Older adults' technology use and its association with health and depressive symptoms: Findings from the 2011 National Health and Aging Trends Study

Internet Use and Higher-Level Functional Capacity Decline Suppression in Japanese Older Adults With Low Education: JAGES 2016-2019 Longitudinal Study

BACKGROUND

Higher-level functional capacity (HLFC) is crucial for the independent living of older adults. While internet use positively impacts the health of older adults, its effect on HLFC and how this effect varies with educational attainment remains uncertain.

OBJECTIVE

This longitudinal study aimed to investigate whether internet use could mitigate the risk of HLFC decline and if this benefit extends to older adults with lower levels of education.

METHODS

The data were sourced from the Japan Gerontological Evaluation Study (JAGES), encompassing 8050 community-dwelling adults aged 65 years and older from 2016 to 2019. The study focused on those who remained self-sufficient from 2016 to 2019, identifying participants with independent HLFC in 2016. The Tokyo Metropolitan Institute of Gerontology Index of Competence defined HLFC operationally, consisting of 3 subscales, namely instrumental activities of daily living, intellectual activity, and social role. The primary variable was the frequency of internet use in 2016; participants who reported using the internet were classified as internet users, while those who answered "No" were identified as nonusers. The study compared the effects of internet use on HLFC decline across educational levels of ≤9 years, 10-12 years, and ≥13 years using Poisson regression analysis adjusted for robust SE to calculate the risk ratio (RR) and 95% CI for HLFC decline in 2019.

RESULTS

After adjusting for demographic and health condition risk factors, internet use was significantly linked to a decreased risk of HLFC decline in older adults over 3 years, including those with lower educational levels. Internet users with ≤9 years of educational attainment experienced a suppressed decline in the total score (RR 0.57, 95% CI 0.43-0.76; P<.001); instrumental activities of daily living (RR 0.58, 95% CI 0.38-0.91; P=.02), intellectual activity (RR 0.60, 95% CI 0.41-0.89; P=.01), and social role (RR 0.74, 95% CI 0.56-0.97; P=.03) compared with nonusers. Participants with 10-12 years of education showed suppression rates of 0.78 (95% CI 0.63-0.98; P=.03), 0.59 (95% CI 0.39-0.90; P=.01), 0.91 (95% CI 0.63-1.31; P=.61), and 0.82 (95% CI 0.68-1.00; P=.05), respectively, and those with ≥13 years displayed suppression rates of 0.65 (95% CI 0.51-0.85; P=.001), 0.55 (95% CI 0.36-0.83; P=.01), 0.64 (95% CI 0.37-1.10; P=.11), and 0.83 (95% CI 0.64-1.08; P=.17), respectively.

CONCLUSIONS

These findings indicate that internet use supports the maintenance of HLFC independence in older adults with higher education and those with lower educational levels. Encouraging internet use among older adults with lower levels of education through future policies could help narrow functional health disparities associated with educational attainment.

Understanding resilience: Lifestyle-based behavioral predictors of mental health and well-being in community-dwelling older adults during the COVID-19 pandemic

BACKGROUND

Changes in sleep, physical activity and mental health were observed in older adults during early stages of the COVID-19 pandemic. Here we describe effects of the COVID-19 pandemic on older adult mental health, wellbeing, and lifestyle behaviors and explore predictors of better mid-pandemic mental health and wellbeing.

METHODS

Participants in the Adult Changes in Thought study completed measures of lifestyle behaviors (e.g., sleep, physical activity) and mental health and wellbeing both pre-pandemic during regular study visits and mid-pandemic via a one-time survey. We used paired t-tests to compare differences in these measures pre- vs. mid-pandemic. Using multivariate linear regression, we further explored demographic, health, and lifestyle predictors of pandemic depressive symptoms, social support, and fatigue. We additionally qualitatively coded free text data from the mid-pandemic survey for related comments.

