JMIR Publications

ABSTRACT

Background:

Mental health issues have emerged as a global challenge, particularly affecting middle-aged and older adults. Research has shown that internet use can potentially promote mental health. Substantial research investigated the relationship between mental health and internet usage time or purposes. However, few studies have examined the association between internet usage time trajectories and mental health.

Objective:

The objective of this study was to identify distinct trajectories of internet usage time over a span of 10 years and assess their relationship with depressive scores among middle-aged and older adults.

Methods:

Utilizing longitudinal data from the China Family Panel Studies spanning 10 years and consisting of 5 waves. Participants aged over 45 years with internet usage data available for at least three waves, including wave 5, were included in the analysis. Internet usage time was operationalized as the number of hours spent on the internet per week, while depressive scores were assessed using the 8-item Center for Epidemiologic Studies Depression Scale. A latent class mixed model was employed to identify distinct trajectories of internet usage time over the course of 10 years. Mixed-effect models were used to test the relationship between distinct trajectories of internet usage time and depressive scores.

Results:

Among 9,263 middle-aged and older adults were included in analysis. The trajectory analysis identified three clusters: ‘Never use,’ ‘Slow increase,’ and ‘Rapid increase.’ The ‘Never use’ cluster indicated no internet use during one decade. In the slow increase cluster, internet use rose slowly with an average of 7.69 hours per week in 2020. In contrast, the ‘Rapid increase’ cluster exhibited a sharp increase, reaching 15.13 hours per week in 2020. Compared to the ‘Never use’ cluster, the ‘Slow increase’ cluster was significantly negatively associated with depressive scores among middle-aged and older adults (P=0.002, 95% CI −0.51-−0.12), while the ‘Rapid increase’ cluster showed no significant association. The benefits of internet use were more pronounced in the lower-income group compared to the higher-income group. The sensitive analysis confirmed the robustness of the results.

Conclusions:

This study identified three trajectory clusters of internet usage time among middle-aged and older adults in China from 2010 to 2020. The ‘Slow increase’ cluster exhibited a negative association with depressive scores, with this relationship being more pronounced among female older adults and those with chronic diseases. Future initiatives should aim to establish a senior-friendly internet environment to facilitate internet access for older adults and promote moderate internet use.