The Positive Effect of Internet Use on Mental Health in Older Adults A Nationally Representative Cross-Sectional Survey

Background There is growing evidence in Europe such as Germany and American discovered that the internet has beneficial effects on the mental health of older people (aged ≥ 60 years); however, the evidence is inconclusive, and the underlying mechanisms are poorly understood. Objective The aim of this cross-sectional survey was to understand the patterns of internet use and measure their associations with the risk of depression in China from two dimensions: the reasons for using the internet use and types of devices used. In addition, this study explored the relationship between internet use and depression risk in elderly people at the individual and provincial levels and in rural and urban subgroups. Methods The survey of CHARLS used a multistage probability-proportional-to-size (PPS) sampling technique. Province-level socioeconomic characteristics were merged with microdata for respondents over 60 years of age from the 2020 China Health and Retirement Longitudinal Study (CHARLS 2020) Wave 5 (n = 10,036) by author. The respondents were asked whether they used the internet, their reasons for using the internet and the types of internet devices used. Risk of depression was assessed using the 10-item Center for Epidemiological Studies Depression Scale (CES-D 10). The chi-square test was used to explore whether internet use was associated with mental health status. A binary logistic regression model was used to evaluate this association further after controlling for confounding factors. Results Overall, 24.2% (2426/10036) of the participants over 60 years of age reported using the internet. Regression analyses revealed that older adults who used the internet (OR = 0.723, 95% CI: 0.607–0.863, p < .001) had a lower risk of depression than did those who did not use the internet. In addition, older adults who were female (P < .005), were single (P < .001), lived in a rural area (P < .001), had poor self-rated health (SRH) (P < .001), had no retirement pension (P < .001) had a greater risk of depression. For province-level characteristics, older adults who lived in provinces in the first quartile (P < .005) of gross domestic product (GDP) per capita were more likely to experience depressive symptoms while the number of beds in medical institutions per 10,000 persons shows no effect. In the binary logistic regression analysis of the urban and rural subgroups separately, the results are indicated Internet use was negatively associated with risks of depression, especially in rural(P < .001) but not in urban(P = .095) participants. And none of the participants in the rural subgroup reported using a laptop. Conclusions Internet use had a positive effect on depression, especially in rural but not in urban participants. And the rate of ownership of internet devices also remains low among older Chinese people in rural area. Therefore, rural-urban disparities should be considered when designing strategies to encourage moderate Internet use.