RESULTS

Participants (N = 896) reported significant changes in mental health and lifestyle behaviors at pre-pandemic vs. mid-pandemic measurements (p < 0.0001). Qualitative findings supported these behavioral and wellbeing changes. Being male, never smoking, and lower pre-pandemic computer time and sleep disturbance were significantly associated with lower pandemic depressive symptoms. Being partnered, female, never smoking, and lower pre-pandemic sleep disturbance were associated with higher pandemic social support. Pre-pandemic employment, more walking, less computer time, and less sleep disturbance were associated with less pandemic fatigue. Participant comments supported these quantitative findings, highlighting gender differences in pandemic mental health, changes in computer usage and physical activity during the pandemic, the value of spousal social support, and links between sleep disturbance and mental health and wellbeing. Qualitative findings also revealed additional factors, such as stresses from personal and family health situations and the country's concurrent political environment, that impacted mental health and wellbeing.

CONCLUSIONS

Several demographic, health, and lifestyle behaviors appeared to buffer the effects of the COVID-19 pandemic and may be key sources of resilience. Interventions and public health measures targeting men and unpartnered individuals could promote social support resilience, and intervening on modifiable behaviors like sleep quality, physical activity and sedentary activities like computer time may promote resilience to fatigue and depressive symptoms during future community stressor events. Further research into these relationships is warranted.

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.

Telehealth impact on biomedical, psychosocial, and behavioural outcomes in patients with diabetes older than 50 years: A systematic synthesis without meta-analysis

BACKGROUND

Elderly people with diabetes are among high-risk groups that require more attention. With the increasing use of technology in healthcare, much emphasis has been placed on telehealth because of its potential to reduce unnecessary healthcare services consumption. We aimed to review and analyse the evidence of various interventions on the effect of using telehealth on biomedical, behavioural, and psychosocial outcomes in patients with diabetes over 50 years.

METHODS

The search method of this systematic synthesis without meta-analysis was guided by the preferred reporting items for systematic reviews (PRISMA) and the new reporting guideline synthesis without meta-analysis (SWiM) in systematic reviews. A coherent search strategy was designed to retrieve articles in databases such as PubMed, Embase, Scopus, Web of Science, and ClinicalTrials.gov from inception to June 2020. We excluded articles with eligibility criteria of the age of under 50 years old and studies conducted on patients with gestational diabetes. The outcomes were categorized into biomedical, behavioural, and psychosocial outcomes. The methodology of articles was evaluated by the Standard Cochrane Collaboration risk of bias tool in Revman 5.3 software.

FINDINGS

Overall, 18 studies with 8273 patients with diabetes over the age of 50 were included in this systematic review. Biomedical outcomes such as blood sugar tests and cholesterol tests had significant improvement by using telehealth. Frequency of self-monitored blood glucose (SMBG) and self-efficacy were behavioural outcomes that increased by telehealth utilization. Telehealth had a positive impact on psychosocial outcomes like depression, quality of life (QoL), cognitive decline, and social support.

INTERPRETATION

Telehealth has the ability to improve multiple outcomes such as behavioural and psychosocial outcomes in health services consumers. Due to varied telehealth interventions and follow-up durations, firm conclusions cannot be reached. As the research investigations studied in the present study were of different kinds and had used different follow-up periods, there is a need for further rigorous studies which consider socio-economic, cultural, and clinical differences.

Purposes of Internet Use and Its Impacts on Physical and Psychological Health of Korean Older Adults

Older adults engage in online activities for various purposes. An increasing number of studies are establishing connections between the purposes of internet use and their impacts on health outcomes. This study aimed to examine how the purposes of internet use affect self-rated health and depressive symptoms among Korean older adults. A nationally representative survey of community-dwelling older adults in Korea was used in the analysis (n = 5094). Instrumental internet use (using the internet to access various forms of information, services, and other resources) in Korean older adults was as common as interpersonal communication use, and the purposes of internet use were mainly for information seeking for everyday needs and engaging in various activities for enjoyment. Internet use for interpersonal communication and instrumental purposes was significantly associated with depressive symptoms and self-rated health. Internet use for instrumental purposes had a greater impact on self-rated health (β = -0.186) and depressive symptoms (β = -0.160) compared with the impacts of interpersonal communication internet use on self-rated health (β = -0.101) and depressive symptoms (β = -0.047). The findings highlighted the necessity of designing interventions that take into account the different purposes of internet use for older adults in order to maximize its benefits, paying special emphasis for information seeking online.

