JMIR Publications

ABSTRACT

Background:

Loneliness is a growing public health challenge among older adults and is associated with a wide range of adverse health outcomes. The role of eHealth literacy in shaping the relationship between loneliness and quality of life remains unclear.

Objective:

This study aimed to examine the contributing role of eHealth literacy in moderating the associations between loneliness and quality of life among older adults.

Methods:

A community-based survey was conducted in 2025 among older adults aged 60 years or above living in northwestern China. A total of 2,110 participants were included. Multiple linear regression and interaction models were used to assess associations and moderating effects.

Results:

Loneliness showed a consistent negative association with quality of life (β = −0.83, 95% CI = −1.18, −0.49). Higher overall eHealth literacy was associated with better quality of life (β = 0.41, 95% CI = 0.35, 0.47). Interaction models indicated a risk amplification pattern: the negative association between loneliness and quality of life was steeper among older adults with higher eHealth literacy (β = −0.04, 95% CI = −0.08, −0.002, ΔR² = 0.0879). Sensitivity analyses produced similar results across alternative outcomes and subgroups.

Conclusions:

Higher eHealth literacy didn’t buffer the adverse association between loneliness and quality of life and instead intensified it. These findings suggest that eHealth literacy may function as a dual-edged resource in later life. Future research is needed to clarify the underlying mechanisms and to examine how digital health competencies interact with psychosocial vulnerability in shaping older adults’ well-being.