Exploring the Relationship Between Internet Use and Mental Health Among Older Adults in England: Longitudinal Observational Study

The Development of the Smartphone Proficiency Questionnaire for Chinese Older Adults (SPQ-COA)

While mobile technology is rapidly evolving, it remains a challenge for some older adults to use smartphones worldwide. To address this issue through tailored skill training and product design, this study developed a questionnaire to assess the smartphone proficiency of older adults. The Smartphone Proficiency Questionnaire for Chinese Older Adults (SPQ-COA) assessed proficiency based on 30 up-to-date tasks (e.g., mobile payment), that covered common operations in daily life of Chinese older adults. The questionnaire was distributed to 452 older adults (age ≥60), as well as 100 young adults (age: 18-30) as a control group. The questionnaire performed well in terms of reliability, difficulty, and discrimination. Among older adults, higher scores were associated with lower age, longer daily use duration, more years of use, higher monthly income, and higher education level, further validating the questionnaire. Overall, the SPQ-COA is a valid tool for evaluating Chinese older adults' smartphone usage skills.

Improving health and reducing health inequality: An innovation of digitalization?

RATIONALE

The association between digitalization and individual health has attracted increasing attention from both scholars and policymakers. Existing research, however, has not agreed on whether digitization can improve health or reduce health inequality.

OBJECTIVE

The purpose of this study is to clarify whether and how the development of digitalization may be related to health and health disparities.

METHODS

We rely on China Family Panel Studies (CFPS) surveys from 2012 to 2018 to obtain a sample of 82,471 observations to explore the impact of digitalization on self-rated health and health inequality and its transmission mechanisms. The hypotheses are tested by Ordinary Least Squares Modeling.

RESULTS

As expected, digitalization is significantly and positively correlated with self-rated health. Furthermore, the development of digitalization has led to a notable decrease in health inequality. The influencing mechanisms of digitalization include income, healthcare consumption and health behaviors. Both dimensions of digitalization-internet development and digital finance-generate significant effects and the effects of internet development are greater.

CONCLUSIONS

This study is the first to systematically investigate the impact of digitalization development on health and health inequality. Our findings provide evidence for the health promotion theory by clarifying the benefits of digitalization in improving residents' health and reducing health inequality. Therefore, utilizing the tools of digitalization efficiently could be a focus of policymakers aiming to accomplish the SDGs' health targets.

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

Background and Objectives

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

Research Design and Methods

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

Results

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

Discussion and Implications

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

Clinical Trials Registration #

NCT03116399.

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

BACKGROUND

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

METHODS

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

RESULTS

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

LIMITATIONS

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

CONCLUSIONS

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

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

Objectives

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

Methods

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

Results

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

Conclusion

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

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.

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.

Longitudinal association between frequency of Internet use and incident disability among community-dwelling older people during the COVID-19 pandemic

BACKGROUND

There is limited evidence of a protective effect of Internet use for incident disability (ID) during the COVID-19 pandemic. We investigated the association between frequency of Internet use (FIU) and ID among community-dwelling older people.

METHODS

We used longitudinal data from the 2019 and 2022 surveys, including 7,913 residents aged ≥65 without disability at baseline. ID was defined as a new public long-term care insurance certification. FIU at baseline was categorized into daily, weekly, monthly, yearly, and non-users. Changes in FIU before and during the COVID-19 pandemic were categorized into continuing frequent (i.e., daily or weekly), continuing moderate (i.e., monthly or yearly), increase in frequency, from non-users to users, decrease in frequency, from users to non-users, and continuing non-users. Covariates included age, gender, education, perceived economic situation, family structure, body mass index, chronic medical conditions, dietary variety, working status, walking time, and cognitive functioning. Multivariable Poisson regression models were used to estimate adjusted cumulative incidence ratio (aCIR) and 95% confidence interval (CI) for ID.

RESULTS

During the 3-year follow-up, 132 of 4,453 people aged 65-74, 595 of 3,460 people aged ≥75, 287 of 3,660 men, and 440 of 4,253 women developed ID. For FIU at baseline, among people aged ≥75 or men, there was a dose-response relationship between more frequent Internet use at baseline and a lower risk of ID (P-trend was 0.005 in people aged ≥75, and <0.001 in men). Compared to non-users, daily users had a significantly lower risk of ID [aCIR (95% CI) = 0.69 (0.53-0.90) in people aged ≥75, and 0.49 (0.34-0.70) in men]. For changes in FIU, "continuing frequent" and "from non-users to users" had a lower risk of ID than continuing non-users. After stratified analyses, "continuing frequent" remained a significant association in people aged ≥75 or in men, while "from non-users to users" had a significant association in those with daily walking time <30 minutes.