Health information behavior and related factors among Estonians aged ≥ 50 years during the COVID-19 pandemic

Purpose

The purpose of the article is to introduce the outcomes of a study analyzing the relationships between willingness to use technology for health purposes, health information behavior (HIB), health behavior (HB) choices, readiness for COVID-19 vaccination, socioeconomic indicators and self-reported health among older adults aged = 50 years living in Estonia.

Design/methodology/approach

A cross-sectional survey was conducted among 501 people aged = 50 in Estonia in 2020, a month after the end of lockdown.

Findings

The results of the study indicate that the more recurrent the need for HI was (rho = 0.11, p < 0.05) and the more regularly one searched for it (rho = 0.14, p < 0.01), the more willing a person was to get vaccinated. Also, interest in digital applications corresponded to vaccination readiness (rho = 0.25, p < 0.001). However, this relationship did not emerge in the case of other HBs such as healthy eating and exercise. Differences in HIB should be taken into account when developing effective means of health communication designed especially for crisis situations.

Originality/value

Estonia is known as one of the digital front runners in the world. However, social welfare and the well-being of disadvantaged groups among the population (e.g. older people) have not yet caught up with the more developed Western countries. Thus, learning more about the health-related information behavior of older adults, e.g. the kind of health information they are seeking and using in Estonia, allows policymakers, health information providers and libraries in Estonia to plan and carry out more effective interventions and help them to improve the existing systems so as to furnish older adults with relevant information.

Online health information seeking and the association with anxiety among older adults

Introduction

The Internet supplies users with endless access to a wealth of information and is generally the first source searched by U.S. adults (18 years and older) when seeking health information. Age and anxiety are associated with online health information seeking (OHIS). Older adults (65 years and older) are increasing their OHIS. Importantly, OHIS can potentially lead to improved health outcomes for older adults. The relationship between OHIS and anxiety is less clear. Studies report those with more symptoms of anxiety are more likely to be OHIS, while other studies find the reverse pattern or no association. Generalized anxiety disorder affects up to 11% of older adults and is oftentimes unrecognized and untreated.

Methods

To address the mixed findings in the literature, we analyzed six waves (2015-2020) of data from the National Health and Aging Trends Study to assess the causal relationship between anxiety and OHIS using a Random Intercept Cross-lagged Panel Model framework.

Results

We found that while anxiety symptoms lead to OHIS in the next wave, OHIS was not associated with anxiety symptoms in the next wave.

Discussion

This suggests that for this sample of older adults, OHIS does not reduce or exacerbate older adults' symptoms of anxiety.

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).

Social and satisfied? Social uses of mobile phone and subjective wellbeing in later life

The current study examined the associations between socio-demographic background and engagement in social uses of mobile phone, and between the engagement in these uses and life satisfaction and health satisfaction in later life through the lens of digital divide and uses and gratifications theories. The data, collected from the retired Internet users (62 and older) residing in seven countries (N = 5713), were analyzed using logistic and linear regression models. The results show that education and age predicted the engagement in social uses in the most consistent way. A number of social uses positively related to both life and health satisfaction. Of the particular uses, e-mailing and instant messaging were positively associated with life and health satisfaction. The results imply that socio-demographic background predicts the engagement in social uses of mobile phone in later life, that the engagement in such uses plays an overall significant role in wellbeing in later life, and that some particular uses play a greater role than others in this regard.

Parents' versus Grandparents' Attitudes about Childhood Vaccination

BACKGROUND

We investigated and compared practices and attitudes about childhood vaccination between young parents and their parents and identified influences and sources of information in the County of Zadar, Croatia.

METHODS

This research was conducted in six general practice and paediatric medical clinics. It included 300 volunteers, including 150 younger parents and 150 older grandparents. Information was collected with a survey questionnaire. The survey data were statistically processed.

