Internet use and health among older adults in China: Indirect associations through social participation and physical activity

Background With the rapid diffusion of digital technologies in later life, Internet use may become an important factor associated with older adults’ health. This study investigated the associations between Internet use and physical and mental health among Chinese older adults, with particular attention to indirect associations through social participation and physical activity. Methods Data were obtained from the 2023 Chinese General Social Survey. The analytical sample consisted of 2,219 respondents aged 60 years and above. Descriptive analysis, Pearson correlation analysis, multiple linear regression, bootstrap analysis of indirect associations, and urban–rural subgroup analysis were used to examine the associations among Internet use, social participation, physical activity, and health outcomes. Results Internet use was positively related to physical health (β = 0.144, p < 0.001) and mental health (β = 0.090, p < 0.001). Internet use also showed positive associations with social participation (β = 0.138, p < 0.001) and physical activity (β = 0.151, p < 0.001). After social participation and physical activity were included in the models, the associations between Internet use and physical health (β = 0.099, p < 0.001) and mental health (β = 0.061, p < 0.01) remained significant. Bootstrap analysis indicated statistically significant total indirect associations for physical health (95% CI: [0.0228, 0.0404]) and mental health (95% CI: [0.0089, 0.0184]). Among the estimated indirect associations, the association through physical activity accounted for the largest proportion. The interaction between Internet use and urban status was significant only in the physical health model (β = −0.061, p < 0.05). Conclusions Internet use is associated with better physical and mental health among older adults in China. Social participation and physical activity statistically account for part of these associations. The stronger association observed for physical health among rural older adults suggests that the health-related role of Internet use may depend on social and resource contexts.