JMIR Publications

ABSTRACT

Background:

Chronic disease incidence among the elderly is increasing, which is correlated with the acceleration of population aging. Evolving Internet technologies may provide prevention and intervention for chronic disease in an accelerating ageing process. However, the impact of daily Internet use on the incidence of chronic disease is not well understood.

Objective:

To investigate if daily Internet use by middle-aged and older adults may inhibit or promote the occurrence of chronic diseases.

Methods:

We included participants from the China Health and Retirement Longitudinal Study (CHARLS), a longitudinal survey of Chinese residents aged ≥45 years. Eight-year data from Wave 1 (June 2011 to March 2012) to Wave 4 (July to September 2018) in the CHARLS were assessed. Data from Wave 4 were used as a cross-sectional study, and data from all four waves were used as a longitudinal study. Self-reported data was used to track variables including Internet use, use frequency and the incidence of different chronic diseases. Cox proportional-hazards modeling was applied in the longitudinal study to examine the relationship between daily Internet use and chronic diseases among middle-aged and older adults while adjusting for sociodemographic characteristics and health behaviors. In addition, longitudinal data were also used to analyze Internet usage trends. Cross-sectional data was used to analyze the factors influencing Internet use.

Results:

Among the 20,113 participants included in the longitudinal analyses, Internet use increased significantly, from 1.98% to 12.25%, between 2011 and 2018. The adjusted model found statistically significant relationships between daily Internet use and lower incidence of the following chronic diseases: hypertension (HR 0.78, 95% CI 0.65–0.95, P=.01), chronic lung disease (HR 0.74, 95% CI 0.57–0.97, P=.03), stroke (HR 0.69, 95% CI 0.50–0.94, P=.02), digestive disease (HR 0.73, 95% CI 0.58–0.91, P<.001), memory-related disease (HR 0.58, 95% CI 0.37–0.91, P=.02), arthritis or rheumatism (HR 0.60, 95% CI 0.48–0.76, P<.001), asthma (HR 0.52, 95% CI 0.33–0.84, P<.01), depression (HR 0.80, 95% CI 0.71–0.89, P<.001), and vision impairment (HR 0.83, 95% CI 0.74–0.93, P=.004). Moreover, our study also showed that with increasing frequency of Internet use, the risk of some chronic diseases decreased.

Conclusions:

This study found that middle-aged and elderly adults who use the Internet have a reduced risk of developing chronic diseases versus those who do not. The increasing prevalence of daily Internet usage among middle-aged and older adults may stimulate contemplation of the potential role of Internet platforms in future research for chronic disease prevention.