessibility (including broadband connection, internet use, frequency, and devices for internet use), as well as its changes, and the risk of incident depressive symptoms for middle aged and older adults based on a cohort study.

METHODS

8772 participants with three repeat waves of follow-up (average 6.04 years) were included. Cox proportional hazards regressions were used to explore risk effects. Hazard ratios (HRs) and 95 % Confidence Intervals [CI] were presented.

RESULTS

Incidence density for depressive symptoms was 53.89 for every 1000 person-years. The rate of internet usage by middle aged and older adults in China increased evidently from 2012 to 2018 (16.39 % vs 77.41 %). Broadband internet connection (BIC) (HR = 0.80, 95%CI: 0.71, 0.90) and moderate frequency of internet use (IU) (HR = 0.30, 95%CI: 0.10, 0.92) were associated with decreased risk of depressive symptoms. Participants who changed from no internet accessibility to internet accessibility were associated with a lower risk of depressive symptoms (BIC: HR = 0.46, 95%CI: 0.41, 0.51; IU: HR = 0.42, 95%CI: 0.34, 0.51). Using large screen devices (HR = 0.64, 95%CI: 0.45, 0.91) for internet access, instead of phones, was associated with lower risk of depressive symptoms.

CONCLUSIONS

Older adults should be encouraged to use the Internet; online time, frequency, and devices for internet use should be considered simultaneously.

Mediating and Moderating Effects of Internet Use on Urban-Rural Disparities in Health Among Older Adults: Nationally Representative Cross-Sectional Survey in China

BACKGROUND

The urban-rural disparities in health outcomes in China are remarkable. The internet has shown the potential to reduce the likelihood of contracting a disease by increasing disease knowledge. However, little is known about the effects of internet use in alleviating health inequities between urban and rural areas.

OBJECTIVE

This study aimed to examine the mediation and moderation of health disparities between urban and rural older adults through internet use.

METHODS

A total of 8223 respondents were selected from the China Health and Retirement Longitudinal Study 2018 data set. Basic activities of daily living, a brief Community Screening Instrument for Dementia, and the Centre for Epidemiologic Studies Depression Scale were used to measure functional disability, cognitive function, and depressive symptoms, respectively. Logistic regressions testing "internet use×urban-rural status" interactions for moderation and Karlson-Holm-Breen decomposition for mediation were performed.

RESULTS

Internet use moderated the urban-rural disparities in cognitive function (odds ratio 7.327, 95% CI 3.011-17.832) and depressive symptoms (odds ratio 1.070, 95% CI 1.037-1.787), but the moderating effects were significant only for those using the internet daily. Karlson-Holm-Breen results showed the suppression effects of using the internet daily (β=.012, 95% CI .002-.021) on the association between urban-rural status and cognitive function. The urban-rural inequality in depressive symptoms was partially attributed to the disparity in internet use (β=-.027, 95% CI -.043 to -.009).

CONCLUSIONS

The urban-rural inequalities in mental health are partially attributable to disparities in the prevalence of internet use between the 2 groups. However, using the internet is more beneficial for the psychological health of rural users, thereby alleviating the urban-rural disparities in health. Providing convenient channels for rural older adults to use the internet, improving the ability of rural users to effectively use the internet, and promoting internet popularity in rural areas are effective approaches to reducing urban-rural health inequalities.

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.

Association between home and community-based services and depressive symptoms in Chinese older adults: a multilevel analysis

BACKGROUND

As the phenomenon of ageing continues to intensify, home and community-based services (HCBSs) have been increasingly important in China. However, the association between HCBSs utilization and depressive symptoms in older adults in China is unclear. Consequently, this study aimed to examine the association between HCBSs utilization and depressive symptoms in Chinese older adults.

METHODS

This study included 7,787 older adults (≥ 60 years old) who were recruited within the framework of the 2018 China Health and Retirement Longitudinal Study (CHARLS). Depressive symptoms were assessed using the 10-item Center for Epidemiological Studies Depression Scale (CES-D-10). HCBSs utilization was assessed via the question, "What kind of HCBSs were being utilized in their community?". Data were analyzed using binary logistic regression models and generalized hierarchical linear models (GHLM).

