Does Mobile Internet Use Affect the Loneliness of Older Chinese Adults? An Instrumental Variable Quantile Analysis

Mapping of technological strategies for reducing social isolation in homebound older adults: A scoping review

BACKGROUND

Homebound older adults (HOAs) are particularly vulnerable to social isolation and loneliness, which engender a poorer physical and mental health, and greater cognitive decline. The purpose of this review is to map the literature to identify potential technological strategies that reduce social isolation in HOAs, and to understand facilitators and barriers for adoption and implementation.

METHODS

Six databases including PubMed (MEDLINE), Google Scholar, Cochrane Database, EBSCOHost, National Library ProQuest, Web of Science, and the Journal of Medical Internet Research were searched for relevant articles. Peer-reviewed literature published in English from Jan 2014 to Feb 2024 that employed technological strategies applicable to HOAs and assessed social isolation or connectedness as an outcome measure were included.

RESULTS

107 studies were reviewed and classified into different technological categories based on their functions and features. A social technology framework encompassing delivery, hardware, software, content, training, and support was conceptualized with core characteristics identified from the reviewed technological strategies. Cost and complexity of technology, and resource commitment were identified as barriers while user-friendliness, content curation and a supportive ecosystem may facilitate the adoption of a technological strategy to address social isolation in HOAs.

CONCLUSION

There is a need for early and concerted effort to identify HOAs, provide technology training, and empower them to tap on the digital world to complement and/or supplement social interactions. Development of cost-effective and rapid-to-implement technology is vital for HOAs who are at highest risk to social isolation.

Prevalence of social isolation in the elderly: A systematic review and meta-analysis

Social isolation has become a global issue among the elderly, posing serious challenges to both social and public health. We assessed the prevalence of elderly social isolation and its related factors. Eight electronic databases were searched up to June 28th, 2023. A meta-analysis of the included literature was performed using Stata 16.0. The results showed that the incidence of social isolation in the elderly was 33 % [95 % CI (0.28, 0.38)]. The subgroup analysis revealed that people over 80, with a sample size under 500, assessed using the Lubben Social Network scale and Social Network Index scale, experienced higher social isolation, especially if they were living alone and lacked higher education. It is suggested to pay attention to the psychological well-being of elderly individuals living alone and lacking a high level of education. Early screening could help reduce the incidence of social isolation, and hence its implications, among the elderly.

Internet use, cardiometabolic multimorbidity, and death in older adults: a multi-cohort study spanning developing and developed countries

BACKGROUND

Internet use is a double-edged sword for older adults' health. Whether internet use can prevent cardiometabolic diseases and death in older adults remains controversial.

METHODS

Four cohorts across China, Mexico, the United States, and Europe were utilized. Internet use was defined using similar questions. Cardiometabolic diseases included diabetes, heart diseases, and stroke, with 2 or more denoting cardiometabolic multimorbidity. Depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale and Europe-depression scale. The competing risk analysis based on subdistribution hazard regression, random-effects meta-analysis, and mediation analysis were utilized.

RESULTS

A total of 104,422 older adults aged 50 or older were included. Internet users (vs. digital exclusion) were at lower risks of diabetes, stroke, and death, with pooled sHRs (95% CIs) of 0.83 (0.74-0.93), 0.81 (0.71-0.92), and 0.67 (0.52-0.86), respectively, which remained significant in sensitivity analyses. The inverse associations of internet use with new-onset cardiometabolic diseases and death were progressively significant in Mexico, China, the United States, and Europe. For instance, older internet users in Europe were at 14-30% lower cardiometabolic risks and 40% lower risk of death. These associations were partially mediated by reduced depressive symptoms and were more pronounced in those with high socioeconomic status and women. Furthermore, patients with prior cardiometabolic conditions were at about 30% lower risk of death if they used the internet, which was also mediated by reduced depressive symptoms. However, certain cardiometabolic hazards of internet use in those aged < 65 years, with low socioeconomic status, men, and single ones were also observed.

CONCLUSION

Enhancing internet usage in older adults can reduce depressive symptoms and thus reduce the risks of cardiometabolic diseases and death. The balance of internet use, socioeconomic status, and health literacy should be considered when popularizing the internet in older adults.

The impact of internet use in the digital age on the subjective well-being of older adults -- an empirical study based on CGSS2021 data

The main objective of this study is the effect of Internet use on the subjective well-being of older adults. Based on the China General Social Survey 2021 cross-sectional data, 11 variables were selected from the perspective of sociology and demography. These variables include one dependent variable, three independent variables, and seven control variables. A binary logistic model was used to study the effects of the three dimensions of Internet use in the digital age (independent variables) on the subjective well-being of the elderly (dependent variable) with the elderly as the research object (N = 1836). The results of the study revealed that Internet use (P < 0.001, Exp(B) = 1.567), information sources (P < 0.001, Exp(B) = 1.695), and frequency of Internet use (P < 0.001, Exp(B) = 0.858) of the elderly had significant effects on their subjective well-being. To improve the subjective well-being of the elderly in the digital era, this paper proposes the following suggestions and countermeasures: 1) strengthen the digital infrastructure for the elderly and create an "Internet + elderly" model; 2) formulate relevant protective policies to promote Internet use among the elderly; 3) regulate the frequency of Internet access to maintain a balance between the virtual and real world. Conclusion: A thoughtful digitalization approach for the elderly can ensure they keep up with the times, bridge the "digital divide" between generations, extend their working lives, and enhance their subjective well-being. This study has some limitations. The object of the study is only the elderly in China, while the elderly in every country in the world have certain differences in subjective or objective conditions.

