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

Association between Internet use and depressive symptoms among older adults in two regions of Myanmar: a cross-sectional study

BACKGROUND

Internet use has both positive and negative effects on mental health. However, few studies have examined the association between internet use and mental health among older adults in developing countries. This study aimed to investigate the association between Internet use and depressive symptoms among older adults in two regions of Myanmar.

METHODS

Data based on a visit to 1,200 older adults in urban and rural Myanmar were obtained through stratified random sampling using the cross-sectional baseline survey of the longitudinal study titled "Healthy and Active Aging in Myanmar." Our analysis included 1,186 participants. The dependent variable was depressive symptoms, and the 15-item version of the Geriatric Depression Scale (GDS) was used as a continuous variable; the higher the score, the more likely a person was to be depressed. Internet use (one of the questions about household property ownership) was used as an independent variable. After confirming the absence of multicollinearity, we adjusted for age, gender, educational background, activities of daily living, residential area, and frequency of meeting friends, and stratified by subjective economic status (above or below average). We also examined the interaction between internet use and subjective economic status. A linear regression analysis was performed.

RESULTS

Among the 1,186 participants included in the analysis (women: 59.5%; median age: 68 years old), 202 (17.0%) were Internet users (95% Confidential Interval [CI]: 0.15, 0.19), and they had significantly lower GDS scores than the participants who did not use the Internet (B: -1.59, 95% CI: -2.04, -1.13).GDS showed a negative association with Internet use even in the multivariate analysis (B: -0.95, 95% CI: -1.41, -0.50). However, the interaction term for GDS between Internet use and subjective economic status was not significantly associated (B: 0.43, 95% CI: -1.11, 1.98).

CONCLUSIONS

Internet use and depressive symptoms were associated especially among the older adults. However, there were no significant interaction between Internet use and subjective economic status for GDS.

Internet Use and Effects on Mental Well-being During the Lockdown Phase of the COVID-19 Pandemic in Younger Versus Older Adults: Observational Cross-Sectional Study

BACKGROUND

Majority of individuals, including both younger and older adults, had to adapt to digital means to cope with lockdown measures and pandemic-induced lifestyle changes during the COVID-19 pandemic. While internet accessibility was beneficial during the pandemic, existing literature suggests that excessive use could lead to the rise of problematic internet use in adolescents and younger adults. However, the effects on older adults remain unclear.

OBJECTIVE

This study aimed to examine differences in internet use during the lockdown phase of the COVID-19 pandemic and explore how age differences in mental health could be explained by time spent on the internet.

METHODS

A door-to-door survey of a nationally representative sample of 602 adults in Singapore was carried out using computer-assisted personal interviewing during the early phase of the COVID-19 pandemic (October to November 2020). Participants were categorized into younger (21-59 years old) and older (60 years or above) age groups. We assessed self-reported measures of depression, anxiety, and stress; psychosocial adaptability; ability to perform essential activities; social support; health status; digital media use patterns, and time spent on the internet. Procedures complied with existing safe distancing measures.

RESULTS

Older adults reported being less able to use digital platforms to meet needs and acquire information updates compared with younger adults during the lockdown period of the pandemic. Older adults spent significantly less time on the internet for both work and personal uses per day (mean 146.00 min, SD 9.18 min) compared with younger adults (mean 433.27 min, SD 14.32 min). Significant age differences in depression, anxiety, and stress were found, with younger adults showing poorer mental health. Mediation analysis showed that age differences in depression, anxiety, and stress were partially explained by time spent on the internet. These variables together explained 43%, 40%, and 40% of the variances in depression, anxiety, and stress scores, respectively.

CONCLUSIONS

The findings showed that younger adults spent significantly more time on the internet compared with older adults during the lockdown phase of the pandemic. They were also ahead in their ability to use digital resources to meet needs and engage socially compared with older adults. Despite this, the mental health of younger adults was poor, and this was partially accounted for by the amount of time spent on the internet. Since past research suggests that excessive time spent on the internet could lead to disordered use, the benefits brought by digital technologies could have been attenuated during the lockdown phase of the pandemic. Considering this potential negative effect, it is imperative to educate both young and old adults in the appropriate use of information and communication technology.

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.

