Full
Outline
To explore the long-term relationship between digital exclusion and depressive symptoms in middle-aged and older adults in China, to evaluate whether social participation serves as a mediator in this connection, and to guide interventions to reduce depression within this group.
A longitudinal analysis was conducted using data from the 2011-2020 waves of the China Health and Retirement Longitudinal Study (CHARLS). Self-reported data were used to evaluate digital exclusion and social participation, while the presence of depressive symptoms was measured with the 10-item version of the Center for Epidemiologic Studies Depression Scale (CES-D 10). Differences in the incidence of depressive symptoms among groups were assessed using Kaplan-Meier estimates and the log-rank test. Cox proportional hazards models were used to analyze the longitudinal association between digital exclusion and depressive symptoms, and causal mediation analysis was employed to test the mediating effect.
A total of 8 808 participants were included in the study. At baseline, 8 334 (94.6%) individuals were classified as digital exclusion group. Over a median follow-up of 7.00 years, 3 969 participants developed depressive symptoms. The survival analysis revealed that the cumulative incidence of depressive symptoms was significantly higher in the digital exclusion group than that in the digital inclusion group (Log-rank P<0.05). After controlling for confounders, Cox regression analysis showed that digital exclusion remained an independent risk factor for depressive symptoms (HR=1.37, 95% CI: 1.11-1.69). The mediation analysis found that social participation partially mediated the association between digital exclusion and depressive symptoms.
Digital exclusion is associated with an increased risk of depressive symptoms among middle-aged and older Chinese adults. This association may be partially mediated by social participation. Promoting digital inclusion and encouraging social engagement may be potential strategies for the prevention and intervention of depression in this vulnerable group.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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