{
  "abstract": "Introduction: The digital divide is treated as a social determinant of later-life mental health, yet most evidence is cross-sectional and cannot separate its prospective effect from contemporaneous confounding. We examined which facets prospectively predict depression in older adults, and through what pathway.\n\nMethods: We analyzed three waves (2018, 2020, 2023) of the China Longitudinal Aging Social Survey. Four 2020 divide indicators (access, proficiency, usage variety, outcomes) predicted 2023 CES-D-9 symptoms, adjusting for baseline symptoms and covariates; the 2018–2020 interval provided an earlier-window replication. Half-longitudinal (Cole-Maxwell) mediation tested four social-connection mediators, moderated by hukou, living arrangement, and gender.\n\nResults: After adjustment for baseline depression, only the usage-variety divide—a narrower range of online activity—predicted higher subsequent depressive symptoms (b = 0.069, 95% CI 0.008–0.131). Of four mediators, only instrumental support mediated this association (indirect 0.019, bootstrap 95% CI 0.010–0.033), replicating in the 2018–2020 window (indirect 0.014, bias-corrected 95% CI 0.005–0.028). The pathway was stronger among urban and co-resident adults, with baseline instrumental support far higher in urban than rural areas (difference 0.82, p < 0.001), consistent with resource multiplication rather than substitution.\n\nDiscussion: Conditioning on baseline depression, only the usage-variety divide—not access, proficiency, or outcomes—is prospectively associated with later depressive symptoms (chiefly as a stable between-person difference); this association was statistically mediated by lower instrumental support. Because the mediated association was stronger in resource-rich subgroups, the pattern is more consistent with resource multiplication than with substitution. Translating digital inclusion into mental-health gains may require broadening use while strengthening instrumental-support infrastructure, especially in rural settings.",
  "abstract_shown": true,
  "affiliations": [
    "Nottingham University Business School China, University of Nottingham Ningbo China , ,"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Ningyi Hou"
    },
    {
      "affs": [
        0
      ],
      "name": "Tianyuan Chen"
    },
    {
      "affs": [
        0
      ],
      "name": "Zhixian Yu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/a8a627qy2tzhv.bib",
  "cited_by": 0,
  "doi": "10.3389/fpubh.2026.1895216",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662110/?tool=EBI",
  "id": "a8a627qy2tzhv",
  "issns": [
    "2296-2565"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13662110",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "3317|Technology Use by Older Adults"
    ]
  ],
  "openalex": "W7214963747",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662110/pdf/?tool=EBI",
  "pmcid": "PMC13662110",
  "pmid": null,
  "published": "2026-09-30",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/a8a627qy2tzhv.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:20Z",
      "native_id": "PMC:PMC13662110",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13662110"
    },
    {
      "first_seen": "2026-10-30T12:20:22Z",
      "native_id": "10.3389/fpubh.2026.1895216",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fpubh.2026.1895216/full"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:2296-2565",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Beyond access: usage variety, instrumental support, and later-life depression in a prospective study of Chinese older adults",
  "title_text": "Beyond access: usage variety, instrumental support, and later-life depression in a prospective study of Chinese older adults",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:22Z",
  "url": "https://research.draconitic.com/paper/a8a627qy2tzhv",
  "venue": "Frontiers in public health",
  "versions": []
}