Acceptance of communication technology, emotional support and subjective well-being for Chinese older adults living alone during COVID-19: A moderated mediation model

Stringent social distancing measures implemented to control the spread of COVID-19 affected older adults living alone by limiting their social interaction beyond their households. During these restrictions, interactions beyond the household could be facilitated by communication technology (CT) such as voice calls, instant messages. Our study provides evidence on how CT acceptance could influence the emotional support and in turn, subjective well-being (SWB) of older adults living alone. We did a cross-sectional survey with 293 community-dwelling Chinese older adults. Participants were surveyed from September to November 2020 and had completed measures on CT acceptance (competency), emotional support, and SWB. PROCESS Model 1 was used to estimate the conditional effects of CT acceptance (competency) on emotional support for those living alone versus with others. Following which, PROCESS Model 7 was used to estimate the conditional indirect effects of CT acceptance (competency) on SWB through emotional support. Our results suggested that living arrangement moderated the indirect effect of CT acceptance (competency) on SWB. For older adults living alone, CT acceptance (competency) was significantly associated with perceived emotional support and, in turn, their SWB. For older adults living with others, CT acceptance was not associated with emotional support and SWB. Our findings call for more research and support to increase older adults' acceptance of CT as an option for communication to increase emotional support for older adults living alone, even during non-pandemic times.

Problematic Internet use in Adults: The Role of Happiness, Psychological Resilience, Dispositional Hope, and Self-control and Self-management

There is increasing literature examining the use of problematic internet in the context of psychological factors. Most of these studies are focused on the young population. On the other hand, the prolongation of human life and the increasing rate of adult individuals in society's population cannot be ignored. It is seen that the number of research examining the use of problematic internet in the context of psychological factors is quite limited. In this current study, the problematic internet usage of primary and secondary school students' parents was examined in happiness, psychological resilience, dispositional hope, self-control and self-management. The research was conducted on 1123 parents. Path analysis was performed to discover the relations between the structures. As a result of the path analysis, it was determined that there is a significant negative relationship between problematic internet use and happiness, problematic internet use and psychological resilience, problematic internet use, and dispositional hope. According to these findings, adults' high happiness levels, psychological resilience, and hope levels will reduce their problematic internet use. It has been determined that there is a significant indirect relationship between self-control and self-management and problematic internet use. Happiness, psychological resilience, and dispositional hope mediating role in this relationship. Increasing parents' happiness levels, developing psychological resilience, increasing dispositional hope levels, and developing self-control and self-management skills will reduce problematic internet use. In line with the findings, what can be done to reduce the use of problematic internet has been discussed.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10942-022-00482-y.

Impact of income on mental health during the COVID-19 pandemic: Based on the 2020 China family panel survey

Since December 2019, the COVID-19 has continued to rage, and epidemic prevention policies have limited contact between individuals, which may has a great influence on the income of individuals, exacerbate anxiety and depression, and cause serious mental health problems. The current study aims to examine the association between income and mental health during the COVID-19 pandemic by using the data of 9,296 observations from the 2020 China Family Panel Studies. Employing ordinary least squares regression and two-stage least squares regression, we find the significant positive effect of income on Chinese mental health during this pandemic. In addition, the number of cigarettes smoked per day has significant negative effects on mental health. Education levelˎmarriage and exercise frequency have significant positive correlation with mental health. Furthermore, the impact of income on individuals of different groups is heterogeneous during this pandemic. The impact of income for well-educated individuals is less strong than their less-educated counterparts. People who exercise regularly respond less strongly to changes in income than those who do not exercise. Finally, individuals’ salary satisfaction and interpersonal relationship are shown to be the potential mechanism for the effect of income on Chinese mental health.

Relationship between Income and Mental Health during the COVID-19 Pandemic in China

Mental health problems represent one most pressing concerns in the world, which produce costly consequences for individuals, families and society as a whole. One of the determinants on mental health during the COVID-19 pandemic is income. To complement relevant research and provide valuable recommendations for governments and societies, this study investigates the nexus between income and mental health in China by employing 8049 observations from the 2020 China Family Panel Studies. Using ordinary least squares regression we find the significant positive relationship between income and mental health, and estimate the effect of income on mental health. Furthermore, this effect is heterogeneous depending on individuals’ education level and registered residence type. Finally, individuals’ economic status and happiness are shown to be the potential mechanism through which the effect of income on mental health operates.