Protective Role of the Internet in Depression for Europeans Aged 50+ Living Alone

The Protective Role of the Internet in Depression for Europeans Aged 50+ Living Alone. Patrícia Silva, Alice Delerue Matos, Roberto Martinez-Pecino. Social Media + Society, March 18, 2022. https://doi.org/10.1177/20563051221077675

Abstract: Depression is a significant and limiting health problem, and living alone has been identified as an essential determinant of depressive symptoms in middle-aged and older adults. This study looks at this relationship by introducing a new factor into the equation—the Internet—which has become increasingly relevant for communication and interaction. It aims to assess to what extent the use of the Internet can mitigate the association between living alone and depression in middle-aged and older adults. This study focuses on a sample of 64,260 individuals aged 50+ who are resident in Portugal, Greece, Italy, Spain, Denmark, Sweden, Austria, Belgium, France, Germany, Switzerland, Luxemburg, Poland, Czech Republic, Slovenia, Estonia, and Croatia and were surveyed in the context of the SHARE project (Survey of Health, Ageing, and Retirement in Europe), Wave 6. The results showed that living alone relates to greater odds of depression. Nevertheless, of particular relevance is that they also evidenced that the Internet has a moderating role on this relationship, revealing a protective role, since Europeans aged 50+ who live alone and are Internet users are less likely to experience depression than other older adults. The findings reinforce the importance of policies aimed at digital inclusion to benefit the mental health of older adults who live alone in Europe.

Keywords: depression, living alone, Internet, 50+ individuals, Europe

Discussion

The main goal of this study was to analyze, with a large sample, the moderating role of the Internet in the relationship between living alone and depression in Europe, after having controlled for the influence of the characteristics of the individuals frequently associated with depression.

In this research, by the previous literature, living alone positively relates to depression (Das Gupta et al., 2020; Djernes, 2006; Gyasi et al., 2020; Hu et al., 2012; D. Russell & Taylor, 2009; Stahl et al., 2017). However, Internet use by adults aged 50+ years is related to fewer depressive symptoms in Europe. This corroborates the results of previous studies (Cotten et al., 2014; Wang et al., 2019) and may reinforce the potential importance of the Internet as a means of communication (Antonucci et al., 2017; Martinez-Pecino et al., 2013; Román-García et al., 2016; C. Russell et al., 2008).

The main result of this study is that the Internet moderates the relationship between living alone and depression; that is, adults who live alone and use the Internet are less likely to experience depression than other middle-aged and older adults, confirming our hypothesis. Considering the increasing number of older adults living alone in the current society (Mudrazija et al., 2020; Reher & Requena, 2018), the result is relevant since the study focuses on a large sample and controls for variables that have traditionally been associated with depression.

One possible explanation for this outcome is that the Internet can constitute a crucial means of communication (Antonucci et al., 2017; Martinez-Pecino et al., 2011; Reis et al., 2021) with social networks of older persons living alone, which are very important for their well-being (Djundeva et al., 2019; Gyasi et al., 2020). As stated by Papacharissi (2015), all media foster communication. Thus, our results align with recent studies that suggest that, although adults living alone have less interaction with their family, through online communication, they can communicate like people who live with their family (Nakagomi et al., 2022). In this sense, the Internet can prevent depression by increasing social contact (Nakagomi et al., 2022). Furthermore, according to Szabo et al. (2019), contact with family and friends through the Internet helps older adults to maintain their sense of belonging, increase social engagement and receive social support, which can be especially important when family members are geographically distant (Szabo et al., 2019). Thus, this study also supports the literature that indicates that social media are essential for activating, strengthening, or maintaining ties (Haythornthwaite, 2002, 2005), even in contexts where older adults reside alone. It also complements the literature that states that social media are essential resources for older adults’ mental health (Bonsaksen et al., 2021; Forsman & Nordmyr, 2017).

