Internet use and frailty in middle-aged and older adults: findings from developed and developing countries.

BACKGROUND: With increasing trend of internet use in all age groups, whether internet use can prevent frailty in middle-aged and older adults remains unclear. METHODS: Five cohorts, including Health and Retirement Study (HRS), China Health and Retirement Longitudinal Study (CHARLS), the Survey of Health, Ageing and Retirement in Europe (SHARE), English Longitudinal Study of Aging (ELSA), and Mexican Health and Aging Study (MHAS), were used in this study. Internet use, social isolation, and frailty status was assessed using similar questions. The Generalized estimating equations models, random effects meta-analysis, COX regression, and mediation analysis were utilized. RESULTS: In the multicohort study, a total of 155,695 participants were included in main analysis. The proportion of internet use was varied across countries, ranging from 5.56% in China (CHARLS) to 83.46% in Denmark (SHARE). According to the generalized estimating equations models and meta-analysis, internet use was inversely associated with frailty, with the pooled ORs (95%CIs) of 0.72 (0.67,0.79). The COX regression also showed that participants with internet use had a lower risk of frailty incidence. Additionally, the association was partially mediated by social isolation and slightly pronounced in participants aged 65 and over, male, not working for payment, not married or partnered, not smoking, drinking, and not co-residence with children. CONCLUSIONS: Our findings highlight the important role of internet use in preventing frailty and recommend more engagements in social communication and activities to avoid social isolation among middle-aged and older adults.

Impact of mobile Internet use on health-seeking behaviors: evidence from China.

Introduction: Although health-seeking behaviors are crucial to China's healthcare delivery system, the influence of mobile Internet use in this context remains under-explored. This study aimed to comprehensively explore the influence of mobile Internet use on health-seeking behaviors, and meticulously examined the heterogeneity in health outcomes associated with the intersection between mobile Internet use and health-seeking behaviors. Methods: We used nationally representative data derived from the China Family Panel Studies. Given that individuals typically make the decision to use mobile Internet autonomously, an instrumental variable regression methodology was adopted to mitigate potential selection biases. Results: Our findings revealed that mobile Internet use significantly promoted self-medication and adversely affected the use of primary care facilities among Chinese adults. Furthermore, our findings highlighted the heterogeneous effects of mobile Internet use across diverse health demographic groups. Conclusion: These findings underscore the importance of strategic planning and utilizing mobile Internet resources to steer individuals toward more appropriate healthcare-seeking behaviors.

Relationship and mechanisms between internet use and physical exercise among middle- and younger-aged groups.

The "Internet Plus" era has established a closer connection between sports and individuals. This study used data from the 2018 China Family Panel Studies and focused on the middle- and younger-aged population aged 15 to 59 years. Employing a negative binomial regression model, this study empirically analyzed the impact of Internet use on physical exercise and its internal mechanisms among this population. The findings revealed that (1) Internet use significantly promoted physical exercise in the middle- and younger-aged population, with the frequency of physical exercise increasing to 1.549 times the original value; (2) The positive effects of the internet on physical exercise outweighed the negative effects, with online learning and entertainment enhancing physical exercise and online socialization limiting it. Specifically, online learning and entertainment increased the frequency of physical exercise among the middle- and younger-aged population by 0.063 and 0.018, respectively. Online socialization reduced the frequency by 0.023; and (3) The influence of internet use on physical exercise varies; significantly, it positively affects the exercise frequency among individuals over 35 years old and shows a positive correlation with employment status, including both employed individuals and those out of the labor market. The positive role of Internet use in encouraging physical exercise participation among the middle- and young-aged groups should be valued and enhanced.

Influence of internet usage on physical activity participation among Chinese residents: evidence from 2017 China General Social Survey.