CONCLUSIONS

Although FIU may act as a marker of disability, or indicate individual adaptability, our findings suggest that Internet use may be a potential preventive measure against ID in community-dwelling older people when social distancing is required.

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

BACKGROUND

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

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

BACKGROUND

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Screen-based and non-screen-based sedentary behaviors are differentially associated with affective states in older adults

Excessive sedentary behavior (SB) contributes to poor affective and physical feeling states, which is particularly concerning for older adults who are the most sedentary sector of the population. Specific types of SB have been shown to differentially impact health in cross-sectional and longitudinal studies, with screen-based SB more negatively impacting aspects of mental health. This study used Ecological Momentary Assessment (EMA), a real-time, intensive longitudinal data capture methodology, to examine the differential impact of screen-based behaviors on momentary affective responses during SB in naturalistic settings. A diverse sample of older adults (pooled across 2 studies) completed an EMA protocol for 8-10 days with six randomly delivered, smartphone assessments per day. At each EMA prompt, participants reported their current activity, whether they were sitting while doing that activity, and affective states. Multilevel models assessed whether screen-based (vs. non-screen-based) behavior moderated affective response during SB. At the within-person level, older adults experienced less positive affect during SB when engaged in a screen-based behavior compared to a non-screen-based SB (B = -0.10, p < 0.01). At the between-person level, positive associations between SB and negative affect (B = 0.79, p = 0.03) were stronger if participants reported engaging in screen-based behaviors for a greater proportion of prompts. Among older adults, screen-based SB may lead to poorer affective states compared to non-screen-based SB. Interventions aiming to reduce SB in this population should consider targeting reductions in screen-based SB as means to improve affective states.

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

Objective

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

Methods

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

Result

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

Conclusion

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

Changes in Internet use patterns among older adults in England from before to after the outbreak of the COVID-19 pandemic

The COVID-19 pandemic brought about an increased reliance on the Internet for various daily activities. Given the known digital divide, it is important to understand whether older adults changed their Internet use patterns, but current evidence is limited to cross-sectional studies. This study documents changes in frequency and types of Internet use among older adults from before to shortly after the outbreak of the COVID-19 pandemic (2018/2019 to June/July 2020), and the factors predicting regular use during these early days of the pandemic. Using data on 6,840 adults aged 50 + from the nationally representative English Longitudinal Study of Ageing, we apply longitudinal fixed-effects models to examine within-individual changes in Internet use behaviour. There was no change in the likelihood of daily Internet use between 2018/2019 and June/July 2020, despite the increased digitalisation of services over the pandemic. Daily use in June/July 2020 was negatively related to age, neighbourhood deprivation, and loneliness, and positively related to partnership status, education, employment, income, and organisation membership. Using the Internet for making calls and getting information about Government services increased, which was important given the social restrictions and overall uncertainty. However, Internet use for finding health-related information decreased. As the world moves towards digital alternatives post-pandemic, it is important to continually ensure older adults are not at risk of exclusion.

Video call and depression among older adults during the COVID-19 pandemic in Japan: The JAGES one-year longitudinal study

Evidence of video call on preventing late-life depression during the COVID-19 pandemic is limited. We examined the associations of social contact (in-person, voice call, and video call) with incidence of depressive symptoms and evaluated whether specific factors (particularly, age and change in the frequency of in-person contact) affect these associations. We used longitudinal data from the 2019 and 2020 waves of the Japan Gerontological Evaluation Study, including 10,523 participants aged ≥65 years in 10 municipalities. Depressive symptoms were measured by the 15-item Geriatric Depression Scale (GDS-15) score ≥5 in main analysis, and GDS-15 score ≥4, 10, or continuous variable in sensitivity analyses. Social contact represented frequency changes before and during the pandemic: non-contact (reference), decreased-contact, maintained-contact, and increased-contact. We employed modified Poisson regression analysis. Compared to non-contact of video call, the association of increased-contact of video call with depressive symptoms was insignificant in main analysis (GDS-15 ≥ 5: risk ratio (RR) = 0.89, 95% confidence interval (CI): 0.79-1.01), whereas significant in sensitivity analyses (GDS-15 ≥ 4: RR = 0.89, 95% CI: 0.82-0.98; GDS-15 ≥ 10: RR = 0.71, 95% CI: 0.53-0.97; GDS-15 = continuous variable: Β = -0.17, 95% CI: -0.33 to -0.002). In-person contact was significantly associated with lower incidence of depressive symptoms (non-contact: reference; maintained-contact: RR = 0.92, 95% CI: 0.85-0.99; increased-contact: RR = 0.84, 95% CI: 0.77-0.91), whereas voice call was not. Age and change in the frequency of in-person contact did not show significant effect modifications on the associations of video call with incidence of depressive symptoms after Bonferroni correction for multiple testing. In conclusion, this study suggests that the evidence supporting video call as a way to protect against depressive symptoms among older adults during the pandemic appears weak compared to the evidence for in-person contact.