RESULTS

Of the 7,787 participants, 20.0% (n = 1,556) reported that they utilized HCBSs, and 36.7% (n = 2,859) were evaluated that they had depressive symptoms. After adjusting for individual- and province-level covariates, the HCBSs utilization was found to be associated with depressive symptoms (OR = 1.180, 95% CI: 1.035-1.346, p < 0.05). Additionally, the depressive symptoms were significantly associated with gender, residence, educational level, marital status, number of chronic diseases, self-rated health (SRH), smoking, and provincial Gross Domestic Product (GDP) per capita.

CONCLUSIONS

This study found HCBSs utilization might be a protective factor against depressive symptoms in Chinese older adults. It is of utmost significance for the government to provide targeted HCBSs at the community level to address the unmet care needs of older adults, which can reduce the occurrence of negative emotions, consequently contributing to less severe depressive symptoms.

Association Between Daily Internet Use and Incidence of Chronic Diseases Among Older Adults: Prospective Cohort Study

BACKGROUND

Chronic disease incidence among the elderly is increasing, which is correlated with the acceleration of population aging. Evolving internet technologies may help prevent and provide interventions for chronic diseases in an accelerating aging process. However, the impact of daily internet use on the incidence of chronic diseases is not well understood.

OBJECTIVE

This study aims to investigate whether daily internet use by middle-aged and older adults may inhibit or promote the occurrence of chronic diseases.

METHODS

We included participants from the China Health and Retirement Longitudinal Study (CHARLS), a longitudinal survey of Chinese residents aged ≥45 years. We assessed 8-year data from wave 1 (June 2011-March 2012) to wave 4 (July-September 2018) in CHARLS. Data from wave 4 were used for a cross-sectional study, and data from all 4 waves were used for a longitudinal study. Self-reported data were used to track variables, including internet use, use frequency, and the incidence of different chronic diseases. Cox proportional hazards modeling was applied in the longitudinal study to examine the relationship between daily internet use and chronic diseases among middle-aged and older adults, while adjusting for sociodemographic characteristics and health behaviors. In addition, longitudinal data were used to analyze internet usage trends, and cross-sectional data were used to analyze the factors influencing internet use.

RESULTS

Among the 20,113 participants included in the longitudinal analyses, internet use increased significantly, from 2% to 12.3%, between 2011 and 2018. The adjusted model found statistically significant relationships between daily internet use and a lower incidence of the following chronic diseases: hypertension (hazard ratio [HR] 0.78, 95% CI 0.65-0.95, P=.01), chronic lung disease (HR 0.74, 95% CI 0.57-0.97, P=.03), stroke (HR 0.69, 95% CI 0.50-0.94, P=.02), digestive disease (HR 0.73, 95% CI 0.58-0.91, P=.005), memory-related disorders (HR 0.58, 95% CI 0.37-0.91, P=.02), arthritis or rheumatism (HR 0.60, 95% CI 0.48-0.76, P<.001), asthma (HR 0.52, 95% CI 0.33-0.84, P=.007), depression (HR 0.80, 95% CI 0.71-0.89, P<.001), and vision impairment (HR 0.83, 95% CI 0.74-0.93, P=.004). Moreover, our study also showed that with increasing frequency of internet use, the risk of some chronic diseases decreases.

CONCLUSIONS

This study found that middle-aged and older adults who use the internet have a reduced risk of developing chronic diseases versus those who do not use the internet. The increasing prevalence of daily internet use among middle-aged and older adults may stimulate contemplation of the potential role of internet platforms in future research on chronic disease prevention.

The effect of internet use on depressive symptoms in middle-aged and older adults with functional disability: the mediating role of social isolation

Objective

The popularization of the internet provides the possibility to improve the depressive symptoms (DS) and social isolation of middle-aged and older adults with functional disability. There was a significant correlation between internet use and DS in middle-aged and older adults with functional disability, but the relationship between internet use, social isolation, and DS remains to be confirmed.