Objectives: This study aimed to examine the impact of internet usage on physical activity participation among Chinese residents, utilizing data from the 2017 China General Social Survey (N = 12,264). The objectives were to investigate the relationship between internet usage and physical activity participation and to explore the moderating effects of gender, age, and education level. Methods: Multiple regression models and a binary Probit model were employed to analyze the data. The study focused on exploring the association between internet usage and physical activity participation, considering the moderating effects of gender, age, and education level. The sample consisted of 12,264 participants from the 2017 China General Social Survey. Results: The study found a positive association between increased internet usage and decreased engagement in physical activity, suggesting a negative influence of internet usage on physical activity. Significant age-related moderating effects were observed, indicating varying patterns of the internet-physical activity relationship across different age groups. Gender and education level were also found to significantly moderate this association, highlighting the impact of gender equality and educational attainment on individuals' utilization of the internet for physical activity purposes. Conclusion: This study underscores the evolving role of the internet in shaping physical activity behaviors in the Chinese context. It emphasizes the importance of considering age-related dynamics and societal factors such as gender equality and educational attainment in health promotion strategies.

Factors associated with problematic internet use among University of Gondar undergraduate students, Northwest Ethiopia: Structural equation modeling.

BACKGROUND: For young adults and adolescents, excessive internet use has become a serious public health concern due to its negative impact on their health. It has been associated with detrimental effects on both physical and mental health. Negative academic outcomes were observed in the students, including missing classes, lower grades, and academic dismissal. Therefore, the purpose of the current study was to identify factors associated with PIU among undergraduate students at the University of Gondar. METHOD: A cross-sectional study was conducted at the University of Gondar among 1514 undergraduate students from June 1-20, 2022. The study participants were selected using a stratified simple random selection procedure. Using structural equation modeling, the degree of relationship was ascertained. A p-value of less than 0.05 and an adjusted regression coefficient with a 95% confidence interval (CI) were used to interpret the data. RESULTS: In our study, being from non-health departments [ß = 0.11, 95% CI: 0.037, 0.181], current alcohol use [ß = 0.12, 95% CI: 0.061, 0.187], depressive symptoms [ß = 0.23, 95% CI: 0.175, 0.291], insomnia symptoms [ß = 0.12, 95% CI: 0.060, 0.196], and ADHD symptoms [ß = 0.11, 95% CI: 0.049, 0.166] had a significant positive effect on PIU, while having a history of head injury had a significant negative effect [ß = -0.12, 95% CI: -0.226, -0.021] on PIU. CONCLUSION AND RECOMMENDATION: Factors such as current alcohol use, non-health department type, depressive symptoms, insomnia, and ADHD symptoms were positively associated with PIU. However, a history of head injuries was negatively associated with PIU. Therefore, strategies aimed at the early identification of PIU may lead to an improvement in the psychosocial health of university students.

Using machine learning algorithms and techniques for defining the impact of affective temperament types, content search and activities on the internet on the development of problematic internet use in adolescents' population.

Background: By using algorithms and Machine Learning - ML techniques, the aim of this research was to determine the impact of the following factors on the development of Problematic Internet Use (PIU): sociodemographic factors, the intensity of using the Internet, different contents accessed on the Internet by adolescents, adolescents' online activities, life habits and different affective temperament types. Methods: Sample included 2,113 adolescents. The following instruments were used: questionnaire about: socio-demographic characteristics, intensity of the Internet use, content categories and online activities on the Internet; Facebook (FB) usage and life habits; The Internet Use Disorder Scale (IUDS). Based on their scores on the scale, subjects were divided into two groups - with or without PIU; Temperament Evaluation of Memphis, Pisa, Paris, and San Diego scale for adolescents (A-TEMPS-A). Results: Various ML classification models on our data set were trained. Binary classification models were created (class-label attribute was PIU value). Models hyperparameters were optimized using grid search method and models were validated using k-fold cross-validation technique. Random forest was the model with the best overall results and the time spent on FB and the cyclothymic temperament were variables of highest importance for these model. We also applied the ML techniques Lasso and ElasticNet. The three most important variables for the development of PIU with both techniques were: cyclothymic temperament, the longer use of the Internet and the desire to use the Internet more than at present time. Group of variables having a protective effect (regarding the prevention of the development of PIU) was found with both techniques. The three most important were: achievement, search for contents related to art and culture and hyperthymic temperament. Next, 34 important variables that explain 0.76% of variance were detected using the genetic algorithms. Finally, the binary classification model (with or without PIU) with the best characteristics was trained using artificial neural network. Conclusion: Variables related to the temporal determinants of Internet usage, cyclothymic temperament, the desire for increased Internet usage, anxious and irritable temperament, on line gaming, pornography, and some variables related to FB usage consistently appear as important variables for the development of PIU.

