Association between mobile device proficiency, digital social participation, and frailty among community-dwelling older smartphone users: a cross-sectional study

Digital technologies may provide older adults with access to health information, service use, social connections, and health management. However, smartphone use alone does not indicate whether older adults can operate mobile devices effectively or use them for social participation. This study examined the associations between mobile device proficiency, digital social participation, and frailty among community-dwelling older smartphone users. This cross-sectional study surveyed adults aged 65 years in an urban ward in Osaka, Japan. Questionnaires were mailed to 1,500 residents randomly selected from the Basic Resident Register. After excluding respondents who did not provide consent, non-smartphone users, and those with incomplete or ambiguous responses, 308 smartphone users were included in the study. Frailty was assessed using the Kihon Checklist. Mobile device proficiency, digital social participation, loneliness, and conventional social participation were assessed using validated measures. Ordinal logistic regression using frailty categories was the primary analysis, and hierarchical multiple regression using the Kihon Checklist total score was an additional analysis. The mean age was 74.2 years, and 57 participants (18.5%) were classified as frail. Mobile device proficiency and digital social participation were negatively correlated with the Kihon Checklist total score. In the ordinal logistic regression, higher mobile device proficiency was associated with lower odds of being in a more severe frailty category, whereas greater loneliness was associated with higher odds of a more severe frailty category. In the additional hierarchical multiple regression, age, mobile device proficiency, and loneliness were independently associated with the Kihon Checklist score. However, digital and conventional social participation were not independently associated with frailty. Among community-dwelling older smartphone users, lower mobile device proficiency and greater loneliness were independently associated with frailty, whereas digital social participation was not. These findings suggest that frailty prevention strategies may need to consider not only whether older adults use smartphones but also whether they can operate them effectively in daily life and whether they experience subjective social disconnectedness.