Methods

Data were obtained from 7,955 middle-aged and older adults aged 45 years and older from the 2018 China Health and Retirement Longitudinal Study (CHARLS). Multiple linear regression models were used to analyze the association between internet use and DS, and the Sobel test was used to explore mediating models.

Results

Results showed that internet use was negatively associated with DS among Chinese middle-aged and older adults. Among them, social needs (B = -0.770, p = 0.041), and information reception (B = -1.067, p = 0.007) were significantly related to DS in middle-aged and older adults. Only information reception (B = -3.161, p = 0.031) was significantly related to DS among middle-aged and older adults with functional disability. Social isolation partially mediated the association between internet use and DS in middle-aged and older adults without functional disability, whereas it was fully mediated in middle-aged and older adults with functional disability.

Conclusion

This study indicates that when formulating health policies to promote the mental health of Chinese middle-aged and older adults, the use of the internet should not be overlooked.

Economic development, weak ties, and depression: Evidence from China

OBJECTIVES

Weak ties are becoming mainstream in daily relationships and play an essential role in the improvement of individuals' mental health. Despite growing concerns on depression, inclusion of weak ties is limited. To address the gap, this study empirically shed light on the role of weak ties on individual depression in the context of economic development.

METHOD

A cross-sectional study was conducted based on 2018 China Health and Retirement Longitudinal Study (CHARLS) with a sample of 16,545 individuals. A moderated mediation model is constructed to evaluate the impact of economic development (GDP) on the degrees of depression, the mediating effect of weak ties, and the moderating effect of residents' residence types (living in urban or rural areas).

RESULTS

Economic development exerts a significant direct impact on depression (β=-1.027, p<0.001). Weak ties are significantly negatively correlated with depression (β=-0.574, p<0.001), and act as a mediator between economic development and local individual depression. In addition, the residence type plays a moderating role between economic development and weak ties (β=0.193, p<0.001). That is, living in urban areas would introduce the higher the level of weak ties.

CONCLUSIONS

Higher economic development is largely conducive to alleviating the degrees of depression, weak ties play a mediating role in economic development and depression, and residence types have a positive moderating effect on the economic development and weak ties.

The effects of a mobile-based multi-domain intervention on cognitive function among older adults

Behavioral and social research has stressed the importance of multi-domain lifestyle interventions to prevent, delay, or remedy age-related cognitive decline among older adults at high risk for dementia. In light of the benefits of multi-domain interventions, some studies demonstrate the effectiveness of a mobile-based program for dementia prevention. Unfortunately, there is limited evidence of whether or not a mobile application of a multi-domain program is effective in improving cognitive functioning among older adults who are a high risk for dementia. Thus, the purpose of this study was to determine whether there was a pre-post change of cognition and there were age-group differences in pre-post change after the 12 weeks multi-domain program, Silvia program (N = 59). The Silvia program consisted of five domains, including (a)daily smart routine, (b)cognitive training, (c)lifestyle monitoring, (d)home-based exercise, and (e)voice-based AI cognitive assessment. Using a paired t-test and analysis of variance, this study found that there was a significant mean difference in cognitive function scores between pre and post-intervention (95 % CI = 1.10-1.87, P <.05). The difference score in cognitive function was higher in the old-old group than in the young-old group (95 % CI = -2.29-0.10, p <.05). The findings of this study demonstrated that Silvia program was effective in promoting cognitive function among older Korean adults, especially for the old-old group.

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 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.

Indoor air pollution from solid fuels use, inflammation, depression and cognitive function in middle-aged and older Chinese adults

BACKGROUND

Few studies have focused on the influence of indoor air pollution on depression and cognitive impairment; besides, the underlying mechanism is not well-established.

OBJECTIVE

This study aimed to fill the above gaps by exploring the underlying influence mechanism of solid fuel use, the major cause of indoor air pollution, with the risk of depression and cognitive impairment.

METHODS

This data came from China Health and Retirement Longitudinal Study (CHARLS) 2015 dataset. Self-reported household cooking fuels were collected and categorized as clean fuels and solid fuels. High-sensitivity C-reactive protein (CRP) and white blood cells (WBC) were used to measure inflammation. Depression and cognitive function were assessed by using standardized questionnaires.