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.

Static and Dynamic Impacts of Internet Use on Self-Rated Health among Adults in China: A Hybrid Model Analysis Based on National Panel Survey Data

The widespread use of the Internet has a substantial impact on people's livelihoods, including health-related factors. Whether this impact is beneficial or harmful to people's health remains unclear. Some cross-sectional studies found static differences in the health status between Internet users and nonusers, whereas panel data studies found dynamic changes in an individuals' health over time, making the issue, including its causality, controversial. Therefore, we aimed to clarify the association between the use of the Internet and people's health from both static and dynamic aspects. Data were obtained for 46,460 adults from the China Family Panel Studies in 2014, 2016, and 2018. The analysis applied a logistic regression hybrid model with self-rated health as the dependent variable and Internet use as the main independent variable. In the hybrid model, time-varying independent variables were decomposed into between-individual (static) differences and within-individual (dynamic) changes over time. The results indicated that the between-individual coefficient of Internet use was significantly positive, but the within-individual coefficient was not, i.e., Internet users felt healthier than nonusers from the static aspect but starting to use the Internet did not increase the self-rated health from the dynamic aspect. These findings suggest that attention is needed in order to not confuse the static differences with dynamic change regarding the causality between Internet use and self-rated health.

Conflict with children, psychological depression, and problematic internet use among Chinese older adults: The moderating effect of sociability and living situation

Introduction

Problematic internet use among the elderly is an emerging area as previous studies focused more among the young people. Only a few studies focused on problematic internet use at the level of individual characteristics of older adults or on mitigating factors at the level of the older adult's family, ignoring family-level disruptive factors.

Objective

The purpose of study is to investigate the relationship between conflict with children and problematic internet use among the elderly, as well as the mediating mechanisms and boundary conditions of the relationship.

Methods

The valid sample of study composed of 428 older adults from 39 different villages and communities in central China. Data analyses were conducted by SPSS, MPLUS, and SmartPLS software. To test our hypotheses, we implement several quantitative methods, including confirmatory factor analysis (CFA), correlations analysis, and ordinary least squares (OLS) regression. Also, we employed partial least square structural equation modeling (PLS-SEM) for robustness testing.

Results

The results indicated that conflict with children was positively associated with problematic internet use of old people; psychological depression mediated the relationship between conflict with children and old adults' problematic internet use; sociability moderated the effect of conflict with children on psychological depression; and living situation moderated the effect of psychological depression on problematic internet use among the elderly.

Conclusion

The current research improved the understanding of the mechanisms that produce problematic internet use among the elderly and helped prevent or reduce problematic internet use in older adults in terms of family support systems and individual ability characteristics.

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

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

Association between Internet Usage and Quality of Life of Elderly People in England: Evidence from the English Longitudinal Study of Ageing (ELSA)

The WHO has stated that the number of senior citizens above age 65 across the world will double by the year 2050: in the UK, the whole population is projected to grow by about 2.5% over a decade, from mid-2018. Although people are living longer, they are not healthier in old age, and there is an increasing number of illnesses and disabilities in the ageing population, which have an impact on their overall well-being and quality of life (QoL). Alongside these trends, Internet technologies have improved and provide a wide range of information, including on medical and health issues. This study aimed to examine the association between the utilisation of the internet among older people in England and their QoL. This study utilised the English Longitudinal Study of Aging (ELSA), a longitudinal study of a representative sample of people aged 50 and over in England. The data from Wave 9 were analysed using bivariate analysis and logistic regression. The results show a strong association between QoL and utilisation of the Internet in older people, even when adjusting for demographic variables and health. Higher use of the internet was associated with older people being less likely to have higher QoL. The excessive use of the internet for communication and gathering information also contributed to lower QoL. From the findings, poorer QoL was also found in people in older age groups, in those who are married, and those who never suffer from chronic diseases. Our findings suggest that the quality of life in older people might not only be associated with the frequency of usage but also the purpose for which the internet is used; however, this relationship is complex and further research should explore this in greater depth. Further research should also investigate how older people's use of the Internet changed during the COVID-19 pandemic and the effects of this on the QoL in older age.