Cannabis use, mental health, and problematic Internet use in Quebec: A study protocol.

BACKGROUND: Problematic Internet use is characterized by excessive use of online platforms that can result in social isolation, family problems, psychological distress, and even suicide. Problematic Internet use has been associated with cannabis use disorder, however knowledge on the adult population remains limited. In Quebec, cannabis use has significatively increased since 2018, and it is associated with various risks in public safety, public health, and mental health. This study aims to identify factors associated with problematic Internet use among adult cannabis users and to better understand their experiences. METHOD: This project is a mixed explanatory sequential study consisting of two phases. Phase 1 (n = 1500) will be a cross-sectional correlational study using probability sampling to examine variables that predispose individuals to problematic Internet use, characteristics associated with cannabis use, Internet use, and the mental health profile of adult cannabis users in Quebec. Descriptive analyses and regression models will be used to determine the relationship between cannabis use and Internet use. Phase 2 (n = 45) will be a descriptive qualitative study in the form of semi-structured interviews aimed at better understanding the experience and background of cannabis users with probable problematic Internet use. DISCUSSION: The results of this study will support the development of public policies and interventions for the targeted population, by formulating courses of action that contribute to the prevention and reduction of harms associated with cannabis use and problematic Internet use. Furthermore, an integrated knowledge mobilization plan will aid in the large-scale dissemination of information that can result useful to decision-makers, practitioners, members of the scientific community, and the general population regarding the use of cannabis and the Internet.

Effects of mobile Internet use on the health of middle-aged and older adults: evidences from China health and retirement longitudinal study.

The rapid development of digital technology has radically changed people's lives. Simultaneously, as the population is rapidly aging, academic research is focusing on the use of Internet technology to improve middle-aged and older people's health, particularly owing to the popularity of mobile networks, which has further increased the population's accessibility to the Internet. However, related studies have not yet reached a consensus. Herein, empirical analysis of the influence of mobile Internet use on the subjective health and chronic disease status of individuals in their Middle Ages and above was conducted utilizing ordered logit, propensity score matching (PSM), and ordered probit models with data from the 2020 China Health and Retirement Longitudinal Study. The study aimed to provide a theoretical basis and reference for exploring technological advances to empower the development of a healthy Chinese population and to advance the process of healthy aging. The health of middle-aged and older adults mobile Internet users was greatly improved, according to our findings. Further, the use of mobile Internet by these persons resulted in improvements to both their self-assessed health and the state of their chronic diseases. As per the findings of the heterogeneity analysis, the impact of mobile Internet use was shown to be more pronounced on the well-being of middle-aged persons aged 45-60 years compared to those aged ≥ 60 years. Further, the endogeneity test revealed that the PSM model could better eliminate bias in sample selection. The results suggest that the estimates are more robust after eliminating endogeneity, and that failure to disentangle sample selectivity bias would overestimate not only the facilitating effect of mobile Internet use on the self-assessed health impacts of middle-aged and older adults, but also the ameliorating effect of mobile Internet use on the chronic diseases of middle-aged and older adults. The results of the mechanistic analysis suggest that social engagement is an important mediating mechanism between mobile Internet use and the health of middle-aged and older adults. This implies that mobile Internet use increases opportunities for social participation among middle-aged and older adults, thereby improving their health.

The association between internet use and the choice of medical institution among Chinese older adults.

