Information and communicative technology use enhances psychological well-being of older adults: the roles of age, social connectedness, and frailty status

A mixed methods feasibility study of a virtual group-based social support program for older adults in residential care

OBJECTIVES

In response to calls for inventive ways to mitigate risks of physical distancing due to the COVID-19 pandemic for older adults living in residential care, the JAVA Music Club-Digital (JMC-D) was developed. The current feasibility study investigated benefits, usability, and implementation of weekly JMC-D sessions over 6 months.

METHOD

Employing a pre-post mixed methods study, depressive symptoms, loneliness, social isolation, and quality of life were measured at baseline, 3 and 6 months. Qualitative interviews were conducted at 3 months.

RESULTS

Twenty-one residents were recruited. Across the three time points there was a large effect for depressive symptoms, social isolation, and quality of life, though not statistically significant. There was a significant immediate increase in happiness following engagement in the JMC-D sessions. Thematic analysis of semi-structured interviews generated two overarching themes: Experiencing the JMC-D (subthemes: Benefits, Navigating the virtual platform, Feedback) and Considerations for Implementation (subthemes: Perceived purpose, Characteristics that impact the experience, and Infrastructure and resources).

CONCLUSION

Findings are encouraging and suggest that the JMC-D may support emotional and other psychosocial indices of wellness in residential care during times of physical distancing. Appropriate staffing, resources, and internet accessibility are important for implementation and uptake.

Usability evaluation of the educational website "understanding my diabetes" for Mexican patients with type 2 diabetes

Background

Diabetes education is an integral part of the treatment for the metabolic control of patients with diabetes. The use of the Internet as a tool for diabetes education, as well as its acceptance, is still under study.

Aim

To assess the usability of the educational website "I understand my diabetes" designed for patients with type 2 diabetes attending primary care clinics.

Material and method

A cross-sectional study was done in 110 patients with type 2 diabetes from two family medicine clinics, each of whom was assigned a user account on the educational website "Entiendo mi diabetes." The web site assigned a user name and password to each patient. They were able to access the educational website at home. After a 15-day review period, participants were asked to evaluate usability using the Computer System Usability Questionnaire. Additionally, we developed an eight-item questionnaire usability focusing on diabetes care. Sociodemographic data, blood pressure, and anthropometric measurements were recorded. Glucose levels and lipid profiles were also measured.

Results

The patients with diabetes had a mean age of 52.7 years and a median of 5 years since they were diagnosed with diabetes. The website received a good usability rating from 89.1% of participants, with favorable assessments in all three dimensions: 87.3% for information, 85.5% for quality, and 88.2% for interface. Regarding usability specifically for diabetes care, 98.2% rated it as having good usability.

Conclusion

The website for education about the disease in patients "I understand my diabetes" had an adequate usability evaluation by patients, so they also considered it very useful for diabetes care. The diabetes care instrument had adequate usability and reliability.

The effect of frailty levels of older individuals on their mental well-being and depression levels

BACKGROUND

Frailty has become an important public health issue. This study was conducted to determine the effect of frailty levels of older individuals on their mental well-being and depression levels.

METHODS

This descriptive cross-sectional study was conducted with a total of 325 older individuals aged 60 years and over. A demographic questionnaire form, the FRAIL Frailty Scale, the Warwick-Edinburgh Mental Well-Being Scale, and the Geriatric Depression Scale-Short Form were used to collect data. Data were evaluated using the SPSS 25.0 package program. Number, percentage, mean, standard deviation, Chi-square, correlation, and multiple regression analyses were used.

RESULTS

The mean age of the older individuals was 69.56 ± 7.75 years, and the variables of age, education level, income status, the person they were living with, regular medication use, forgetting to take medication, urinary incontinence, hospitalisation, and accidents were found to affect both frailty and depression (P < 0.05). There was a positive correlation between frailty and depression (r: 0.460, P < 0.001) and a negative correlation between mental frailty and well-being (r: -0.391, P < 0.001). Socio-demographic variables, depression, and mental well-being had a 40% effect on frailty (P < 0.001).

CONCLUSION

Depression status and mental well-being level are related to frailty, so negativity in one of them negatively affects the other. In line with these results, it is recommended to determine the level of depression and mental well-being of older individuals with high risk of frailty, and according to the results of the research, to provide care and support regarding the predictors affecting frailty.

Factors Impacting Chinese Older Adults' Intention to Prevent COVID-19 in the Post-COVID-19 Pandemic Era: Survey Study

BACKGROUND

Understanding the factors influencing individuals' health decisions is a dynamic research question. Particularly, after China announced the deregulation of the COVID-19 epidemic, health risks escalated rapidly. The convergence of "no longer controlled" viruses and the infodemic has created a distinctive social period during which multiple factors may have influenced people's decision-making. Among these factors, the precautionary intentions of older individuals, as a susceptible health group, deserve special attention.

OBJECTIVE

This study aims to examine the intention of older adults to engage in preventive behaviors and the influencing factors, including social, media, and individual factors, within the context of the postepidemic era. Drawing upon the structural influence model of communication, this study tests the potential mediating roles of 3 different types of media exposure between cognitive and structural social capital and protective behavior intention, as well as the moderating role of negative emotions between social capital and media exposure.

METHODS

In this study, a web survey was used to collect self-reported quantitative data on social capital, media exposure, negative emotions, and the intention to prevent COVID-19 among older adults aged ≥60 years (N=399) in China.

RESULTS

The results indicate that cognitive social capital significantly influenced protective behavior intention (P<.001), with cell phone exposure playing an additional impactful role (P<.001). By contrast, newspaper and radio exposure and television exposure mediated the influence of structural social capital on protective behavior intention (P<.001). Furthermore, negative emotions played a moderating role in the relationship between cognitive social capital and cell phone exposure (P<.001).

CONCLUSIONS

This study suggests that using tailored communication strategies across various media channels can effectively raise health awareness among older adults dealing with major pandemics in China, considering their diverse social capital characteristics and emotional states.

The effect of intergenerational support from children on loneliness among older adults-the moderating effect of internet usage and intergenerational distance

Objective

Loneliness is a key social and public health issue, mainly affecting the mental health of older adults. The article aimed to explore the influence of intergenerational support from children on loneliness among older adults. Meanwhile, the article also analyzed the moderating effects of internet usage and intergenerational distance in this process.

Methods

Based on the data received from 2018 China Longitudinal Aging Social Survey (CLASS), the ordinary least square (OLS) regression model was used to analyze the influence of intergenerational support from children on loneliness among older adults. Furthermore, the Bootstrap method was used to test the moderating effect of internet usage and intergenerational distance on the relationship between intergenerational support from children on loneliness among older adults.

Results

Baseline regression showed that economic support (β = -0.059, p < 0.001), caregiving support (β = -0.070, p < 0.001), and emotional support (β = -0.108, p < 0.001) from children can positively influence loneliness among older adults. Meanwhile, the results of the moderated effects analysis showed that internet usage and intergenerational distance moderates the relationship between caregiving support, emotional support from children and loneliness among older adults.

Conclusion

The article demonstrates that family support, particularly intergenerational support from children plays a pivotal role in alleviating loneliness among older adults, so the government should further regulate the behavior of children's alimony support, improve the digital infrastructure, these measures help to reduce loneliness among older adults and expand the depth and breadth of family care of older adults.