This study also observed the influence of the traditional determinants associated with depression, controlled in the analyses. Thus, we could observe that in Europe, as underlined in the research literature, depression is influenced by a set of sociodemographic, economic, and health characteristics. In fact, as in other studies, increasing age (Weyerer et al., 2013) and being female (Calvó-Perxas et al., 2016; Conde-Sala et al., 2019; Ylli et al., 2016; Zunzunegui et al., 2007) are positively related to depression. However, increased education reduces the chances of depressive symptoms, which also corroborates the results of other studies (Calvó-Perxas et al., 2016; Kok et al., 2012; Portellano-Ortiz et al., 2018; Ylli et al., 2016). Depression has also been associated with financial difficulties (Calvó-Perxas et al., 2016; Conde-Sala et al., 2019; Portellano-Ortiz et al., 2018; Ylli et al., 2016) and increased chronic diseases and functional limitations (Calvó-Perxas et al., 2016; Conde-Sala et al., 2019; Djernes, 2006; Huang et al., 2010; Portellano-Ortiz et al., 2018; Weyerer et al., 2013; Ylli et al., 2016).

Our results reinforce the possibility that Internet use may decrease the effect of social inequalities concerning depression in older adults (Mu et al., 2021). This is in line with research that has concluded that socio-economic characteristics contribute to disparities in depression at an older age. Using this technology can decrease this disparity, contributing to the mental health of middle-aged and older individuals (Mu et al., 2021).

This study has several limitations. The main one is that a single item was used to measure overall Internet use. Nevertheless, a yes/no response to whether someone regularly uses the Internet has frequently been used to assess Internet use by seniors (Cotten et al., 2012, 2014; Hogeboom et al., 2010; König & Seifert, 2020; König et al., 2018; Silva et al., 2017). Nonetheless, considering that the impact of the Internet in the social sphere depends on the type of activities conducted online (Chen, 2013; Hampton et al., 2009; Zhao, 2006), future studies need to consider the impact that different uses of the Internet may have on depression. It is also important to remember that Wave 6 of the SHARE project was collected in 2015. SHARE Wave 7 was dedicated to life stories, and data collection of Wave 8 was interrupted due to the COVID-19 pandemic. Since there is still evidence worldwide about the existence of a high percentage of older people who do not use the Internet (König et al., 2018; Silva et al., 2017) also of those who live alone (Mudrazija et al., 2020; Reher & Requena, 2018) and those who suffer depression (Castro-Costa et al., 2007; Conde-Sala et al., 2019), the findings of this study are entirely relevant to today’s society. Also, these issues are gaining increasing relevance in the current era marked by the COVID-19 pandemic, where recommendations for self-isolation emerge (García-Portilla et al., 2021). Since seniors are considered high risk under COVID-19, and their deaths are more common, they can accumulate stress and fear (Hui et al., 2020). The COVID-19 outbreak and associated physical distancing measures altered the social world for most older adults, but people who live alone may have been disproportionately affected (Fingerman et al., 2021). Due to the COVID-19 pandemic, social isolation of the older population has intensified mental health concerns about anxiety, depression (García-Portilla et al., 2021; Sepúlveda-Loyola et al., 2020; WHO, 2020), and even suicides (Rana, 2020; Sher, 2020). As noticed by some authors, the outbreak of COVID-19 will have a long-term and profound impact on older adults’ health (Wu, 2020). Thus, attention should be paid to adults who may struggle to maintain social contacts in light of physical distancing guidelines and overcome the challenges brought by this complex environment. The outcomes of this study precisely show the need to promote Internet use to face depression among older adults living alone.

Despite the above limitations, this study contributes to the open debate about the relation between Internet use and mental health where literature shows unclear outcomes and mixed evidence of the connection between the use of the Internet, well-being, and depression (Barbosa Neves et al., 2019; Hülür & Macdonald, 2020; P. Nie et al., 2017; Quintana et al., 2018; Sum et al., 2008). Studies are often criticized due to small samples and lack of consistency in measurement, and the need to control for co-variables (Cotten et al., 2012; Hargittai et al., 2019; Hülür & Macdonald, 2020; Meshi et al., 2020). In this regard, we contribute with a large sample of 64,260 individuals of different European countries and controlling for the influence of co-variables, frequently associated with depression, to evidence the moderating role of the Internet in the relationship between living alone and depression in middle-aged and older adults, and show the importance of this technology in preventing and combating depression in those who live alone. Thus, this study has important implications for a society with an increasing number of older people who live alone. It points to the need to develop policies that address the e-inclusion of these individuals to improve their mental health.