Self-reported visual impairment and depression of middle-aged and older adults: The chain-mediating effects of internet use and social participation

Background

Visual impairment (VI) is a strong predictor of depression in middle-aged and older adults. However, the underlying mechanisms and pathways have not been well characterized. The purpose of this study was to determine whether Internet use and social participation mediate the effects of self-reported VI on depression.

Methods

The study used the fourth wave of cross-sectional data from the China Health and Retirement Longitudinal Study, including 19,766 Chinese adults. Depression was assessed according to the CES-D 10 International Scale. Logistic regression models were used to examine the relationship between self-reported VI and depression. While adjusting for relevant covariates, the PROCESS macro (model nos. 6 and 91) was used to assess the chain-mediating effects of Internet use and social participation.

Results

A total of 17,433 respondents were included in this study. The CES-D 10 results showed that 7,327 middle-aged and older adults had depressive symptoms, of whom 39.5% were male and 10.2% were ≥75 years old. 32.1% of respondents self-reported VI. Regression analysis showed a positive association between VI and depression, while Internet use and social participation had a negative predictive effect on depression. In the mediation analysis, the social participation pathway contributed the most to the total effect, accounting for 52.69% of it. The proportion of Internet use is 37.72%. When these two mediators were considered together in the full model, they accounted for 9.58% of the total effect of VI on depression.

Conclusion

Internet use and social participation were important mediators that mitigated the effects of VI on depression. Combined with previous evidence, online activities such as e-health and m-health can effectively promote disease monitoring and diagnosis, and various offline social participation activities can also play a role in regulating emotions. Therefore, Internet use and social participation factors may serve as relevant entry points for the development of intervention programs that may further improve the mental health of the visually impaired.

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

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

How does the Internet enhance the subjective well-being of elderly individuals in China?

Although several studies have explored the relationship between the Internet and elderly individuals, little is known about whether and how the Internet affects elderly individuals’ subjective well-being (SWB) from multiple perspectives. This study examines the effects of the Internet on physical satisfaction and life satisfaction and explores the potential mechanisms by which the Internet produces its effects on elderly individuals. Using nationally representative data from the China General Social Survey (CGSS), this study finds that the Internet has a significant positive impact on physical satisfaction and life satisfaction of the elderly in China. The mechanism analysis shows that the Internet can improve the level of health insurance participation, which we interpret as potential mechanisms through which the Internet positively affects physical satisfaction among elderly individuals. Correspondingly, the Internet affects life satisfaction of elderly individuals by influencing social networks. Further heterogeneity tests find that the effect is stronger for urban areas, male and high human capital samples. This study highlights the important micro effects of the Internet and provides a reference for exploring the mechanism of the Internet affecting SWB.

The effect of Internet access on body weight: Evidence from China

The Internet has significantly changed people's daily lives, including their health status. In this paper, we study the health implications of Internet access with a specific focus on body weight. We exploit an Internet speed upgrading project in China and conduct a difference-in-differences analysis, where the treatment intensity depends on cities' pre-existing Internet infrastructure conditions. We find consistent and robust evidence that increased Internet access reduces the incidence of being overweight. Regarding the mechanisms behind this result, we provide indirect evidence for the information channel, evidenced by improved health behaviors after the project: less engagement in risky health behaviors and increased participation in preventive health services and exercise. Internet diffusion also increases income, supporting the income channel through which the Internet can affect body weight.

The relationship between real-life social support and Internet addiction among the elderly in China

Internet addiction among the elderly is a novel issue in many countries. However, extant research about excessive use of the Internet is focusing on adolescents and younger adults. There are few studies to explore the topic of the elderly's Internet addiction. The purpose of this study is to investigate the relationship between real-life social support and Internet addiction among older adults during the COVID-19 pandemic. This article adopted a self-reported questionnaire via internet links to collect data. A total of 303 valid samples about Internet addiction for the elderly were obtained in China. The results suggested that real-life social support is significantly and negatively related to Internet addiction among the aged. Moreover, the findings revealed that real-life social support could mitigate Internet addiction by increasing the levels of hopefulness and decreasing the feeling of loneliness. We expect that this study can enrich the understanding of the problematic Internet usage within older populations. Finally, the contributions, practical significance, and limitations of this study were discussed.