A study on Internet use and subjective well-being among Chinese older adults: based on CGSS (2012-2018) five-wave mixed interface survey data

Objective

This study is designed to investigate the relationship between Internet use and subjective well-being of the older adults in China, and to analyze the mediating role of subjective social fairness in the above relationship.

Methods

Based on the five-wave mixed interface survey data of China General Social Survey (CGSS) in 2012, 2013, 2015, 2017, and 2018, we select a total of 18,458 older adults aged 60 and above, and comprehensively used ordered probit regression, propensity score matching (PSM), and Karlson-Holm-Breen (KHB) mediating effect test methods.

Results

The analysis results show that (1) Internet use is significantly positively correlated with the subjective well-being of the older adults, and the higher the frequency of use, the stronger the subjective well-being. (2) Place of residence, education, and regional factors moderated the effect of Internet use on subjective well-being. The subjective well-being effect of Internet use is significant among male older adults, as well as on urban, educated, or eastern older adults. (3) Subjective social fairness plays a negative mediating role in the relationship between Internet use and subjective well-being of older adults.

Conclusion

The findings suggest that Internet use contributes to the improvement of subjective well-being in older adults, but attenuates this effect by reducing the subjective social fairness. Future research should further consider other factors such as the purpose, specific function, intensity of Internet use, etc., to gain a deeper understanding of how the Internet can help promote well-being.

Impact of China's digital economy development on the health of middle-aged and older people: an air pollution-based perspective

China has shown good momentum on the road of digital economy development, however, it is also rapidly entering an aging society. Exploring the health effects of the digital economy is of positive significance for realizing healthy aging in China. This paper focuses on the relationship between the digital economy and the health of middle-aged and older people using microdata from the China Health and Retirement Longitudinal Study (CHARLS) 2011-2018 and macrodata from Chinese cities. The study found that the digital economy showed a significant inverted U-shaped relationship on the health of middle-aged and older people. The results of subgroup regressions indicated heterogeneity in this effect across gender, education level, urban/rural and region. Individual health in female, highly educated, and urban groups is more closely related to the digital economy. Middle-aged and old groups in the western region are better able to enjoy the dividends of the digital economy, while middle-aged and old groups in the eastern region are more negatively affected by the digital economy. In the lead-up to the development of the digital economy, individual health can be promoted by narrowing the urban-rural income gap and increasing basic medical resources, while in the later stage of the development of the digital economy, it manifests itself in inhibiting the level of individual health by widening the urban-rural income gap and lowering the level of basic medical resources. In addition, air pollution exhibits a positive moderating effect between the digital economy and individual health, suggesting that air pollution reinforces the impact of the digital economy on health. Expansive analyses indicate that the digital economy has a negative impact on physiological health.

The age-based digital divide in an increasingly digital world: A focus group investigation during the COVID-19 pandemic

BACKGROUND AND OBJECTIVES

Previous research has identified numerous benefits of information and communication technology (ICT) on the well-being of older adults. However, it has been increasingly recognized that older adults do not necessarily catch up with the rapidly digitalized society, known as the 'age-based digital divide'. The progress of digitalization has been accelerated during the COVID-19 pandemic, which may have widened the digital divide. This study aimed to gain a better understanding of their living experience and concerns about digital exclusion during the pandemic. The perceptions of older adults in Hong Kong, a highly digitalized, metropolitan city, towards the digital age and its impact on their daily living during the COVID-19 pandemic were explored.

RESEARCH DESIGN AND METHODS

We conducted 12 focus group interviews with 77 community-dwelling older adults during the COVID-19 pandemic. Data were analyzed using thematic analysis, applying both organization, reduction, and refinement.

RESULTS

Four themes were identified: 1) Diversified means to access community information; 2) Facilitated daily living through the usage of ICTs; 3) Concerns about age-related decline in function; and 4) Fear of digital exclusion and accelerated digitalization during the pandemic. The results indicate that ICT provided numerous benefits to the daily life of older adults, but our participants also expressed concerns about age-related losses and the fear of digital exclusion due to the ongoing digitalization of society.

DISCUSSION AND IMPLICATIONS

Our findings indicated that older adults do not necessarily benefit from technological innovations, which are becoming more pervasive during the pandemic. To create age-friendly environments that cater to the needs of all members of society in the digital age, policymakers and service providers should provide diverse choices for older adults, rather than relying solely on one-size-fits-all technological solutions.

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.

The Relationship Between Internet Use for Social Purposes, Loneliness, and Depressive Symptoms Among the Oldest Old

The internet enables communication with social partners and has been found to be related to higher psychological well-being among older adults. Using data from the representative German North Rhine-Westphalia 80+ (NRW80+) study (n = 1,698, Mage = 84.86), we conducted linear regression and mediation analyses to compare levels of loneliness and depressive symptoms of onliners using the internet for social or other purposes with offliners. Oldest old onliners used the internet mostly for social purposes, and this type of internet use was related to a significantly lower level of loneliness and fewer depressive symptoms compared to offliners. The mediation analysis revealed that internet use for social purposes was related to lower levels of loneliness, which in turn was associated with a lower number of depressive symptoms. The findings suggest that internet use for social purposes may help the oldest old to reduce feelings of loneliness and depressive symptoms.

Association of Public Sports Space Perception with Health-Related Quality of Life in Middle-Aged and Older Adults-Evidence from a Survey in Shandong, China

Creating a healthy living environment for middle-aged and older adults is a key strategy for countries to address the aging challenge, but the effects of such an environment on the health-related quality of life (HRQoL) of middle-aged and older adults remain underexplored. This study aimed to examine the link between public sports facilities and the HRQoL of middle-aged and older adult residents in communities. A total of 1169 respondents (average age: 66.84; male: 46.19%) were selected from the Shandong, China. This study measured respondents 'physical activity (PA) using the International Physical Activity Questionnaire, the HRQoL of respondents using the 36-item Short Form Health Survey, and the Public Sports Space Perception Scale for respondents' public sports space perception. Correlation analysis and logistic regression analysis were employed to test the relationship among public sports space perception, physical activity (PA), and HRQoL. The mediating role of PA was conducted using the PROCESS macro for SPSS. The results revealed that public sports space perception only influenced the HRQoL of middle-aged and older adults through light-intensity PA (PCS: B  =  0.09, 95% CI 0.01, 0.03; MCS: B  =  0.02, 95% CI 0.01, 0.05) among light-intensity PA, moderate-intensity PA, vigorous-intensity PA., and this mediation model varied across different age groups of middle-aged and older adults. Moreover, digital inclusion only moderated the psychological aspect of HRQoL of middle-aged and older adults (p < 0.05). This study provided empirical evidence for enhancing the HRQoL of middle-aged and older adults and offered useful insights for the planning and design of public sports facilities and the formulation of health management policies for 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.

Use and Acceptance of Digital Communication Technology by Older Adults for Social Connectedness During the COVID-19 Pandemic: Mixed Methods Study

BACKGROUND

Older adults are at higher risk for health issues, including mental health problems. This was especially apparent during the COVID-19 pandemic, where older adults were simultaneously more vulnerable to the disease and the mental health concerns created by social distancing. Subsequently, the use of digital communication technology (DCT) became a critical option for maintaining social connectedness in older adults. Prior to the pandemic, the low uptake and use of technology by older adults was an established problem, known as the digital divide. However, not much is known about how this may have changed as a result of the pandemic.

OBJECTIVE

This study aims to explore how older adults maintained social connectedness through DCT during the pandemic and to understand factors influencing the use and acceptance of DCT.

