JMIR Publications

ABSTRACT

Background:

The effects of smartphone use on mental health and brain activity in adolescents have received much attention, however, the effects on older adults have received little. As more and more older adults begin to use smartphones, it is imperative to explore the effects of non-addictive smartphone use on mental health, cognitive function, and brain activity in older adults.

Objective:

This study aimed to examine differences in cognitive performance, emotional symptoms (depression, anxiety, and insomnia), and brain functional activity between older adults who use smartphones and those who do not.

Methods:

A total of 1014 community-dwelling older adults aged 60 years and above were surveyed in a rural area of China. Participants were categorized into two groups based on smartphone use status. Depression, anxiety, and insomnia symptoms were evaluated using the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), and Insomnia Severity Index (ISI), respectively. Cognitive function was assessed with the Montreal Cognitive Assessment-Basic (MoCA-B). To explore neural mechanisms, a subsample of 130 participants (89 smartphone users and 41 non-users) was selected using stratified random sampling for resting-state fMRI scanning. Participants with contraindications for MRI (e.g., metal implants, claustrophobia) or who refused participation were excluded. Functional brain activity was analyzed and compared between groups.

Results:

Among all 1015 older adults, 641 reported using smartphones while 373 reported never using smartphones. Older adults who use smartphones exhibited better cognitive function compared with those who never use smartphones (Z = 3.806, P < .001), especially in the domains of fluency (Z = 3.025, P = .002) and abstraction (Z = 5.311, P < .001). But there were no significant differences in levels of depression (Z = 0.689, P = .49), anxiety (Z = 0.934, P = .35) and insomnia (Z = 0.340, P = .73). In terms of the MRI findings, a total of 130 participants completed fMRI scanning, including 89 who use smartphones and 41 who never use smartphones, and results showed that older adults who were smartphone users exhibited higher degree centrality values in the left parahippocampal gyrus.

Conclusions:

These findings suggest that smartphone use among older adults is associated with better cognitive performance and fewer emotional symptoms, potentially linked to enhanced brain activity in key cognitive regions. Promoting digital engagement may offer cognitive and emotional benefits for aging populations. Longitudinal studies are warranted to examine causal relationships.