The impact of interaction with children on internet addiction in older adults: A moderated mediation model

Internet addiction among older adults is a new problem in many countries. However, previous studies on excessive Internet use have focused more on young people, and only few studies have focused on Internet addiction in older adults. There is a need to continue to expand research on Internet addiction in older adults. This paper aimed to fill the gap in exiting literature. We adopted a self-reported questionnaire to assess the elderly’s interaction with children, loneliness, life satisfaction and Internet addiction among old adults. A total of 241 old people were obtained from data collection in China via online survey with the help of a professional research company. We used OLS regression analysis and bootstrap method to test the hypothesis. The results of the empirical analysis indicated that (1) interaction with children was significantly negatively associated with the Internet addiction of old people; (2) loneliness mediated the relationship between interaction with children and old adults’ Internet addiction; and (3) life satisfaction moderated the effect of interaction with children, and the indirect effect between interaction with children and old adults’ addiction via loneliness was stronger for those with low life satisfaction. Finally, we discussed the theoretical significance, practical implications, limitation of this research. Interventions to improve family function systems especially for older people with low life satisfaction can help prevent the development of Internet addiction.

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

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

For Better or for Worse? A Scoping Review of the Relationship between Internet Use and Mental Health in Older Adults during the COVID-19 Pandemic

Older adults were advised to avoid social activities during the outbreak of COVID-19. Consequently, they no longer received the social and emotional support they had gained from such activities. Internet use might be a solution to remedy the situation. Therefore, this scoping review sought to map the literature on Internet use and mental health in the older population during the pandemic to examine the extent and nature of the research. A scoping review was conducted using eight databases—PubMed, Scopus, Ebscohost Medline, Ebscohost Academic Search, Ebscohost CINAHL Plus, Ebscohost Cochrane, Ebscohost Psychology and Behavioural Sciences Collection, and Ebscohost SPORTDiscus, according to PRISMA guidelines. Two pre-tested templates (quantitative and qualitative studies) were developed to extract data and perform descriptive analysis and thematic summary. A total of ten articles met the eligibility criteria. Seven out of ten studies were quantitative, while the remainder were qualitative. Five common themes were identified from all the included studies. Our review revealed that Internet use for communication purposes seems to be associated with better mental health in older adults during the COVID-19 pandemic. Directions for future research and limitations of review are also discussed.

Predictors, types of Internet use, and the psychological well-being of older adults: A comprehensive model

OBJECTIVES

This study aims to evaluate a comprehensive model that includes predictors of use, types of internet use, and psychological well-being outcomes in the older population.

METHODS

The total sample comprised 650 older Internet users. Structural equation modeling was used to estimate the effect of predictors (i.e., effort expectancy, performance expectancy, social influence, and ageism) on types of Internet use (i.e., information seeking, communication, instrumental use, and leisure) and the impact of the type of use on the psychological well-being of older adults (i.e., depressive and anxious symptomatology). In addition, the indirect effect of different types of Internet use was evaluated, that is, they were considered as mediator variables.

RESULTS

Effort expectancy, social influence, and ageism predicted different types of Internet use. The relationship between effort expectancy and anxious symptomatology had an indirect effect via information seeking, whereas the relationship between ageism and anxious symptomatology showed an indirect effect via leisure.

DISCUSSION

The findings support the importance of differentiating the types of Internet use to understand its impact on psychological well-being. Information seeking is associated with anxious symptomatology and is predicted by effort expectancy. On the contrary, leisure is crucial because of its relationship with anxious symptomatology, and less ageism can promote it. This information is useful for developing effective interventions that promote the well-being of older adults through the Internet, including strategies to cope with some online challenges that could lead to negative consequences, such as overload information.

Latent Profile Analysis to Survey Positive Mental Health and Well-Being: A Pilot Investigation Insight Tunisian Facebook Users

BACKGROUND

To examine mental health during COVID-19 peaks, lockdown, and times of curfew, many studies have used the LPA/LCA person-centered approach to uncover and explore unobserved groups. However, the majority of research has focused only on negative psychological concepts to explain mental health. In this paper, we take another perspective to explore mental health. In addition, the study focuses on a period of peak decline in the COVID-19 pandemic.