BACKGROUND: As older people have complex medical needs and still encounter challenges in accessing online health information, the relationship between Internet use and the choice of medical institution made by them is unclear, and we aimed to examine this relationship. METHODS: Data from the newly released 2020 China Family Panel Survey database were used. Furthermore, we used descriptive statistics to analyze the background characteristics of the sample and a logistic regression model to estimate the impact of Internet use on the choice of medical institution made by older adults. We conducted a stratified analysis to explore the influence of different characteristics on the relationship between Internet use and the choice of medical institution. RESULTS: Totally 4,948 older adults were included. Multivariate logistic regression showed that, compared to non-Internet users, Internet users were less likely to choose community health service centers over general hospitals (P < 0.001, OR = 0.667, 95CI%: 0.558-0.797). The subgroup analyses found that Internet use only had an impact on the choice of medical institution in older adults aged 65-69 years, those with partners, those with primary or secondary education, those residing in urban areas, those without medical insurance, those with a self-rated health status as average or healthy, those with unchanged or better health trend, and those without chronic disease. The effect of Internet use on the choice of medical institution did not differ by sex, satisfaction, or trust in doctors. CONCLUSION: Internet use may significantly affect older adults' tendency to choose general hospitals to meet their daily medical needs. The subgroup analyses indicated that different characteristics of older people affected this association.

Digital exclusion and cognitive impairment in older people: findings from five longitudinal studies.

OBJECTIVES: Older people are more likely to have digital exclusion, which is associated with poor health. This study investigated the relationship between digital exclusion and cognitive impairment in older adults from 23 countries across five longitudinal surveys. DESIGN AND MEASUREMENTS: Digital exclusion is defined as self-reported non-use of the Internet. We assessed cognitive impairment on three dimensions: orientation, memory, and executive function. We used generalized estimation equations fitting binary logistic regression with exchangeable correlations to study the relationship between digital exclusion and cognitive impairment, and apply the minimum sufficiently adjusted set of causally directed acyclic graphs as the adjusted variable. SETTING AND PARTICIPANTS: We pooled a nationally representative sample of older adults from five longitudinal studies, including the China Health and Retirement Longitudinal study (CHARLS), the English Longitudinal Study of Ageing (ELSA), the Health and Retirement Study (HRS), the Mexican Health and Ageing Study (MHAS) and the Survey of Health, Ageing and Retirement in European (SHARE). RESULTS: We included 62,413 participants from five longitudinal studies. Digital exclusion varied by country, ranging from 21.69% (SHARE) in Denmark to 97.15% (CHARLS) in China. In the original model, digital exclusion was significantly associated with cognitive impairment in all five studies. In the adjusted model, these associations remained statistically significant: CHARLS (Odds ratio [OR] = 2.81, 95% confidence interval [CI] 1.84-4.28, ELSA (1.92 [1.70-2.18]), HRS(2.48[2.28-2.71), MHAS (1.92 [1.74-2.12]), and SHARE (2.60 [2.34-2.88]). CONCLUSION: Our research shows that a significant proportion of older people suffer from digital exclusion, especially in China. Digital exclusion was positively correlated with cognitive impairment. These findings suggest that digital inclusion could be an important strategy to improve cognitive function and reduce the risk of cognitive impairment in older adults.

Digital media use, depressive symptoms and support for violent radicalization among young Canadians: a latent profile analysis.

BACKGROUND: Despite the prominent role that digital media play in the lives and mental health of young people as well as in violent radicalization (VR) processes, empirical research aimed to investigate the association between Internet use, depressive symptoms and support for VR among young people is scant. We adopt a person-centered approach to investigate patterns of digital media use and their association with depressive symptoms and support for VR. METHODS: A sample of 2,324 Canadian young people (Mage = 30.10; SDage = 5.44 ; 59% women) responded to an online questionnaire. We used latent profile analysis to identify patterns of digital media use and linear regression to estimate the associations between class membership, depressive symptoms and support for VR. RESULTS: We identified four classes of individuals with regards to digital media use, named Average Internet Use/Institutional trust, Average internet use/Undifferentiated Trust, Limited Internet Use/Low Trust and Online Relational and Political Engagement/Social Media Trust. Linear regression indicated that individuals in the Online Relational and Political Engagement/Social Media Trust and Average Internet Use/Institutional trust profiles reported the highest and lowest scores of both depression and support for VR, respectively. CONCLUSIONS: It is essential to tailor prevention and intervention efforts to mitigate risks of VR to the specific needs and experiences of different groups in society, within a socio-ecological perspective. Prevention should consider both strengths and risks of digital media use and simulteaneously target both online and offline experiences and networks, with a focus on the sociopolitical and relational/emotional components of Internet use.