Association Between Internet Use and Physical Health, Mental Health, and Subjective Health in Middle-aged and Older Adults: Nationally Representative Cross-sectional Survey in China

BACKGROUND

Internet use is an important means of accessing health-related information. Identifying the associations between internet use and health outcomes could provide insight into strategies for improving public health among middle-aged and older adults (45 years and up).

OBJECTIVE

This study aimed to examine the relationship between internet use and health outcomes in middle-aged and older adults.

METHODS

Data were obtained from the 2018 China Health and Retirement Longitudinal Study. Physical, mental, and subjective health were assessed using the Activities of Daily Living (ADL) Scale, the 10-item Center for Epidemiologic Studies Depression Scale, and the 3-level Self-Rated Health Scale, respectively. The chi-square test and rank sum test were used to explore whether internet use was associated with health status. A multivariate logistic regression model was used to determine this association further after controlling for the confounding factors.

RESULTS

Overall, 13% (1752/13,474) of the participants used the internet. Regression analyses revealed that the prevalence of depression (odds ratio [OR] 0.59, 95% CI 0.52-0.68; P<.001), negative self-rated health (OR 0.68, 95% CI 0.61-0.76; P<.001), and difficulty with ADL (OR 0.48, 95% CI 0.39-0.60; P<.001) in the participating middle-aged and older adult was lower in those using the internet than nonusers. After controlling for confounding factors, internet use was found to be negatively associated with difficulty with ADL (urban: OR 0.44, 95% CI 0.32-0.61; P<.001 vs rural: OR 0.55, 95% CI 0.41-0.75; P<.001), depression (urban: OR 0.69, 95% CI 0.57-0.84; P<.001 vs rural: OR 0.52, 95% CI: 0.43-0.63; P<.001), and self-rated health status (urban: OR 0.70, 95% CI 0.61-0.81; P<.001 vs rural: OR 0.67, 95% CI 0.57-0.78; P<.001) among middle-aged and older adults in both urban and rural areas.

CONCLUSIONS

Internet use had a positive effect on the physical and mental health of middle-aged and older adults who participated in this study. However, the internet usage rate remains low among older Chinese people. Therefore, the internet penetration rate should be a priority.

The Impact of Internet Use on the Social Networks of the Elderly in China—The Mediating Effect of Social Participation

Introduction: Under the overlapping interaction of digitization and aging, the number of elderly Internet users has increased yearly. However, the impact of Internet use on the social networks of the elderly is still unclear. Methodology: In this study, we utilize the methods of ordinary least square regression (OLS), propensity score matching (PSM), instrumental variable (IV), and Bootstrap-mediated effect analysis methods using data from the Chinese General Social Survey (CGSS) to analyze the impact of Internet use on the social networks of the elderly and examine the mediating effect of social participation. Objectives: A total of 1363 validated respondents aged 60 or above were included to explore the relationship between Internet use, social networks, and social participation among the elderly in China. Results: The results show that Internet use positively and significantly impacts the social networks of the elderly. Compared to the elderly who do not use the Internet, the elderly who use the Internet have a larger social network size, more significant social network heterogeneity, and higher social network upper reachability. The mediated analysis shows that social participation plays a positive mediating role in the influence of Internet use on the social networks of the elderly. That is, Internet use will benefit the social network of the elderly by improving the level of their social participation. Besides, there also exists heterogeneity in the effect of Internet use on social networks among the elderly with different genders, ages, and places of residence. Conclusions: Internet use benefits the social network of the elderly, and social participation partially mediates the relationship between Internet use and the social network of the elderly. These findings have implications for formulating public policies aimed at active aging; it is necessary to bridge the “digital divide” and promote the digital integration of the elderly. Let more older adults benefit from Internet use, thus improving the social network and quality of life of the elderly.

The Impact of Interface Design Element Features on Task Performance in Older Adults: Evidence from Eye-Tracking and EEG Signals

It is crucial that the interface design of mobile apps be age-appropriate at this stage of global aging, as the new epidemic has resulted in a higher sense of isolation among older persons. In this study, four typical senior social service mobile applications were chosen to give older persons the ability to complete user login duties. The participants were 16 older adults (7 men and 9 women) aged 55 to 76. Both objective and subjective data, including task completion time, gaze length, pupil diameter changes, EEG wave amplitude changes, and subjective sensations of older persons, were gathered using a combination of eye-movement and EEG signal approaches. The program was created to investigate the effects of interface design aspects on older people’s task performance, including interface layout, interface color, information density, icon size and position, etc. The study’s findings revealed that when the user task completion time and average fixation duration were shorter, the line of sight was more equally distributed, the visual focus was closer to the login button, and the average EEG amplitude of the user changed more, the older adults performed better. The palace layout had a more positive effect on job completion among older individuals when it came to interface layout. In terms of interface color, colored (contrasting) colors should serve to highlight the interface’s essential information points while they can be removed. In terms of interface information density, a low-density level interface design can simplify and lower the cognitive load of task execution for older people. The first level of icons in the interface and their position in the visual center of the interface is the best interface design for older persons in terms of icon size and position. The results of this study have theoretical ramifications for a thorough understanding of the factors influencing older people’s task performance, practical ramifications for the design of older people-centered interfaces, and they contribute to our understanding of the characteristics of older people’s interface interaction behavior.