METHODS

A mixed methods explorative field study was set up, involving surveys and interviews of 25 community-dwelling older adults (65-88 years old) living in the United Kingdom. The surveys included the internet acceptance questionnaire (based on the Technology Acceptance Model [TAM]); COVID-19 dysfunctional anxiety was captured using the COVID-19 Anxiety Scale (CAS). Background information (demographics, use of technology) was gathered before conducting semistructured interviews. We hypothesized that CAS would affect constructs of TAM and that predictive constructs of TAM would have remained valid during the pandemic. We also posited that there would be unidentified themes outside TAM that impacted the acceptance and use of DCT. We used the quantitative data to guide the semistructured interviews, which were then analyzed through thematic analysis to identify additional themes.

RESULTS

Correlational analysis showed that CAS influences all constructs of TAM. We also saw that the predictive constructs of TAM, especially the perceived ease of use (PEU) and perceived usefulness (PU), remained valid during the pandemic. Common acceptance-influencing themes were encountered in both quantitative and qualitative analyses, with 3 matching the known constructs of TAM (PU, PEU, and behavioral intention). We identified 2 additional themes affecting acceptance, namely influence of the pandemic (situational context) and privacy and security concerns. DCT use (especially email and videoconferencing use) increased during the pandemic, but the results related to social networking sites were mixed.

CONCLUSIONS

The COVID-19 pandemic impacted technology acceptance and use by older adults, encouraging their use of certain DCT apps (email and videoconferencing apps, such as WhatsApp). These apps helped insulate them from adverse effects (social isolation and loneliness). Other social networking apps, however, exerted a negative influence, increasing anxiety and a general feeling of negativity. Future studies should maximize older adult agency related to design, privacy, security, and user requirements for development. We also recommend that when studying DCT acceptance for older adults, our additional identified themes should be considered alongside the existing TAM constructs.

Older adult communication types and emotional well-being outcomes during COVID-19 pandemic

BACKGROUND

The rationale for the present study is a result of the COVID-19 pandemic, as there are fewer opportunities available for older adults to engage in face-to-face interaction and social activities, which may result in changes in the communication methods with their social contacts. The purpose of this study was to explore the relationship between methods of social connectedness and emotional well-being outcomes among older adults at the start of the pandemic.

METHODS

Two thousand five hundred and fifty-eight older adults Medicare beneficiaries (65 + years of age) in the National Health and Aging Trends Study at wave 10 (June 2020 to January 2021) were selected for cross-sectional analysis. Participants were measured on brief questionnaires regarding forms of communication with family and friends before and during the pandemic. Emotional well-being outcomes were measured on single items of sadness/depressed and loneliness; as well as a 6-item Likert scale of anxiety during the pandemic. Paired sample t-tests were utilized to examine the forms of communication between before and during pandemic. Hierarchical regressions were conducted to assess the relationship between forms of communication and emotional well-being outcomes.

RESULTS

We found that there were overall decreases in communication frequency during pandemic. Findings from regression analyses indicated information communication technology (ICT) are associated with negative emotional well-being outcomes, whereas in-person social contact are associated with lower levels of negative affect.

CONCLUSION

These findings suggest utilizing higher levels of ICT has negative implications for older adults' emotional well-being, contrasting with the positive implication of in-person contacts. These findings highlight the role of ICT in emotional well-being among older adults during pandemic.

ICT literacy and community connectedness in a Hispanic-majority community

While many studies have examined information and communication technology (ICT) among digital natives, there has been little investigation of the ICT literacy skills among digital immigrants, individuals who were raised in a time before the widespread use of digital technology. This study examined the ICT literacy skills of Hispanic-majority communities relative to measures of community connectedness, Internet use and demographics of individuals. The researchers made use of a survey method in collecting the data from participants involved in the study. Data collected were later analyzed using regression and correlation analysis techniques with the help of the SPSS tool, to find the relationship and effect among variables under study. The findings suggest that it is exposure to technology, not age, gender, ethnic, or educational factors, that is responsible for the development of greater ICT literacy skills. As discovered in the study, factors like age, ethnicity, educational attainment and political beliefs have no significant effect on ICT literacy.

Benefits of Intergenerational Contact: Ageism, Subjective Well-Being, and Psychosocial Developmental Strengths of Wisdom and Identity

The present study examines the benefits of an in-person intergenerational contact program called SAGE (Successful Aging and Inter-Generational Experiences). The SAGE Program pairs older adults (M age 85 years) and younger adults (M age 23 years) for 2 to 3-hour weekly meetings over a 7-week period, where participants can share memories, skills, and values, and foster new perspectives and friendships. We expected the SAGE Program to benefit both older and younger participants with respect to identity processes, subjective well-being, positive mood, and wisdom while reducing ageist beliefs compared to old and young participants serving as their matched controls. Overall, participants in the SAGE Program reported greater identity synthesis,subjective well-being, and positive mood. Exploratory analyses suggested that identity synthesis is a likely mediator of that effect. The SAGE Program did not reduce ageist beliefs, but age differences in ageism were found. We address additional results,limitations, and future research directions.

Pandemic Related Changes in Technology Use Among a Sample of Previously Hospitalized Older Adult New Yorkers: An Observational Study

BACKGROUND

The COVID-19 pandemic increased the importance of technology for all Americans, including older adults. Although a few studies have indicated that older adults might have increased their technology use during the COVID-19 pandemic, further research is needed to confirm these findings, especially among different populations, and using validated surveys. In particular, research on changes in technology use among previously hospitalized community-dwelling older adults, especially those with physical disability, is needed because older adults with multimorbidity and hospital associated deconditioning were a population greatly impacted by COVID-19 and related distancing measures. Obtaining knowledge regarding previously hospitalized older adults' technology use, before and during the pandemic, could inform the appropriateness of technology-based interventions for vulnerable older adults.

OBJECTIVE

In this paper, we 1) described changes in older adult technology-based communication, technology-based phone use, and technology-based gaming during the COVID-19 pandemic, compared to before the COVID-19 pandemic and 2) tested whether technology use moderated the association between changes in in-person visits and well-being, controlling for covariates.

METHODS

Between December 2020 and January 2021 we conducted a telephone-based objective survey with 60 previously hospitalized older New Yorkers with physical disability. We measured technology-based communication through three questions pulled from the National Health and Aging Trends Study COVID-19 Questionnaire. We measured technology-based smart phone use and technology-based video gaming through the Media Technology Usage and Attitudes Scale. We used paired t tests and interaction models to analyze survey data.

RESULTS

This sample of previously hospitalized older adults with physical disability consisted of 60 participants, 63.3% of whom identified as female, 50.0% of whom identified as White, and 63.8% of whom reported an annual income of $25,000 or less. This sample had not had physical contact (such as friendly hug or kiss) for a median of 60 days and had not left their home for a median of 2 days. The majority of older adults from this study reported using the internet, owning smart phones, and nearly half learned a new technology during the pandemic. During the pandemic, this sample of older adults significantly increased their technology-based communication (mean difference=.74, P=.003), smart phone use (mean difference=2.9, P=.016), and technology-based gaming (mean difference=.52, P=.030). However, this technology use during the pandemic did not moderate the association between changes in in-person visits and well-being, controlling for covariates.

CONCLUSIONS

These study findings suggest that previously hospitalized older adults with physical disability are open to using or learning technology, but that technology use might not be able to replace in-person social interactions. Future research might explore the specific components of in-person visits that are missing in virtual interactions, and if they could be replicated in the virtual environment, or through other means.

