How Does the Relationship between Social Technology Use and Mental Health Differ Among Older Adults with Varying Levels of Disability?

Background/Purpose: As the older adult population expands, mental health issues become a significant social concern. Depression and anxiety are negatively associated with quality of life among older adults, making protective interventions a critical focus in mental health research and policy. Research indicates that the use of social technology mitigates depression and isolation among older adults. However, while disability has been found to moderate the relationship between social technology use and depression among older adults, little is known about how diverse experiences of disability may influence this relationship. In particular, varying levels of impairment with activities of daily living—often used as an indicator of disability—might impact technology accessibility and its usage. This study aims to examine how social technology use relates to mental health—specifically, depression and anxiety—among older adults with varying levels of disability.

Methods: This study analyzed Round 13 (2023/2024) of the National Health and Aging Trends Study. A stratified three-stage sampling design was utilized to collect detailed lifestyle data from Medicare beneficiaries aged 65+ in the U.S. Disability scores were calculated using six activities of daily living (ADLs) and four instrumental activities of daily living (IADLs). Respondents with difficulties in three to four ADLs/IADLs were classified as having moderate disability levels, and those with five or more were categorized as having severe disability levels. Social technology use was calculated based on respondent usage of video calls with family and friends, social network sites, and emails and texts during the past month. Depression and anxiety were assessed using the 4-item Patient Health Questionnaire-4, comprising a 2-item depression subscale and a 2-item anxiety subscale (reported both separately and combined).

Results: Older adult participants were largely female (57.8%), White (57.3%), married (42.5%), aged 70–79 (42.2%), and reported having good, very good, or excellent health (67.6%). Most older adults had problems with zero (59.1%) or one or two (31.1%) ADLs/IADLs. Fourteen percent suffered from depression and 9.4 % from a combination of depression/anxiety. When comparing disability levels, social technology use was negatively associated with depression (β=-.05, p <0.01) and depression/anxiety (β=-.06, p <0.05) among older adults with no or mild disability, controlling for socio-demographics. Conversely, among older adults with severe disabilities, the use of social technology was positively associated with depression (β=.64, p <0.01) and depression/anxiety (β=1.17, p <0.01). No association was found between social technology use and depression/anxiety for older adults with moderate disability.

Conclusions/Implications: Social internet use negatively relates to depression among older adults with difficulty in 0-2 ADLs/IADLs, which corresponds with research findings. The unexpected positive relationship between depression/anxiety and social internet use among older adults with severe levels of disability may correspond with research indicating a positive correlation between excessive internet use and depression. Therefore, while social workers may promote social internet use for clients with no/low disability levels to alleviate depression, caution should be exercised in recommending social internet use for older adults experiencing severe disability levels. Longitudinal examination of these relationships is recommended to illuminate causal relationships (beyond the associations presented) and to inform future intervention.