OBJECTIVE

The present paper aim (a) empirically identifies different profiles among a cohort of Facebook users in Tunisia based on positive factors of mental health using a person-centered approach, (b) outline identified profiles across sociodemographic, internet use, and physical activity, and (c) establish predictors of these profiles.

METHODS

Cross-sectional data were collected through an online survey among 950 Facebook users were female (n = 499; 52.53%) and male (n = 451; 47.47) with an average age =31.30 ± 9.42. Subjects filled Arabic version of Satisfaction with Life Scale, Scale of Happiness (SWLS), Gratitude Questionnaire (GQ-6), International Physical Activity Questionnaire (IPAQ), and the Spirituel Well-Being Scale (SWBS).

RESULTS

The LPA results revealed three clusters. The first cluster (n = 489, 51,47%) contains individuals who have low scores on the positive psychology scales. The second cluster (n = 357, 37,58%) contained individuals with moderate positive psychology scores. However, a third cluster (n = 104, 10,95%) had high positive psychology scores. The selected variables in the model were put to a comparison test to ensure that the classification solution was adequate. Subsequently, the clusters were compared for the variables of socio-demographics, use of the internet for entertainment and physical activity, the results showed significant differences for gender (low mental well-being for the female gender), socio-economic level (low for the low-income class), and physical activity (low mental well-being for the non-exerciser). However, no significant differences were found for the variables age, location, and use of the Internet for entertainment.

CONCLUSION

Our results complement person-centered studies (LPA/LCA) related to the COVID-19 pandemic and can serve researchers and mental health practitioners in both diagnostic and intervention phases for the public. In addition, the GQ6 scale is a valid and reliable tool that can be administered to measure gratitude for culturally similar populations.

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

Background

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

Methods

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

Results

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

Conclusions

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

More Frequent Internet Use during the COVID-19 Pandemic Associates with Enhanced Quality of Life and Lower Depression Scores in Middle-Aged and Older Adults

Concerns have been raised regarding middle-aged and older adults' mental health during the coronavirus outbreak. The aim of the current study was to characterise associations between internet use (frequency and purpose), depression symptoms and Quality of Life (QoL) during the pandemic, in individuals aged 55-75. Data (N = 3491) were drawn from the English longitudinal study of ageing (ELSA) cohort study collected in June/July 2020 (while social distancing measures were in place). Associations with frequency of use were tested using analysis of covariance (ANCOVAS), controlling for covariates such as wealth and education. Type of internet use (for communication, information search) was also analysed amongst frequent users. Significant effects of frequency of use were observed (p = 0.01 for depression, p < 0.001 for QoL), with lower depression symptoms and higher QoL scores amongst more frequent users. Regarding purpose of use, those who reported using the internet for communication purposes had higher QoL. However, use for health-related or Government services information searching was associated with more depression symptoms. Results provide important information regarding the potential benefits of internet use for middle-aged and older people, suggesting that strategies to increase internet usage (particularly for communication) might benefit middle-aged and older adults' mental health and counter isolation as the coronavirus crisis continues to evolve.

To What Extent is Internet Activity Predictive of Psychological Well-Being?

Background

Healthy internet activity (eg, making use of eHealth and online therapy) is positively associated with well-being. However, unhealthy internet activity (too much online time, problematic internet use/PIU, internet dependency/ID, etc.) is associated with reduced well-being, loneliness, and other related negative aspects. While most of the evidence is correlational, some research also shows that internet activity can be predictive for well-being.

Objective

The aim of this article is to elaborate on the question as to what extent internet activity is predictive of psychological well-being by means of (a) a scoping review and (b) theoretical understanding which model the interrelation of internet activity and psychological well-being.

Methodology

We searched different electronic databases such as Web of Science by using the search terms "Internet" OR "App" OR "digital" OR "online" OR "mobile application" AND "Use" OR "Activity" OR "Behavior" OR "Engagement" AND "Well-being" OR "Loneliness" for (a, the scoping review) or CCAM for (b, the theoretical understanding).