Socio-economic inequalities in the breadth of internet use before and during the COVID-19 pandemic among older adults in England.

Understanding digital exclusion in older adults during the COVID-19 pandemic could help tailor responses to future outbreaks. This cohort study used data from older adults aged 60+ years in England who participated in wave nine (2018/2019) of the main English Longitudinal Study of Ageing (ELSA) survey, and/or wave one of the ELSA COVID-19 sub-study (June/July 2020). Using latent class analysis and latent transition analysis, we aimed to identify distinct subgroups of older adults characterised by different patterns of internet use pre- and intra-pandemic, explore the extent to which individuals remained in the same subgroup or transitioned to a different subgroup during the COVID-19 pandemic, and examine longitudinal associations of socio-economic factors (education, occupational class, and wealth) with latent class membership. Preliminary tests showed that the types of internet activities differed between men and women; therefore, subsequent analyses were stratified by biological sex. Three clusters (low, medium, and high) were identified in male participants at both timepoints. Among female participants, three clusters were distinguished pre-pandemic and two (low versus high) during the pandemic. The latent classes were characterised by participants' breadth of internet use. Higher education, occupational class, and wealth were associated with greater odds of membership in the medium and/or high classes, versus the low class, in men and women. A high degree of stability in latent class membership was observed over time. However, men experienced a stark decrease in online health information-seeking. Our results highlight that inequality regarding the range of functional and social opportunities provided by the internet prevailed during the pandemic. Policymakers should ensure that digital access and upskilling initiatives are equitable for all.

Internet use and its association with physical activity among adolescents in Beni Municipality, Myagdi, Nepal.

INTRODUCTION: Adolescence is a critical phase marked by distinct health and developmental needs and rights. It represents a pivotal time for the acquisition of knowledge, skills, emotional regulations, and relationship management. However, a recent surge in internet usage among adolescents has been observed, leading to a concerning decline in physical activity. This study aims to evaluate the level of physical activity and its correlation with internet use among adolescents. MATERIALS AND METHODS: A cross-sectional study, conducted within educational institutions in Beni, Nepal, utilized a self-structured questionnaire to collect data on physical activity levels and associated factors. The relationship between physical activity and independent variables was assessed through the chi-square test, and regression analysis was employed to quantify the strength of this association. RESULTS: The study revealed that 75.3% of adolescents (out of 385) exhibited inadequate physical activity levels. Notably, late adolescents were more susceptible to insufficient physical activity than their middle adolescent counterparts were. Adolescents from nuclear families (UOR = 2.689, C.I = 4.074-22.822), those with higher monthly family income (UOR = 3.318, C.I = 1.209-9.105), and individuals using Wi-Fi (UOR = 1.801, C.I = 1.117-2.904) demonstrated a higher likelihood of internet addiction. Moreover, these groups were more prone to engage in inadequate physical activity (UOR = 1.1740, C.I = 0.938-3.226) compared to their counterparts not addicted to the internet. CONCLUSION: The study concludes that over two-thirds of adolescents were addicted to the Internet, and three-fourths were inadequately physically active, with late adolescents being more affected than middle adolescents. Inadequate physical activity was associated with various factors, including family type, monthly family income, monthly pocket money, father's occupation, type of school, type of internet access, and Internet Addiction Test (IAT) score. Internet-addicted adolescents were found to be more likely to be physically inactive.

The parents' internet use and children's extracurricular tutoring class participation.