RESULTS

Respondents had an average Center for Epidemiologic Studies Depression Scale (CESD-10) scores of 7.68 (SD = 6.14) and cognitive function scores of 15.97 (SD = 4.84). In the whole sample, 36.4 % of respondents used solid fuels use, but this proportion was much greater among those living in rural areas (78.38 %). Compared with clean fuel users, solid fuel users had more depression and worse cognitive function. After adjusting for confounders, indoor air pollution was significantly associated with depression and cognitive function respectively (β = -0.444, p < 0.001; β = 0.656, p < 0.001). Indoor air pollution was significantly related to the WBC (β = 0.170, p < 0.01), but not for the CRP. The WBC mediated the association between indoor air pollution and depression (β = 0.026, p < 0.01).

CONCLUSION

In conclusion, solid fuel use was significantly associated with a higher risk of depression and cognitive impairment. Furthermore, we found that solid fuel use influences depression partly via the inflammatory profile.

Does internet use promote mental health among middle-aged and older adults in China?

In recent years, China's Internet penetration rate has increased, and the scale of middle-aged and older adults' netizen has continued to expand. However, the impact of internet use on mental health remains controversial. This paper analyzes 14,497 middle-aged and older adults' valid respondents in the 2018 Chinese Family Panel Study (CFPS2018) to evaluate the impact of Internet use on the mental health of middle-aged and older adults and its intermediary mechanisms. The findings show that moderate use of the Internet can significantly reduce depression levels and boost cognitive function in middle-aged and older adults. But excessive internet use will also lead to increased levels of depression and decreased cognitive function. Different Internet use purposes will also lead to different psychological states. Online socializing, entertainment and business activities can significantly reduce depression levels and promote cognitive functions. Online studying and working only have positive effects on cognitive functions, which have no significant relationship to depression levels. In addition, analysis of the mediation effect found that life satisfaction is a path mechanism for Internet use and affect different dimensions of mental health.

A study on the impact of Internet use on depression among Chinese older people under the perspective of social participation

Purpose

This study aimed to evaluate the role of social participation in the relationship between internet use and depressive symptoms among Chinese older adults and investigate how the internet use interact with social participation to reduce the risk of depressive symptoms.

Methods

Based on the survey from the China Health and Retirement Longitudinal Study (CHARLS) in 2018, we identified 4645 subjects and used the Ordinary Least Square method (OLS) and Propensity Score Matching method (PSM) to identify the association between Internet use and depression of older people, and further test how social participation played a role in the relationship.

Results

The level of depression of older people was significantly reduced in those who using internet in China, and the effect was still robust under different identification methods. The mental health was improved when using internet because of the increase of social participation and social capital. Further, The positive effect was stronger especially in those who were female, living in rural areas, has low education attainments and were 70–79 years old.

Conclusions

The popularity of internet use has a positive effect on the depressive symptoms of Chinese older adults. Effective measures were encouraged to improve the friendliness of internet for older people and promote the popularization of the Internet and older group, achieving the spiritual well-being of them in the Internet society.

The relationship between Comprehensive Geriatric Assessment parameters and depression in elderly patients

Background

Depression is common and serious among elderly patients. The treatment of elderly depression is often delayed owing to insufficient diagnosis, which eventually leads to adverse consequences.

Aims

To explore the association between the parameters of the Comprehensive Geriatric Assessment and depression in elderly patients.

Methods

A cross-sectional study of 211 outpatients and inpatients aged ≥ 65 years from the Comprehensive Geriatric Assessment database was conducted. A Comprehensive Geriatric Assessment inventory was prepared by compiling and screening general characteristics, chronic diseases (cardiovascular disease, diabetes, and peptic ulcer disease), nutritional status, daily living ability, anthropometric measurements (body mass index (BMI), upper arm circumference, and calf circumference), and blood biochemical indicators (hemoglobin, albumin, prealbumin, triglycerides, and low-density lipoprotein cholesterol). The Geriatric Depression Scale was also conducted for each elderly patient to screen for depression. A multivariable logistic regression analysis was used to determine the association between the parameters of the Comprehensive Geriatric Assessment and geriatric depression.

