BACKGROUND
Previous evidences regarding the association between internet use and depressive symptoms in older adults have been inconsistent. 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 longitudinal national cohort study in China.
METHODS
8772 participants from the China Health and Retirement Longitudinal Study with 7-year follow-ups were included. Cox proportional hazards regressions were used to explore risk of incident depressive symptoms. Hazard ratios (HRs) and 95% Confidence Intervals [CI] were presented.
RESULTS
Incidence density for depressive symptoms was 53.89 for every 1000 persons. The rate of internet usage by middle aged and older adults in China increased evidently from 2012 to 2018 (16.39% vs 77.41%). We found that broadband internet connection (BIC) (Hazard ratio [HR] = 0.80, 95% Confidence Interval [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 (such as computer or tablets) (HR = 0.64, 95%CI: 0.45, 0.91) for internet access, instead of using cell phones or smart phones, was associated with lower risk of depressive symptoms.
CONCLUSIONS
We recommend that older adults should be encouraged to use the Internet; however, online time, frequency, and devices for internet use should be considered simultaneously.