Internet usage among the oldest-old: does functional health moderate the relationship between internet usage and autonomy?

In recent years, research on internet usage in old age and its associations with well-being outcomes has increased. However, the oldest-old age group (80 years and older) is frequently underrepresented, and autonomy and functional health are rarely considered in these studies. By applying moderation analyses with a representative dataset of the oldest-old in Germany (N = 1863), our study has analyzed the hypothesis that the autonomy of older individuals, in particular of those with limited functional health, can be enhanced by internet usage. The moderation analyses indicate that the positive association between internet usage and autonomy is greater for older individuals with lower functional health. This association remained significant after controlling for social support, housing situation, education, gender, and age. Explanations for these results are discussed, and imply that further research is needed to understand the relationships between internet usage, functional health, and autonomy.

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 relationship between older adults' technology use, in-person engagement, and pandemic-related mental health

OBJECTIVE

The objectives of this study are to 1) describe changes in in-person communication/activity and changes in older adult technology use during the COVID-19 pandemic and 2) examine whether less in-person communication/activity mediates the relationship between pandemic-related mental health and technology use.

METHOD

Linear regressions (stratified by age and financial strain) and structural equation modeling were employed using a nationally representative, cross-sectional survey of 3,188 older adults from the 2020 National Health and Aging Trends Study's COVID-19 Questionairre.

RESULTS

Older adults engaged in more technology-based activity (b = 0.24; p<.001), more technology-based health care communication (b = 0.22; p<.001), and more technology-based food acquisition (b = 0.21; p<.001) during the COVID-19 pandemic, as compared to before the pandemic. Results indicate that adults <80 years old demonstrated greater increases in technology-based activity, technology-based health communication, and technology-based food acquisition, compared to adults ≥80 years old. Change in in-person communication significantly mediated the relationship between pandemic-related mental health and technology-based communication (standardized coefficient= -0.012; p=.005), and change in in-person activity significantly mediated the relationship between pandemic-related mental health and technology-based activity (standardized coefficient= -0.017; p=.020).

CONCLUSIONS

This study suggests that older adults are utilizing technology more, and therefore should be considered in technology design and dissemination. Technology use could be an important positive response to help those with pandemic related worries stay safely engaged with friends and family. Technologies should be produced that are modifiable for older adults with disabilities and affordable for older adults with fixed incomes.

Assessing the significance of first place and online third places in supporting Malaysian seniors' well-being during the pandemic

The enforced lockdowns and social distancing measures associated with COVID-19 may have influenced older adults' preferences towards their homes and neighborhoods as well as social spaces. One objective of this research is to determine whether home and neighborhood environments ("first place") affect how satisfied older adults are with their lives during the epidemic. This study also examined the extent to which social spaces that exist in the virtual world ("online third places") affect older adults' life satisfaction when they would have to practice risk-averse behaviors in times of pandemic. To collect data, this study analyzed the responses of 500 active older adults and conducted in-depth interviews with seven older adults who served as neighborhood leaders in Klang Valley, Malaysia. The study found that there is a direct relationship between older adults' satisfaction with their current housing and their overall life satisfaction during the pandemic. Similarly, having a quality neighborhood nearby increases the likelihood of living a satisfied life during the pandemic. Most online third parties, with the exception of instant messaging apps, do not appear to provide older adults with an adequate platform to interact with their friends, participate in social networking, and join communities for emotional support during the pandemic. The findings and recommendations of this study would be very useful in developing effective interventions to promote aging in place during the coronavirus outbreak.

An observational cohort study of longitudinal impacts on frailty and well-being of COVID-19 lockdowns in older adults in England and Spain

To reduce the spread of COVID-19, governments initiated lockdowns, limiting mobility and social interaction of populations. Lockdown is linked to health issues, yet the full impact on health remains unknown, particularly in more vulnerable groups. This study examined the impact on frailty and outcomes in high and low COVID-19 risk older adults. We examined health-related behaviours and support resources participants used during lockdown(s). Lockdown impacts in two countries were compared across four time points to examine impacts of different rules. We recruited 70 participants (aged >70 years) in England and Spain. Participants were allocated to higher or lower COVID-19-risk groups based on UK NHS guidelines. They completed assessments for frailty, quality-of-life, loneliness, exercise frequency and social interaction, coping resources and perception of age-friendliness of their environment. The four assessments took place over a 7-month period. Frailty was highest at Time 1 (most severe lockdown restrictions) and significantly higher in the Spanish group. It was lower at Time 3 (lowest restrictions), but did not continue to reduce for the English participants. Perceptions of the age friendliness of the environment matched these changes. Coping resources did not mitigate changes in frailty and outcomes over time, but more frequent physical activity predicted more reduction in frailty. Lockdown had a negative impact on frailty, increasing risk of adverse events for older people, but recovery once lockdowns are eased is evidenced. Further research is required to consider longer term impacts and methods to mitigate effects of lockdown on health.

Internet use and physical activity of older adults during the COVID-19 pandemic: a cross-sectional study in a northern Japanese City

Background

Little is known of whether Internet use is associated with physical activity among socially isolated older adults during the coronavirus disease 2019 (COVID-19) pandemic. This study investigated the association between Internet use and physical activity, and whether this association differs depending on social isolation among community-dwelling Japanese older adults.

Methods

A cross-sectional study was conducted with 1048 community-dwelling residents aged 65–90 years. Data were obtained using a self-reported questionnaire in August 2020. Physical activity was assessed using the International Physical Activity Questionnaire-Short Form. Multivariable logistic regression analyses were used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between Internet use and moderate-to-vigorous physical activity (MVPA).

Results

Internet use showed a significant association with MVPA (OR = 1.42, 95% CI: 1.06–1.90) after adjusting for age, sex, self-reported socioeconomic status, and other health-related characteristics. When the results were stratified by social participation and living status, Internet use was associated with a significantly higher likelihood of MVPA among participants with no social participation (OR = 1.81, 95% CI: 1.03–3.17) and living with family (OR = 1.40, 95% CI: 1.02–1.93).

Conclusion

Internet use was associated with sufficient physical activity, and this association may differ depending on the social isolation among community-dwelling older adults in Japan.

Morbidities Worsening Index to Sleep in the Older Adults During COVID-19: Potential Moderators

Older adults were considered a vulnerable group for the COVID-19 infection and its consequences, including problems with sleep.

Mobile Application Use and Loneliness among Older Adults in the Digital Age: Insights from a Survey in Hong Kong during the COVID-19 Pandemic

Existing literature on the associations between use of mobile applications (i.e., mobile apps) and loneliness among older adults (OAs) has been mainly conducted before the outbreak of the COVID-19 pandemic. Since mobile apps have been increasingly used by OAs during the pandemic, subsequent effects on social and emotional loneliness need updated investigation. This paper examines the relationship between mobile app use and loneliness among Hong Kong’s OAs during the pandemic. In our research, 364 OAs with current use experience of mobile apps were interviewed through a questionnaire survey conducted during July and August 2021, which assessed the use frequency and duration of 14 mobile app types and levels of emotional and social loneliness. The survey illustrated communication (e.g., WhatsApp) and information apps were the most commonly used. Emotional loneliness was associated with the use of video entertainment (frequency and duration), instant communication (duration), and information apps (duration). Association between video entertainment apps’ use and emotional loneliness was stronger among older and less educated OAs. Our findings highlight the distinctive relationships between different types of apps and loneliness among Hong Kong’s OAs during the pandemic, which warrant further exploration via research into post-pandemic patterns and comparative studies in other regions.