RESULTS

The 300 participants were divided into 2 groups. Most of the respondents were married, employed, had a high school education, and had a good economic status, often with two children and living in the city. Generally, the attitude towards vaccination was positive. Healthcare workers made the most important influence on the decision for vaccination. The younger age group was significantly affected by social networks and the internet and wanted more information. They were afraid of the adjuvants in vaccines. The older respondents held that vaccination must be legally regulated and did not believe the anti-vaccine media headlines.

CONCLUSIONS

Our respondents had positive attitudes towards childhood vaccination, noticed the benefits of vaccinating children, and held that untreated children represent a risk for the community. They were well informed and satisfied with the collaboration with medical professionals, although the media and social networks had some impact on attitudes.

Socio-economic and technological aspects of mental health of older persons: the role of strong and weak ties in Ghana

Research indicates that social capital can influence the extent to which socio-economic status (SES) and information and communications technology (ICT) affect mental health. This study uses empirical data to examine the veracity of this claim by examining the effect of SES and ICT use on the mental health of older persons in Ghana, as well as the moderating role of bonding (i.e. strong ties) and bridging (i.e. weak ties) social capital in these associations. Data were drawn from 409 older persons from four regions in Ghana as part of a broader cross-sectional survey. Ordinal logistic regression analyses showed that SES and ICT use had positive associations with mental health after adjusting for other socio-demographic factors. Bridging social capital modified the association between SES and mental health positively. Bonding social capital also moderated the relations between ICT use on mental health positively. We argue that the prevalent nature of resources embedded in strong ties and the diversity of support that emerge from weak ties account for the difference in their influence observed in this study. Thus, while advances in socio-economic and technological conditions can enhance older persons’ mental health, equal attention must be paid to the characteristics of their strong and weak ties as they possess the resources to make socio-technological policies even more meaningful.

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.

Have changes in Internet use during the COVID-19 pandemic affected older adults' self-rated health? A cross-sectional study of young-old and old-old populations in Korea

Disparities in Internet access are barriers to older populations' well-being. This study examined the association between changes in older adults' Internet usage during the coronavirus disease 2019 (COVID-19) pandemic and their self-rated health. Participants were adults aged 65 years and above, selected from the 2020 Digital Divide Survey conducted in Korea (n = 1150). Changes in Internet use among younger (aged 65-74 years) and older (aged 75 years and above) groups and the association between these changes and participants' self-rated health were examined. Internet usage remained similar or increased during the COVID-19 pandemic, particularly among the younger group. Increased Internet use was associated with better self-rated health of the participants. Other characteristics, including age, income, and education level, were also positively associated with their health. This study highlights the need for increasing older adults' access to online activities to enhance health equity in the digital era.

Frequency of contact with friends and relatives via internet and psychosocial factors in middle-aged and older adults during the COVID-19 pandemic. Findings from the German Ageing Survey

OBJECTIVES

Previous studies have examined the association between frequency of contact with friends and relatives via internet and psychosocial factors (in terms of loneliness, life satisfaction and depressive symptoms). However, far less is known about such a link during the COVID-19 pandemic, particularly based on nationally representative samples. Therefore, the aim of this study was to examine this association among middle-aged/older adults.

METHODS/DESIGN

Data were taken from the short survey of the German Ageing Survey (June/July 2020, 3134 individuals in the analytical sample). The De Jong Gierveld scale was used to quantify loneliness, the Satisfaction with Life Scale was used to quantify life satisfaction and the 10-item version of the Center for Epidemiological Studies-Depression was used to quantify depressive symptoms.

RESULTS

Regressions showed that-compared to daily users-less frequent users of the internet for contact with friends and relatives reported increased loneliness, lower life satisfaction and more depressive symptoms. With regard to covariates, better psychosocial factors were associated with medium education (compared to low education), living with partner in the same household (compared to singles), better self-rated health, and favourable COVID-19 factors (in terms of decreased feeling that the Corona crisis is a threat for oneself, not having an infection with the coronavirus and an increased feeling that you can influence an infection with the coronavirus yourself).

CONCLUSIONS

Data suggest that individuals with a high frequency of contact with friends and relatives via internet reported better psychosocial factors. Future research in other cultural settings are required.