The Relationship Between Internet Use and Depression Among Middle and Older Adults With Self-Reported Vision Impairment: Case-Control Study (Preprint)
BACKGROUND The number of middle and older adults using the internet is increasing in China. Internet-based eHealth and mHealth technologies are also gradually changing people's lifestyles. In recent years, as visual impairment (VI) in the elderly has become increasingly prominent, we have focused our research on the relationship between internet use and depression in the middle and older adults with VI. OBJECTIVE This study examined (1) whether the rate of internet use and depression among middle and older adults with VI are different from the matched sample of peers without VI, and (2) associations among VI, internet use and depression. METHODS Data were obtained from the wave 4 of the China Health and Retirement Longitudinal Study (CHARLS) in 2018. Middle and older adults (aged≥45 years) with self-reported VI were matched with middle and older adults without VI, in a 1:1 ratio, based on age, sex, health status, and number of chronic diseases (N=15,398). Descriptive statistics and logistic regression models were used to examine the relationship of internet use and depression among middle and older adults with self-reported VI. RESULTS A total of 7699 middle and older adults reported VI in this study, 47.6 % of them were male and 9.8% aged ≥75. Those with internet use were significantly more socioeconomically advantaged than those who do not, and those who with VI were less likely to use the internet (adjusted odds ratio (aOR) 0.67, 95% CI 0.61- 0.74). People who have VI or blindness were associated with greater odds of depressive symptoms/depression (aOR 1.25, 95% CI 1.16 – 1.33, and aOR 1.48, 95% CI 1.22 – 1.80, respectively), and those who use the internet was associated with lower odds of depressive symptoms/depression (aOR 0.74, 95% CI 0.66 – 0.82). Some of the health seeking behaviors were also associated with higher odds of internet use and depressive symptoms or depression. CONCLUSIONS Compared with peers without VI, middle and older adults with VI are less likely to use the internet. Internet use may be an effective way to relieve depression, especially for VI groups, eHealth and mHealth can promote disease monitoring, diagnosis and treatment effectively. Therefore, it is necessary to strengthen the training and guidance of internet use for middle and older adults, especially for those with VI.