Smartphone Use, Technology Affordance for Healthcare and Elders' Life Satisfaction

Previous studies have examined how smartphones influence the life satisfaction of the elderly, but the existence of conflicting conclusions suggests the existence of a “black box”. In this study, using a survey from 941 elders, we examine whether smartphone use can improve life satisfaction of the elders by inducing emotional affordance offered by social networking Apps and functional affordance offered by healthcare system Apps. It is found that both emotional affordance and functional affordance acted as intermediating variables between the use of smartphone and elders' life satisfaction. In addition, it is founded that living arrangement with adult children moderates the positive impact of smartphone use on functional affordance, but there was no such moderating effect on emotional affordance. This study offers insights about how digital healthcare innovation will be applied to increase well-being of elders by applying framework of selective optimization with compensation.

Effects of Game Mode in Multiplayer Video Games on Intergenerational Social Interaction: Randomized Field Study

BACKGROUND

Maintaining social relationships is a basic human need and particularly essential in old age, including when living in a retirement home. Multiplayer video games can promote positive social interactions among players from different generations while playing. Yet, such facilitation of positive social interactions depends on specific game design. To systematically investigate the effects of game design on social interaction between seniors and their coplayers, the game Myosotis FoodPlanet was developed in this study, and the impacts of 3 different game modes on social interaction were compared in a controlled field trial.

OBJECTIVE

This study aims to compare the effects of 3 different game modes (competitive, cooperative, and creative) on social interactions (verbal and nonverbal communication) between seniors and their younger coplayers.

METHODS

This study was conducted in a Swiss retirement home as a controlled field trial. Participants were residents of the retirement home (N=10; mean age 84.8 years, SD 5.9 years) and played in pairs with their caregivers. Each pair played 3 game modes in random order. This resulted in 30 game sequences of 20 minutes each. A within-subject design was applied with game mode as the within-factor and social interaction as the outcome variable. To assess the quality of social interaction, 30 video-recorded game sequences were analyzed based on an event sampling method.

RESULTS

Analysis of variance for repeated measurements revealed significant effects: there was significantly more verbal communication in the creative mode than in the cooperative mode (P=.04) with a strong effect size (Cohen f=0.611). An examination of verbal communication revealed more game-related communication in the creative mode than in the cooperative mode (P=.01) and the competitive mode (P=.09) with marginally significant effects and strong effect sizes (Cohen f=0.841). In addition, significantly more biography-related communication occurred in the creative mode than in the cooperative mode (P=.03), with a strong effect size (r=0.707). Regarding nonverbal communication (eg, laughing together), analysis of variance for repeated measurements showed significant differences among the game modes (P=.02) with a strong effect size (Cohen f=0.758). Results showed that there was significantly more laughing together in the competitive mode (competitive>cooperative>creative).

CONCLUSIONS

The results show that game mode can be an important factor for shaping the social interactions of players playing together. Compared with other modes, creative game modes can increase verbal communication. In contrast, competitive modes may stimulate more laughing together. This has important implications for game design and the use of computer games to promote social interaction between seniors and their coplayers in practice.

Narcissism, Social Experiences, and Mood in Late Life

OBJECTIVES

Social ties increase in importance in late life and narcissism may be deleterious to these ties. More narcissistic older adults may have more frequent social encounters than less narcissistic people and may prefer weak ties (e.g., acquaintances) over close ones (e.g., family, close friends). They may benefit more from these encounters due to their need for adulation. This study examined how daily social experiences and mood varied by narcissism among older adults.

METHODS

Older adults aged 65-92 years (N = 303) completed the Narcissistic Personality Inventory-16 and completed ecological momentary assessments in which they reported number, type, and quality of social contacts and positive and negative mood every 3 h for 5-6 days.

RESULTS

In multilevel models, narcissism did not predict the number or pleasantness of social encounters. But more narcissistic older adults reported a greater percentage of stressful discussions with weak ties. With regard to mood, more narcissistic people reported higher negative mood if they had more encounters with weak ties and when discussing something stressful with weak ties. Less narcissistic people reported lowered positive mood after they discussed something stressful with close ties.

DISCUSSION

The findings present a nuanced understanding of how the self-centeredness of narcissism may be manifest in late life. More narcissistic people may be less sensitive to close partner's (e.g., family, friends) distress, but their mood may be more susceptible to negative social events, especially with weak ties (e.g., acquaintances).

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.

OUP accepted manuscript

The purpose of this study was to examine the association between age-friendliness of a city, loneliness and depression moderated by internet use among older people during the coronavirus disease 2019 (COVID-19) pandemic. The survey was from ‘The 2020 Survey of Needs Assessment for a Safe Community and Age-Friendly City’ in Xinyi District, Taipei, which was conducted by face-to-face interviews with community-based older adults who were aged 65 and above from one district of Taipei City from May to June 2020 (n = 335). Partial least square structural equation modeling and the SPSS PROCESS macro were used for data analysis. Two domains of an age-friendly city (housing and community support and health services) were found to be associated with reduced loneliness, while one (respect and social inclusion) was associated with decreased depression. The age-friendliness of cities mitigates depression through moderator (internet use) and mediation (loneliness) mechanisms. Although some age-friendly domains of the city reduced loneliness and depression directly, the age-friendliness–loneliness-depression mechanism held true only for older adults who used the internet and not for nonusers. Maintaining the age-friendliness of an environment is beneficial to mental health, and internet use is a necessary condition to gain optimum benefits from age-friendly initiatives. Policy suggestions are discussed.

Overcoming Barriers for Older Adults to Maintain Virtual Community and Social Connections during the COVID-19 Pandemic

OBJECTIVES

We describe the evaluation of remote training, an innovative use of technology to maintain older adults' virtual connection with their community and socialization, which were disrupted by the pandemic. Remote training was conducted via telephone using principles of cognitive rehabilitation and delivered by trained clinicians.

METHODS

We thematically analyzed trainer reflection notes and interviews with older adult participants.

RESULTS

The main facilitators were technology training with exposure, and the main barrier was fear of technology.

CONCLUSIONS

We describe how telephone-based training grounded in principles of cognitive rehabilitation can be used to remotely train older adults to use new technology and to help them maintain their community-based connections and engage in socialization.

CLINICAL IMPLICATIONS

Fear of technology during the pandemic can cause significant impairment in social functioning for older adults, at least when the only method for socialization is technology mediated such as during the COVID-19 pandemic. Empathically delivered remote training in an understanding manner can reduce fear and increase social and community connections in the era of physical distancing.

Psychometrics of Persian Version of the Ageism Survey Among an Iranian Older Adult Population During COVID-19 Pandemic

Background: Studies have revealed an increase in discrimination, neglect, and abuse among the older adult population during this period. This study assessed the validity and reliability of the Persian version of the ageism survey instrument tested on a sample of the Iranian older adult population during coronavirus disease (COVID-19) pandemic. An important move in counteracting ageism is to classify the ageism scale comprehensively by employing adequate psychometrics.

Methods: The Persian version of the ageism scale was developed using a two-step procedure. The first step involved translating and revising the original scale to develop a Persian version of the ageism scale. The second step involved assessing the psychometric features of the newly adapted scale using construct validity through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) and thereafter assessing the reliability through the average inter-item correlation (AIC), Cronbach's alpha. The sample consisted of 400 older adults (age 65 and older), who were recruited through online data collection, with samples for EFA and CFA randomly selected from the total samples.

