Discover how staying connected online reduces depression and boosts well-being in older adults, offering hope for better mental health strategies across the globe!

Study: Positive association between Internet use and mental health among adults aged ≥50 years in 23 countries. Image Credit: Halfpoint / Shutterstock

In a recent study published in the journal Nature Human Behaviour, a group of researchers examined the relationship between Internet use and mental health outcomes among adults aged ≥50 years across 23 countries, using statistical analyses to inform public health strategies.

Mental health issues among middle-aged and older adults are a global public health concern, with about 14% of those aged 55 and over experiencing conditions like depression. Mental health includes overall well-being, enabling individuals to handle life’s stresses and contribute to their communities.

Internet use has become an important social determinant, offering access to health information, social connections, and entertainment, positively impacting mental health. However, research findings are mixed, and most studies focus on single countries, overlooking cross-national differences. Additionally, the interaction between Internet use and genetic predispositions in influencing mental health outcomes remains underexplored. Therefore, further research is needed to understand these associations across diverse populations and inform effective mental health promotion strategies.

Data were gathered from six aging cohorts: the Health and Retirement Study (HRS) in the United States of America (USA), the English Longitudinal Study of Ageing (ELSA), the China Health and Retirement Longitudinal Study (CHARLS), the Mexican Health and Aging Study (MHAS), the Survey of Health, Ageing and Retirement in Europe (SHARE), and the Brazilian Longitudinal Study of Aging (ELSI). These nationally representative longitudinal surveys included adults aged 50 or older, with data collected at various intervals between 2008 and 2021. Participants were selected based on the availability of information on Internet use and at least two waves of follow-up data.

The study focused on individuals who had complete data on Internet use, mental health outcomes (depressive symptoms and life satisfaction), and relevant covariates at baseline. Those with memory-related diseases or psychological disorders at baseline were excluded. Internet use was assessed through questionnaires, with definitions varying slightly between cohorts but generally capturing whether participants used the Internet during specified periods. The frequency and cumulative use of the Internet were also evaluated in some cohorts. These additional dimensions provide a richer understanding of how sustained and frequent use impacts mental health.

Mental health outcomes were standardized across cohorts to ensure comparability, given differences in measurement methods. Covariates included demographic characteristics, socio-economic status, health behaviors, and physical health indicators. For the HRS and ELSA cohorts, polygenic scores for depressive symptoms and subjective well-being were calculated using genome-wide association studies, allowing for the examination of interactions between Internet use and genetic predisposition.

Statistical analyses involved summarizing baseline characteristics and using linear mixed models and meta-analyses to investigate associations between Internet use and mental health outcomes. Sensitivity analyses were conducted to test the clarity of the findings, including adjustments for potential confounders and assessments of bidirectional relationships. These bidirectional analyses revealed that individuals with better mental health were more likely to engage in Internet use, highlighting a reciprocal relationship.

The present study analyzed data from six aging cohorts across 23 high- and middle-income countries, including 87,559 participants with 298,199 observations and a median follow-up of six years. Participants’ baseline characteristics revealed a mean age range of 56.4 years in Poland to 67.9 years in Sweden, with the prevalence of Internet use among those aged ≥50 years varying from 2.2% in China to 84.8% in Denmark.

Baseline Internet use was associated with improved mental health outcomes, including fewer depressive symptoms (pooled average marginal effect (AME): -0.09; 95% CI: -0.12 to -0.07), higher life satisfaction (pooled AME: 0.07; 95% CI: 0.05 to 0.10), and better self-reported health (pooled AME: 0.15; 95% CI: 0.12 to 0.17). These associations were consistent across most countries but varied in magnitude, with factors such as income inequality, digital skills, and gross domestic product per capita contributing to cross-national differences.

Subpopulation analyses indicated that Internet use was more strongly associated with reduced depressive symptoms in individuals aged ≥65, those with physical inactivity or disabilities in activities of daily living, and those with lower wealth. Similarly, positive associations with life satisfaction and self-reported health were more prominent in subgroups, including men, the retired, and individuals with chronic conditions. The statistical significance of some differences was notable, such as for physical activity (P = 0.014) and disabilities in activities of daily living (P = 0.021).

In England and the USA, polygenic scores for depressive symptoms and subjective well-being allowed for the assessment of genetic risk interactions. Internet use showed beneficial associations across all genetic risk categories for depressive symptoms and self-reported health. However, for life satisfaction, the significant association was limited to individuals with intermediate genetic risk in the USA.

Frequency and cumulative Internet use further demonstrated that higher usage was linked to better mental health outcomes. Each additional wave of Internet use was associated with reductions in depressive symptoms (pooled AME: -0.06) and improvements in life satisfaction (pooled AME: 0.05) and self-reported health (pooled AME: 0.10). Notably, the relationship between frequency of use and life satisfaction varied, with inconsistent findings in some countries such as England.

Sensitivity analyses confirmed these findings, indicating consistent results after adjustments for potential confounders and selection biases, underscoring a bidirectional relationship between Internet use and mental health.

To summarize, this study demonstrated that Internet use is associated with improved mental health outcomes, including reduced depressive symptoms, higher life satisfaction, and better self-reported health among adults aged 50 and older across 23 countries. However, the protective effects varied across countries and subpopulations, influenced by genetic, sociodemographic, and behavioral factors.

The study's findings emphasize the need for precision mental health interventions tailored to specific subpopulations, addressing variations in digital skills and access. Greater frequency and sustained use of the Internet were linked to enhanced mental health benefits. At the same time, the potential risks of excessive use, such as interference with offline activities, were noted as areas for further research. The findings suggest that promoting Internet use could be an effective strategy for improving mental health, especially in regions with limited access to mental health services.