Results

There were 63 patients in the depression group with a median age of 84.00 years, and 148 patients in the non-depression group with a median age of 78.50 years. After controlling for confounders, the risk of depression in elderly patients with cardiovascular diseases was 6.011 times higher than that in those without cardiovascular diseases (p < 0.001); and the risk of depression in elderly patients with peptic ulcer diseases was 4.352 times higher than that in those without peptic ulcer diseases (p < 0.001); the risk of depression in elderly patients decreased by 22.6% for each 1-point increase in the Mini Nutritional Assessment (p < 0.001). The risk of depression in elderly patients decreased by 19.9% for each 1-point increase in calf circumference (p = 0.002), and by 13.0% for each 1-point increase in albumin (p = 0.014).

Conclusion

Our findings suggest that Comprehensive Geriatric Assessment parameters, such as cardiovascular disease, peptic ulcer disease, Mini Nutritional Assessment score, calf circumference, and albumin, were associated with depression. The Comprehensive Geriatric Assessment can assist in the early identification of depression in the elderly population.

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.

Effects of Social Participation and Its Diversity, Frequency, and Type on Depression in Middle-Aged and Older Persons: Evidence From China

Background

Depression is one of the greatest public health problems worldwide. The potential benefit of social participation (SP) on mental health has been widely acknowledged. Nevertheless, a few studies have used propensity score matching (PSM) to reduce the influence of data bias and confounding variables. This study explored the effect of social participation on depression among middle-aged and older Chinese persons through a PSM method, considering the frequency, type, and quantity of SP. Effects were compared among different age groups, genders, and places of residence.

Methods

The datasets were obtained from the 2018 wave of the China Health and Retirement Longitudinal Study. A total of 9,404 respondents aged 45 and above were included in the study. PSM and ordinary least squares methods were used to estimate the effect of social participation on depression.

Results

PSM estimation results showed that SP had a significantly positive effect on decreasing depression scores (p < 0.001) by 0.875-0.898 compared with persons without SP. All types of SP had a significantly positive effect (p < 0.001), and participating in community activities had the largest effect (β = -1.549 to -1.788, p < 0.001). Higher frequency of participation and more types of SP promoted lower depression scores; subgroup analyses revealed that the promotion effect was significantly greater among women, those aged ≥75 years, and those living in urban areas.

Conclusion

PSM indicated that SP could alleviate the depression of middle-aged and older Chinese persons. Targeted measures should be adopted to promote SP and thereby improve mental health and promote healthy and active aging.

Smartphone non-users experience disproportionately higher psychological distress than their counterparts: Mediations via psychosocial resources in a large sample of college students in China

BACKGROUND

Despite growing adoption of digital technologies, the gap between users and non-users (aka digital divide) persists. It is imperative to determine whether and how such a gap can lead to disparities in mental health outcomes among populations. However, few empirical studies have explored the effect of smartphone non-use on psychological well-being.

METHODS

A large-scale cross-sectional survey was conducted among 26,951 college students in Shaanxi Province, China. Levels of depression and loneliness were first compared between smartphone non-users and their user counterparts. Based on the Conservation of Resources theory, structural equation modeling was then used to test the mediating roles of social support, quality of peer relationship, and self-esteem.

RESULTS

Around 56.8% of smartphone non-users had probable depression and they reported significantly higher depressive symptoms (Cohen's d = 0.52) and loneliness (Cohen's d = 0.30) than users. The hypothesized mediation model was well supported with good model fit. Lower levels of social support, quality of peer relationship, and self-esteem fully mediated the total effect of smartphone non-use status on loneliness and explained 69.4% of the total effect on depression.

LIMITATIONS

Findings might be subject to self-reporting bias and limitations due to a cross-sectional design.

CONCLUSIONS

The study adds new evidence that the minority group of smartphone non-users exhibited disproportionately greater psychological distress than users resulting from lower supportive social relationships and positive sense of self. The findings inform the future investigation into digital divide in smartphone use/access and its negative impact on population's psychological well-being.