Results: The Persian version of the ageism survey has three factors: age-related deprivation with five items, dignity with three items, and employment with three items; all of which explained 57.02% of the total variance. The outcome of the EFA was verified by the CFA, with internal consistency reliability being excellent (Cronbach's alpha was 0.725, 0.698, and 0.708 for the three factors).

Conclusion: This study specifically offers a restructured three factors Persian version of the ageism survey for Iranian older adults with acceptable construct validity and reliability.

Teaching and Practicing Cognitive-Behavioral and Mindfulness Skills in a Web-Based Platform among Older Adults through the COVID-19 Pandemic: A Pilot Randomized Controlled Trial

The outbreak of the COVID-19 pandemic has led to an acceleration in the development of web-based interventions to alleviate related mental health impacts. The current study explored the effects of a short-term digital group intervention aimed at providing cognitive behavioral and mindfulness tools and skills to reduce loneliness and depression and to increase social support among older adults in Israel. This pilot randomized controlled trial included community-dwelling older adults (n = 82; aged between 65–90 years; 80% female) who were randomized either to an intervention group (n = 64) or a wait-list control group (n = 18). The intervention included seven online sessions, over 3.5 weeks. Depression, loneliness, and social support measures were administered at baseline, immediately post-intervention, and at 1-month follow-up. Repeated measures ANOVA revealed statistically and clinically significant reductions in depression in the intervention group, with results maintained at one-month follow-up. Loneliness levels also significantly decreased post-intervention; however, this benefit was not maintained at one-month follow-up. Social support slightly increased both post-intervention and 1-month follow-up—but these changes were not statistically significant. There were no overall changes for the wait-list control group. Our intervention provided promising evidence regarding the effectiveness of an online group intervention to alleviate mental health effects and to promote the coping of older adults during the COVID-19 pandemic. This relatively simple model can be effectively utilized by communities globally to help connect lonely and isolated older inhabitants, both during the pandemic and in more routine times.

Digital technology use and depressive symptoms among older adults in Korea: beneficial for those who have fewer social interactions?

OBJECTIVES

Our study examines the relationship between digital technology use and depressive symptoms among older Koreans and whether social interaction moderates the relationship.

METHODS

The data were drawn from the 2017 Survey of Living Conditions and Welfare Needs of Korean Older Persons, a nationally representative survey. Digital technology use was measured by the number of digital functions that respondents perform with their electronic devices. Social interactions were measured by the frequencies of face-to-face and remote connections with friends or neighbors. Relationships were estimated with multiple regression analyses.

RESULTS

Digital technology use was inversely associated with depressive symptoms even after adjusting for covariates including cognitive function. Both remote and face-to-face connections with friends or neighbors were associated with fewer depressive symptoms. An interaction between digital technology use and remote contact also was detected: the effect of digital technology use on depressive symptoms was more beneficial for older adults with infrequent remote contact with friends or neighbors than for those with frequent remote contact.

CONCLUSION

Findings suggest that digital technology use can reduce depressive symptoms of older adults, especially those who have fewer social interactions. Educating older adults to increase their digital literacy level and use of remote interactions may improve their psychological wellbeing, perhaps even during times of a viral pandemic.

Video-Based Communication and Its Association with Loneliness, Mental Health and Quality of Life among Older People during the COVID-19 Outbreak

The aim of the study was to examine the use of video-based communication and its association with loneliness, mental health and quality of life in older adults (60-69 years versus 70+ years) during the COVID-19 pandemic. A cross-sectional online survey was conducted in Norway, UK, USA and Australia during April/May 2020, and 836 participants in the relevant age groups were included in the analysis. Multiple regression analyses were conducted to examine associations between the use of video-based communication tools and loneliness, mental health and quality of life within age groups, while adjusting by sociodemographic variables. Video-based communication tools were found to be more often used among participants aged 60-69 years (60.1%), compared to participants aged 70 or above (51.8%, p < 0.05). Adjusting for all variables, the use of video-based communication was associated with less loneliness (β = -0.12, p < 0.01) and higher quality of life (β = 0.14, p < 0.01) among participants aged 60-69 years, while no associations were observed for participants in the oldest age group. The use of video-based communication tools was therefore associated with favorable psychological outcomes among participants in their sixties, but not among participants in the oldest age group. The study results support the notion that age may influence the association between the use of video-based communication tools and psychological outcomes amongst older people.

Non-use of information and communication technology as a predictor of frailty in postmenopausal midlife and older women

BACKGROUND

Frailty is a clinically discernible state in which decreased physiological reserve and function result in a reduced ability to cope with stressors. Information and communication technology (ICT) has been proposed as an aid to help with frailty, yet the use of ICT by older people, particularly women, is an understudied area.

AIM

To analyze the association between use of ICT (specifically internet functions and social media) and frailty status in postmenopausal midlife and elderly women.

METHODS

A cross-sectional study was designed to investigate whether frailty status is related to ICT use in postmenopausal midlife and older women. Community-dwelling women attending primary health care centers for health checks were invited to participate in the study. Postmenopausal status was the only inclusion criterion, whereas limitations that could interfere with use of ICT were exclusion criteria. The Fried phenotype was used to assess frailty. Four types of ICT use were examined: the internet for e-mail, the internet for other functions, and social media (WhatsApp or Facebook). Chi-square test and multivariate multinomial regression analysis were used to examine the association between frailty status and ICT use.

RESULTS

We included 409 women (age = 67.45 ± 7.81 years, mean ± SD), who were frail (n = 135, 33.01%), pre-frail (n = 159, 38.87%), or robust (n  =  115, 28.11%). Frailty status was significantly and inversely associated with any ICT use, showing a strong association with use of WhatsApp (P < 0.001) and internet searches (P < 0.001). ICT non-use was a predictor of frailty, while ICT users were more likely to be robust (OR 10.62; 95% [CI], 5.34-21.10) or pre-frail (OR 9.03; [CI], 95% 5.18-15.74).

CONCLUSION

Postmenopausal midlife and older women not using ICT were more likely to be frail.

The Differential Effects of Social Media on Depressive Symptoms and Suicidal Ideation Among the Younger and Older Adult Population in Hong Kong During the COVID-19 Pandemic: Population-Based Cross-sectional Survey Study

BACKGROUND

Social media has become a ubiquitous part of daily life during the COVID-19 pandemic isolation. However, the role of social media use in depression and suicidal ideation of the general public remains unclear. Related empirical studies were limited and reported inconsistent findings. Little is known about the potential underlying mechanisms that may illustrate the relationship between social media use and depression and suicidal ideation during the COVID-19 pandemic.

OBJECTIVE

This study tested the mediation effects of social loneliness and posttraumatic stress disorder (PTSD) symptoms on the relationship between social media use and depressive symptoms and suicidal ideation, as well as the moderation effect of age on the mediation models.

METHODS

We administered a population-based random telephone survey in May and June 2020, when infection control measures were being vigorously implemented in Hong Kong. A total of 1070 adults (658 social media users and 412 nonusers) completed the survey. Structural equation modeling (SEM) and multigroup SEM were conducted to test the mediation and moderation effects.