Results

The scoping review (a) summarizes recent findings: the extent to which internet activity is predictive for well-being depends on the internet activity itself: internet activity facilitating self-management is beneficial for well-being but too much internet activity, PIU and ID are detrimental to well-being. To understand (b) why, when and how internet activity is predictive for well-being, theoretical understanding and a model are required. While theories on either well-being or internet activity exist, not many theories take both aspects into account while also considering other behaviors. One such theory is the Compensatory Carry-Over Action Model (CCAM) which describes mechanisms on how internet use is related to other lifestyle behaviors and well-being, and that individuals are driven by the goal to adopt and maintain well-being - also called higher-level goals - in the CCAM. There are few studies testing the CCAM or selected aspects of it which include internet activity and well-being. Results demonstrate the potentials of such a multifactorial, sophisticated approach: it can help to improve health promotion in times of demographic change and in situations of lacking personnel resources in health care systems.

Conclusion and Recommendation

Suggestions for future research are to employ theoretical approaches like the CCAM and testing intervention effects, as well as supporting individuals in different settings. The main aim should be to perform healthy internet activities to support well-being, and to prevent unhealthy internet activity. Behavior management and learning should accordingly aim at preventing problematic internet use and internet dependency.

Adequacy of Web-Based Activities as a Substitute for In-Person Activities for Older Persons During the COVID-19 Pandemic: Survey Study

BACKGROUND

Senior centers and other types of clubs provide activities for older adults to address boredom, social isolation, and loneliness. Due to the COVID-19 pandemic, most of these activities have been cancelled. A limited range of web-based activities have been offered as alternatives. However, the effectiveness of these web-based group activities for older adults has scarcely been researched.

OBJECTIVE

We aimed to understand the extent to which web-based activities for older adults provide an adequate substitute for in-person activities.

METHODS

In this telephone survey, we interviewed 105 older adults in Israel who had been offered the opportunity to participate in web-based activities after routine activities closed due to the COVID-19 pandemic. Of the total sample, 49/105 (46.7%) participated in the activities and 56/105 (53.3%) did not. We inquired about the respondents' background characteristics, satisfaction with the activities, and reasons for participation or nonparticipation.

RESULTS

The respondents who participated in the web-based activities tended to be highly satisfied with at least some of them. They rated the enjoyment derived from the content of the activity as the most important motivator, followed by maintaining a routine and by enjoying the group and the presence of others. Over 50% of the participants (28/49, 57%) wished to continue with the exercise programming after the end of the COVID-19 pandemic, and 41% (20/49) wished to continue with the web-based lectures. Participants were more likely to report partaking in alternative activities than nonparticipants (P=.04). The most common reasons cited by nonparticipants were being unaware of the web-based program (24/56, 43%) despite a notification having been sent to the entire sample, lack of interest in the content (18/56, 32%), and technical issues (13/56, 23%), such as not owning or being able to fully use a computer. Both participants and nonparticipants were interested in a wide range of topics, with many being very particular about the topics they wished to access. Approximately half expressed willingness to pay for access; those who were willing to pay tended to have more years of education (P=.03).

CONCLUSIONS

Our findings suggest a need for web-based activities for countering boredom and feelings of isolation. The main factors that influence the use, efficacy, and sustainability of online activities are access, motivational and need-fulfilling factors, and whether the activities are sufficiently tailored to individuals' preferences and abilities. Challenges in substituting in-person services are promoting social relationships that are currently not sufficiently incorporated into most web-based programs, accommodating a wider range of topics, and increasing the accessibility of current programs to older adults, especially those who are homebound, both during and after the COVID-19 pandemic.

Impact of Internet Use on Elderly Health: Empirical Study Based on Chinese General Social Survey (CGSS) Data

In the current era, the rapid spread of Internet technology has combined with various traditional industries; this provides new research perspectives and solutions for current problems, such as those in the elderly care industry. Elderly health is an important social problem in various countries, and governments have turned to the internet for new methods and better solutions. However, internet-use behavior has a certain influence on the elderly’s health status. This study investigates the effects of internet use on the elderly’s physical health, mental health, and self-rated health, along with the moderating role of individual cognitive ability in the above relationship. This study uses data from the Chinese General Social Survey (CGSS) in 2012 and 2015 as samples for analysis via the hierarchical regression method. The sample is from China and had 2821 and 3185 valid respondents in 2012 and 2015, respectively. Results show that internet use significantly affects the physical and mental health of the elderly and does not significantly affect self-rated health. In addition, individual cognitive ability plays a negative moderating role between internet use and physical and mental health. Finally, on the basis of results analysis and discussion, this study provides new recommendations to achieve targeted health improvements.