The Relationship Between Internet Use and Mental Health Among Older Adults in China: The Mediating Role of Physical Exercise

Objective

Affected by internet applications, mental health among older adults has become an important public health issue in China. This study aimed to use cross-sectional data to explore how internet use affects mental health among older adults in China, along with the moderating role of physical exercise in the above relationship.

Methods

This study employed data from the Chinese General Social Survey (CGSS) conducted in 2017. In addition, OLS regression was adopted to explore the impacts of internet use on the mental health of older adults in China.

Results

Results from the cross-sectional data model showed that internet use had a statistically significant and positive correlation with the mental health of older adults. The regression result of the full sample showed that the regression coefficient of the influence of internet use on the mental health of the elderly was 0.114, which was significant at the 1% level. Furthermore, this study used mediating analysis to explore the possible underlying mechanism by which internet use influenced mental health status through physical exercise. Physical exercise played a mediating role in the relationship between internet use and mental health; the ratio of the indirect effect to total effect mediated was 0.272. It is important to note that the effect size of the indirect effect through physical exercise was quite large.

Conclusion

Our findings suggested that internet use was significantly associated with better mental health status for older Chinese residents, mediated by higher physical exercise frequency, which was consistent with China’s recent efforts to promote health governance with the “Internet Plus Exercise” campaign. Consequently, the government must encourage the development of more internet applications suitable for the elderly to increase their exercise frequency and ultimately improve their mental health. These results also provided insights for clinical solutions.

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A perception-based study to explore COVID-19 pandemic stress and its factors in Bangladesh

BACKGROUND AND AIMS

Worldwide the COVID-19 pandemic has accelerated sufferings of mental health and behaviour attitudes of people. Many countries, including Bangladesh, reported suicide as extreme consequences of the psychological burden influenced by COVID-19. The present study explores human stress and its factor influenced by COVID-19 in Bangladesh, which significantly affect the quality of life.

METHODS

An online-based questionnaire survey was conducted among 651 adult Bangladeshi populations by capturing socio-demographic information, possible human stress, and consequences of the pandemic. A set of statistical tools such as Pearson's Correlation Matrix (PCM), T-test, Principal Component Analysis (PCA) and Hierarchical Cluster Analysis (HCA) were applied to identify the relationship between different factors and influential factors increasing human stress.

RESULTS

More than 83% of the participants are facing COVID-19 related mental stress, which results in short temper, sleep disorder, and family chaos. PCA and HCA outcomes indicated a significant relationship between the respondents' opinions and human stress factors, which harmonized with the country's existing scenario. PCM results enlighten the relationship between human stress factors and found financial hardship, cutting back daily spending, and food crisis are interconnected together causes stress. Also, hampering students' formal education and future career plans significantly contribute to mental stress.

CONCLUSION

Based on the above findings, it's crucial to introduce a time-oriented strategy and implement precaution monitoring plans for Bangladesh. The rescue plan will help people to manage the pandemic and improve mental health to fight against psychological challenges related to COVID-19 and future pandemics.

Mobile Phone Use and Cognitive Impairment among Elderly Chinese: A National Cross-Sectional Survey Study

The study aimed to investigate the relationship between mobile phone use and cognitive impairment using the data of the Prevention and Intervention on Neurodegenerative Disease for Elderly in China (PINDEC) survey. A total of 21,732 participants aged 60 years and above in China were recruited using a stratified, multi-stage cluster sampling method, providing information on demographics, lifestyle and health-related characteristics, mobile phone use, and cognitive impairment through face-to-face interviews by trained staff according to a standard protocol. All estimates of rates were weighted by sex, age, and living area (rural or urban) in the elderly Chinese population. The rate of mobile phone usage was 65.5% (14.3% for smartphone use). The prevalence of cognitive impairment in non-users of mobile phone, dumbphone users, and smartphone users were 17.8%, 5.0%, and 1.4%, respectively. The odds of having cognitive impairment in users of dumbphone and smartphone were lower than non-users after adjusting for demographics, lifestyle, and health-related factors (adjusted odds ratio (AOR), 0.39, 95% CI 0.35 to 0.45; p < 0.001; AOR, 0.16, 95% CI 0.11 to 0.25; p < 0.001, respectively). Smartphone use in Chinese elderly people was quite low. A strong correlation was found between mobile phone use and better cognitive function; yet longitudinal studies are warranted to explore the causal relationship. Future design of mobile phone-based interventions should consider the feasibility among those in need.