RESULTS

The weighted prevalence of probable depression was 11.6%; 1.6% had suicidal ideation in the past 2 weeks. Both moderated mediation models of depressive symptoms (χ²₆₂=335.3; P<.05; comparative fit index [CFI]=0.94; nonnormed fit index [NNFI]=0.92; root mean square error of approximation [RMSEA]=0.06) and suicidal ideation (χ²₃₄=50.8; P<.05; CFI=0.99; NNFI=0.99; RMSEA=0.02) showed acceptable model fit. There was a significantly negative direct effect of social media use on depressive symptoms among older people (β=-.07; P=.04) but not among younger people (β=.04; P=.55). The indirect effect via PTSD symptoms was significantly positive among both younger people (β=.09; P=.02) and older people (β=.10; P=.01). The indirect effect via social loneliness was significant among older people (β=-.01; P=.04) but not among younger people (β=.01; P=.31). The direct effect of social media use on suicidal ideation was not statistically significant in either age group (P>.05). The indirect effects via PTSD symptoms were statistically significant among younger people (β=.02; P=.04) and older people (β=.03; P=.01). Social loneliness was not a significant mediator between social media use and suicidal ideation among either age group (P>.05).

CONCLUSIONS

Social media may be a "double-edged sword" for psychosocial well-being during the COVID-19 pandemic, and its roles vary across age groups. The mediators identified in this study can be addressed by psychological interventions to prevent severe mental health problems during and after the COVID-19 pandemic.

Older Adults' Experiences With Using Technology for Socialization During the COVID-19 Pandemic: Cross-sectional Survey Study

BACKGROUND

Technology use has become the most critical approach to maintaining social connectedness during the COVID-19 pandemic. Older adults (aged >65 years) are perceived as the most physiologically susceptible population to developing COVID-19 and are at risk of secondary mental health challenges related to the social isolation that has been imposed by virus containment strategies. To mitigate concerns regarding sampling bias, we analyzed a random sample of older adults to understand the uptake and acceptance of technologies that support socialization during the pandemic.

OBJECTIVE

We aimed to conduct a population-based assessment of the barriers and facilitators to engaging in the use of technology for web-based socialization among older adults in the Canadian province of British Columbia during the COVID-19 pandemic.

METHODS

We conducted a cross-sectional, population-based, regionally representative survey by using the random-digit dialing method to reach participants aged >65 years who live in British Columbia. Data were analyzed using SPSS (IBM Corporation), and open-text responses were analyzed via thematic analysis.

RESULTS

Respondents included 400 older adults aged an average of 72 years, and 63.7% (n=255) of respondents were female. Most respondents (n=358, 89.5%) were aware of how to use technology to connect with others, and slightly more than half of the respondents (n=224, 56%) reported that, since the beginning of the pandemic, they used technology differently to connect with others during the pandemic. Additionally, 55.9% (n=223) of respondents reported that they adopted new technology since the beginning of the pandemic. Older adults reported the following key barriers to using technology: (1) a lack of access (including finance-, knowledge-, and age-related issues); (2) a lack of interest (including a preference for telephones and a general lack of interest in computers); and (3) physical barriers (resultant of cognitive impairments, stroke, and arthritis). Older adults also reported the following facilitators: (1) a knowledge of technologies (from self-teaching or external courses); (2) reliance on others (family, friends, and general internet searches); (3) technology accessibility (including appropriate environments, user-friendly technology, and clear instructions); and (4) social motivation (everyone else is doing it).

CONCLUSIONS

Much data on older adults' use of technology are limited by sampling biases, but this study, which used a random sampling method, demonstrated that older adults used technology to mitigate social isolation during the pandemic. Web-based socialization is the most promising method for mitigating potential mental health effects that are related to virus containment strategies. Providing telephone training; creating task lists; and implementing the facilitators described by participants, such as facilitated socialization activities, are important strategies for addressing barriers, and these strategies can be implemented during and beyond the pandemic to bolster the mental health needs of older adults.

Does digital technology reduce health disparity? Investigating difference of depression stemming from socioeconomic status among Chinese older adults

Background

Prior studies on health disparity have shown that socioeconomic status is critical to inequality of health outcomes such as depression. However, two questions await further investigation: whether disparity in depression correlated with socioeconomic status will become larger when depression becomes severer, and whether digital technology will reduce the disparity in depression correlated with socioeconomic status. Our study aims to answer the above two questions.

Methods

By using the dataset from China Health and Retirement Longitudinal Study 2015, we use quantile regression models to examine the association between socioeconomic status and depression across different quantiles, and test the moderating effect of digital technology.

Results

Our study obtains four key findings. First, the negative effects of socioeconomic status on depression present an increasing trend at high quantiles. Second, Internet usage exacerbates the disparity in depression associated with education level on average, but reduces this disparity associated with education level at high quantiles. Third, Internet usage reduces the disparity in depression associated with income on average and at high quantiles. Fourth, mobile phone ownership has almost no moderating effect on the relationship between socioeconomic status and depression.

Conclusions

Our findings suggest the potential use of digital technology in reducing disparity in depression correlated with socioeconomic status among middle-aged and aged individuals in developing countries.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-021-02175-0.

Impact of the Mass Media on Adherence to the Mediterranean Diet, Psychological Well-Being and Physical Activity. Structural Equation Analysis

BACKGROUND

The influence of mass media on emotions, subjective well-being and behaviours in society should be clearly understood. Physical-health education has an important role to play as a preventive tool. The aim of this study was to develop an explanatory model regarding the relationships between mass media, psychological well-being, physical activity, Mediterranean diet and age and to compare the model with multi-group analysis according to gender.

METHODS

A descriptive, non-experimental, cross-sectional design was used, with 634 participants between 18 and 66 years old (M = 35.18 ± 9.68).

RESULTS

Structural equation modeling was found to be satisfactory for all parameters. Results show that mass media have a significant direct influence on well-being, with negative effects on physical activity and adherence to a Mediterranean diet. The model fitted better for males in terms of gender differences, showing a better fit of psychological well-being being associated with higher levels of physical activity and better adherence to the Mediterranean diet. Among women, no relationships were found between mass media pressure and psychological well-being and healthy physical habits, but higher personal satisfaction was associated with better physical activity and better dietary patterns.

CONCLUSIONS

Thus, the study approaches society to a perspective influenced by mass media and physical-health education, reporting and emphasizing the importance of healthy lifestyles.

A Double Burden of Exclusion? Digital and Social Exclusion of Older Adults in Times of COVID-19

The COVID-19 pandemic has excluded older adults from a society based on physical social contact. Vulnerable populations like older adults also tend to be excluded from digital services because they opt not to use the internet, lack necessary devices and network connectivity, or inexperience using the technology. Older adults who are frail and are not online, many of whom are in long-term care facilities, struggle with the double burden of social and digital exclusion. This paper discusses the potential outcomes of this exclusion and provides recommendations for rectifying the situation, with a particular focus on older adults in long-term care facilities.

More Active Participation in Voluntary Exercise of Older Users of Information and Communicative Technology even during the COVID-19 Pandemic, Independent of Frailty Status

OBJECTIVES

The aim of this study was to examine whether older users of information and communicative technology (ICT) participate in active behaviors, such as voluntary exercise, to maintain health, even under community containment to suppress the coronavirus disease 2019 (COVID-19) pandemic.

DESIGN

Cross-sectional study.

SETTING

Community setting.

PARTICIPANTS

Independent community-dwelling older residents aged ≥75 years.

MEASUREMENTS

The municipality sent the Kihon Checklist (KCL) and Simplified Nutritional Appetite Questionnaire (SNAQ) with several questions on lifestyle and health conditions under social restriction.

