The impact of Internet use on depressive symptoms in older adults: based on the chain mediating role of physical activity and self-rated health

Tentatively accepted

Background Depressive symptoms in older adults represent a major public health problem. Although many studies suggest a possible association between Internet use and depressive symptoms, the underlying mechanisms of this association in older adults remain unclear. The aim of this study was to examine the multiple mediating effects of physical activity and self-rated health on the association between Internet use and depressive symptoms in older adults. Results After controlling for age, gender, marital status, chronic illness and education level, the regression results showed that Internet use had a significant direct influence on depressive symptoms in older people (β=-0.684, t=-4.318, P <0.001). Physical activity and self-rated health status significantly influenced depressive symptoms in older people (β=-0.176, t=-7.939, P<0.001; β=-0.937, t=-18.681, P<0.001). The mediating results showed that the mediating effect of physical activity between Internet use and depressive symptoms in the elderly was -0.220 (95% CI: -0.2877~-0.1598), and the mediating effect of self-rated health was between Internet use and depressive symptoms in the elderly was -0.084 (95% CI: -0.1716~-0.0008) and the chain mediation effect was -0.022 (95% CI: -0.0371~-0.0076). The potential profile analysis of depressive symptoms in older people without using the Internet showed that they can be divided into three groups, namely high loneliness - high depression group (7.4%), medium loneliness - moderate depression group (14.7% ) and low loneliness – low depression group (77.9%). Conclusion Internet use may directly affect older people's depressive symptoms, and may also indirectly affect older people's depressive symptoms through physical exercise and self-rated health. The depressive symptoms of older people who do not use the Internet are heterogeneous and can be divided into three categories. With the popularization of the Internet, the use of the Internet for the elderly should be promoted and the frequency of physical exercise should be increased to achieve physical and mental health.