The association between Internet use and health-related outcomes in older adults and the elderly: a cross-sectional study

Background

Older adults and elderly persons can experience a significant digital divide. However, there are many studies reporting that the use of the Internet has benefits related to a person’s health status and social inclusion. It is not fully clear if Internet use and health-related outcomes share common antecedents or if using the Internet may have a favourable effect on the determinants responsible for good health. The main aim of this study was to assess the relationship between the use of the Internet and health-related outcomes in older adults and elderly people in Poland.

Methods

The effect of the use of the Internet was analysed with regression models after adjusting for sociodemographic factors. The data used for the analysis were obtained through a telephone-based survey on a representative sample of Polish adults at least 50 years of age.

Results

By categorising the frequency of Internet use by the respondents, it was found that some categories were significantly related to less favourable health behaviours. Rare Internet users were less likely to undertake physical activity than nonusers (odds ratio, OR, 95% confidence interval, 95%CI 0.48, 0.28–0.83). Those using the Internet every day less frequently consumed fruit and vegetables (OR, 95%CI 0.64, 0.42–0.99). Internet use was also associated with more frequent consumption of alcohol (OR, 95%CI 1.65, 1.09–2.50 comparing nonusers with those accessing the Internet several times a week). Persons rarely using the Internet, but not those who accessed it at least a few times a week, possessed a lower health literacy than nonusers (OR, 95%CI 0.71, 0.52–0.97). Internet users were also more likely to assess their health status as unsatisfactory (OR, 95%CI 0.59, 0.42–0.82 comparing nonusers with those using the Internet daily). Finally, the use of the Internet was consistently associated with a lower prevalence of chronic conditions and disability, as well as less frequent visits to health care facilities.

Conclusions

In conclusion, in contrast to earlier findings, Internet use is not associated with favourable patterns of lifestyle or higher self-rated health in older Polish adults. However, persons with chronic conditions or disabilities less frequently declare the use of the Internet. It was also revealed that older adults and the elderly who make use of the Internet are less likely to utilise health services.

Use of machine learning approach to predict depression in the elderly in China: A longitudinal study

BACKGROUND

Early detection of potential depression among elderly people is conducive for timely preventive intervention and clinical care to improve quality of life. Therefore, depression prediction considering sequential progression patterns in elderly needs to be further explored.

METHODS

We selected 1,538 elderly people from Chinese Longitudinal Healthy Longevity Study (CLHLS) wave 3-7 survey. Long short-term memory (LSTM) and six machine learning (ML) models were used to predict different depression risk factors and the depression risks in the elderly population in the next two years. Receiver operating curve (ROC) and decision curve analysis (DCA) were used to evaluate the prediction accuracy of the reference model and ML models.

RESULTS

The area under the ROC curve (AUC) values of logistic regression with lasso regularisation (AUC=0.629, p-value=0.020) was the highest among ML models. DCA results showed that the net benefit of six ML models was similar (threshold: 0.00-0.10), the net benefit of lasso regression was the largest (threshold: 0.10-0.17 and 0.22-0.25), and the net benefit of DNN was the largest (threshold: 0.17-0.22 and 0.25-0.40). In two ML models, activities of daily living (ADL)/ instrumental ADL (IADL), self-rated health, marital status, arthritis, and number of cohabiting were the most important predictors for elderly with depression.

LIMITATIONS

The retrospective waves used in the LSTM model need to be further increased.

CONCLUSION

The decision support system based on the proposed LSTM+ML model may be very valuable for doctors, nurses and community medical providers for early diagnosis and intervention.