RESULTS

Among 3199 responders (72.1%), we analyzed the data of 2304 residents who provided complete answers to the KCL and SNAQ and on ICT use, voluntary exercise, polypharmacy, and families. The mean age was 79.7 years (51.3% male). The percentages of frailty assessed by the KCL, voluntary exercise, and low SNAQ scores (≤14) were 16.0%, 61.4%, and 43.8% in 808 ICT users and 30.3%, 47.2%, and 54.1% in 1496 ICT non-users, respectively (p<0.001). ICT use was significantly associated with voluntary exercise even during social restriction, independent of age, sex, polypharmacy, low SNAQ scores, and frailty status (odds ratio, 1.503; 95% confidential interval, 1.246-1.813).

CONCLUSION

Older ICT users are more active to maintain health even during social restriction, independent of frailty status.

Using virtual care interventions to provide person-centred care to hospitalised older people with dementia

BACKGROUND

Being in an unfamiliar environment away from family can exacerbate emotional stress in hospitalised older people with dementia. Technology solutions can be used to address their mental and emotional health needs.

AIM

To generate greater understanding of technology adoption and to test strategies supporting virtual care interventions in hospitalised older people with dementia, such as the use of an iPad to connect them with their family members.

METHOD

Older people with dementia in two Canadian hospitals were observed and interviewed to explore their experiences of using an iPad. Focus groups were conducted with staff and interviews were undertaken with two frontline nurses and three research partners with lived experience of dementia in hospitalised older people. Data were thematically analysed in collaboration with 12 stakeholders. Strategies to overcome the barriers identified were tested as part of the study.

FINDINGS

There were three main barriers to implementing virtual care interventions: lack of familiarity with the technology; difficulties with operating the device; and privacy and connectivity issues. Strategies to overcome these barriers included providing personalised support, working with users to support adaptation, and ensuring privacy and optimal connectivity.

CONCLUSION

Using an iPad has the potential to enable hospitalised older people with dementia to connect with their family members and take part in activities that support person-centred care. This is particularly important in times, such as the COVID-19 pandemic, when restrictions to hospital visits lead to social isolation.

Chinese Middle-Aged and Older Adults' Internet Use and Happiness: The Mediating Roles of Loneliness and Social Engagement

Little research has examined the effects of internet use in promoting well-being among middle-aged and older people using large-scale samples in developing countries. Using a subsample of a national survey with 4,083 adults aged 50 years and above, we explored this topic in China. Internet users were found to be significantly younger, more educated, with a higher SES, and more likely to live in urban areas. Structural equation modeling showed that internet use was indirectly associated with higher levels of happiness, and this association was mediated by less loneliness and more volunteering. In the multi-group analysis, age, gender, and household registration (urban vs. rural) moderated path coefficients but did not impact the general pattern. This study suggests promising benefits of internet use for Chinese middle-aged and older adults. In addition, the digital divide between our urban and rural subsamples calls for interventions to promote internet use in rural areas.

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

Background

Information and communication technology (ICT) provides older adults with access to information and resources that benefit their health.

Purpose

To explore ICT use among older adults and examine the influence of information technology (IT), communication technology (CT), or ICT use on older adults' self-rated health status and depressive symptoms.

Method

A sample of community-dwelling Medicare beneficiaries aged 65 and older in the United States (N = 4,976) from the 2011 National Health and Aging Trends Study.

Findings

Older adults who embraced ICT and used this technology for a variety of purposes were more likely to report better health status, and were less likely to experience major depressive symptoms than nonusers.

Discussion

In accordance with the Health Information Technology for Economic and Clinical Health Act, nursing professional can play an important role by responding to older adults' diverse technology preferences and effectively incorporating them into nursing practice.

Internet and Health Information Technology Use and Psychological Distress Among Older Adults With Self-Reported Vision Impairment: Case-Control Study

BACKGROUND

The number of older adults with vision impairment (VI) is growing. As health care services increasingly call for patients to use technology, it is important to examine internet/health information technology (HIT) use among older adults with VI.

OBJECTIVE

This study aimed to examine (1) the rates of internet/HIT use among older adults with VI compared with a matched sample of their peers without VI, (2) associations of VI with internet/HIT use, and (3) association of HIT use with psychological distress, assessed with the Kessler-6 screen.

METHODS

Data were obtained from the 2013 to 2018 US National Health Interview Survey. Older adults (aged ≥65 years) with self-reported VI were matched with older adults without VI, in a 1:1 ratio, based on age, sex, number of chronic medical conditions, and functional limitations (N=2866). Descriptive statistics and multivariable logistic regression models, with sociodemographic factors, health conditions, health insurance type, and health care service use as covariates, were used to examine the research questions.

RESULTS

In total, 3.28% of older adults (compared with 0.84% of those aged 18-64 years) reported VI, and 25.7% of them were aged ≥85 years. Those with VI were significantly more socioeconomically disadvantaged than those without VI and less likely to use the internet (adjusted odds ratio [aOR] 0.64, 95% CI0.49-0.83) and HIT (aOR 0.74, 95% CI 0.56-0.97). However, among internet users, VI was not associated with HIT use. HIT use was associated with lower odds of mild/moderate or serious psychological distress (aOR 0.62, 95% CI 0.43-0.90), whereas VI was associated with greater odds of mild/moderate or serious distress (aOR 1.84, 95% CI 1.36-2.49). Health care provider contacts were also associated with higher odds of internet or HIT use.

CONCLUSIONS

Compared with their matched age peers without VI, older adults with VI are less likely to use HIT because they are less likely to use the internet. Socioeconomically disadvantaged older adults experiencing a digital divide need help to access information and communication technologies through a fee waiver or subsidy to cover internet equipment and subscription and ensure continuous connectivity. Older adults with VI who do not know how to use the internet/HIT but want to learn should be provided instruction, with special attention to accessibility features and adaptive devices. Older adults with a low income also need better access to preventive eye care and treatment of VI as well as other health care services.

Depression, everyday technology use and life satisfaction in older adults with cognitive impairments: a cross-sectional exploratory study

RATIONAL

Life satisfaction is strongly associated with participation in everyday life activities. Yet, older adults with cognitive impairments have been found to experience difficulties in accessing and engaging in more complex everyday activities, especially, if these involve everyday technology. Considering the rapidly advancing technological landscape, this may substantially affect individuals' life satisfaction and their participation in meaningful community-based and home-based activities.

OBJECTIVES

This study aimed to explore the associations between life satisfaction, ability to use everyday technology and number of relevant everyday technologies used in older adults (n = 117) with and without mild cognitive impairment (MCI) and Alzheimer's disease (AD). It also aimed to understand the role of depression, activity involvement and diagnosis regarding life satisfaction in this sample.

METHOD

Descriptive statistics, Mann-Whitney U tests and t-tests were applied to compare those satisfied and those dissatisfied with life regarding ability to use everyday technology and number of relevant everyday technologies used.

FINDINGS

The number of relevant community-based everyday technologies currently not used was significantly associated with being dissatisfied with life (p < 0.05). Further, depression and withdrawal from activities and interests significantly differed across life satisfaction groups, while no group differences were found regarding overall number of everyday technologies in use and ability to use everyday technology.

CONCLUSION

Attention from healthcare professionals and researchers to early withdrawal from activities that rely on community-based everyday technologies is called for, especially in older adults with depression. Preventing everyday technology-related barriers in community life may increase life satisfaction.