The educational burden from extracurricular tutoring class has become a pressing social issue in China. This study used data from the China family panel studies (CFPS) in 2014, 2016, and 2018 to empirically analyze the impact of Internet usage on children's participation in extracurricular tutoring class. There are many factors that influence parents' decisions to enroll their children in extracurricular tutoring class. These factors include family income status, the level of importance parents place on their children's education, the marginal returns on educational investment, academic pressure, etc. However, in today's digitalized society, the widespread use of the internet will also become an important influencing factor in parents' decisions regarding educational investment. The study finds that, parents by using the Internet significantly increase the probability of enrolling their children in extracurricular tutoring class. Through mechanism regression analysis, it is concluded that internet usage has a positive influence on parents enrolling their children in extracurricular tutoring class by increasing the frequency of social interaction and raising parents' educational expectations for their children. Based on the empirical results, the following policy suggestions were proposed: 1. Schools should establish a more comprehensive after-school education service system to improve the engagement of students in compulsory education; 2. The government can enhance the accessibility and optimization of educational resources by increasing investment in education, improving the quality of in-school education, and optimizing the management and supervision of extracurricular tutoring class. This ensures that students can access high-quality educational services.

Parent-adolescent conflict and problematic internet use among Chinese adolescents: the mediating role of depression and the moderating role of school climate.

BACKGROUND: Problematic Internet use (PIU) may lead adolescents to physical, emotional, social, or functional impairment due to the risky, excessive, or impulsive internet use manner. How do the experiences of adolescents influence them using the internet in a problematic manner? The answer to this question is the key to preventing and intervening PIU of adolescents. To address this question, we focus on the interactions among family (parent-adolescent conflict), school (school climate), and individual factors (PIU, depression), exploring the influence factors of PIU. METHODS: A moderated mediation model was constructed to explore the relationship between variables. Using a two-wave longitudinal design with a six-month interval between timepoints, this study collected data from 801 Chinese adolescents (411 boys, Mage = 14.68) by questionnaires. Path analysis was employed to test the model and participants' age, sex and baseline were controlled. RESULTS: Parent-adolescent conflict at Time 1 (T1) was positively related to PIU at Time 2 (T2) in adolescents. Depression at T2 mediated the relationship between parent-adolescent conflict at T1 and PIU at T2. School climate at T2 significantly moderated the mediation effect of depression on the relationship between parent-adolescent conflict at T1 and PIU at T2. Specifically, positive school climate could significantly weaken the negative effect of depression on PIU for adolescents with low level of depression. CONCLUSIONS: The present study reveals that parent-adolescent conflict leads to PIU in adolescents through depression whilst the school climate moderates the impacts of depression on PIU. This adds further evidence regarding the significance of systematically and consistently incorporating family and school in the alleviating of problem behaviors displayed by teens.

Internet Use and Loneliness Among Urban and Non-Urban Chinese Older Adults: The Roles of Family Support, Friend Support, and Social Participation.

OBJECTIVES: This study investigated the association between internet use and loneliness among older Chinese adults, and the mediating effects of family support, friend support, and social participation. These associations were evaluated in the context of urban and non-urban geographic settings. METHODS: This study used data from the 2018 wave of the China Longitudinal Ageing Social Survey (N = 10,126), examining samples of urban (n = 3,917) and non-urban (n = 6,209) older adults separately. Linear regression and path analysis within a structural equation modeling framework were employed. RESULTS: Internet use was negatively associated with loneliness for both urban and non-urban residing older adults. Family support and social participation mediated the association between internet use and loneliness for both urban and non-urban residing older Chinese adults, but friend support mediated this association only for urban older residents. DISCUSSION: This study shed light on our understanding of the relationship between internet use and loneliness among older adults in the Chinese context. Also, these findings suggested that digital interventions for loneliness should pay special attention to the different characteristics of urban and non-urban dwelling older Chinese adults.

Using Two-Step Cluster Analysis and Latent Class Analysis to Construct a Typology of Internet Users Among Community-Dwelling Older People.

This study utilizes data, spanning 2016-2021, from the Belgian Ageing Studies and presents a typology of older internet users based on nine internet activities. Two-step Cluster Analysis and Latent Class Analysis revealed three groups: (1) "Basic users" primarily engage in information search and mailing, (2) "Allrounders" participate in nearly all internet activities and (3) "Selective users" are intermediary, predominantly using the internet for information search, mailing, e-banking and communication with (grand)children. These clusters varied in sociodemographic characteristics, with "Allrounders" being younger, more educated, wealthier and predominantly male, compared to "Selective users" and "Basic users," respectively.