Quantifying the association between rural older adult daily internet use duration and affective disorders: an empirical study based on propensity score matching.

BACKGROUND

There are significant disparities in internet usage among rural older adults, while affective disorder is an increasing public health concern. The potential link between these phenomena remains underexplored. This study investigates the association between internet use and affective disorder among rural older adults, to inform public health policies promoting appropriate internet engagement and psychological well-being.

METHODS

The baseline survey of the Northern China Lifestyle Medicine Cohort was conducted among rural older adult (≥65 years old) in China from July 2023 to January 2024. Questionnaires were used to collect data on the average daily usage schedule of the Internet and emotional disorders. Multivariate Logistic regression models were used to determine the factors influencing the prevalence of affective disorders. Propensity score matching (PSM) analysis was adopted to explore the relationship between Internet usage and emotional disorders.

RESULTS

A total of 9,924 participants were included in this study (43.0% were male), significantly higher than that of medium-term users (29.79%) and long-term users (25.29%). The prevalence of affective disorders is 18.54%, and there is a significant gender difference (males: 14.24%; females: 21.77%). After adjusting for potential confounders, we found that female gender was associated with a higher risk of affective disorders in both the medium-long internet usage group [aOR = 1.44, 95%CI (1.21-1.72)] and the short usage group [aOR = 1.39, 95%CI (1.15-1.68)], compared to males. For participants in the medium-long internet usage group, healthy sleep duration was associated with a lower risk of affective disorders [aOR = 0.68, 95%CI (0.58-0.79)]. The short prevalence of affective disorders among short-term Internet users is associated with healthy physical activity [aOR = 0.57, 95%CI (0.48-0.68)]. PSM analysis shows that after matching, the prevalence of affective disorders among short-term Internet users was higher than that among medium to long-term Internet users by 2.64%, and among all educational levels, the prevalence rate among women is higher than that among men.

CONCLUSION

This study indicates that Internet use is associated with a lower prevalence of affective disorders among rural older adult. These findings emphasize the importance of formulating a public health strategy that integrates digital inclusion and mental health promotion.

CLINICAL TRIAL REGISTRATION

https://www.chictr.org.cn/showprojEN.html?proj=206128.

Copyright © 2026 Miao, Wang, Guo, Li, Wei, Shen, Zhu, Zhang, Zhang, Zhen, Li, Cui, Tarimo, Lu, Han, Mou and Qin.