Internet adoption among older adults was associated with more favorable cognitive change, whereas evidence for depressive symptoms was weaker and less consistent, suggesting digital inclusion may be relevant to cognitive health promotion but should be complemented by offline social and community support.
Key Findings
Results
Cross-sectionally, older adults who combined internet use with offline social participation (Dual-mode) showed the most favorable cognitive and depressive symptom profiles compared to Inactive and Offline-only participants.
Three digital-social profiles were compared in 2018: Inactive, Offline-only, and Dual-mode participants.
Total cross-sectional sample was n = 10,935.
Dual-mode participants combined internet use with offline social participation.
This cross-sectional comparison was based on the 2018 wave of the China Health and Retirement Longitudinal Study (CHARLS).
Results
New internet adoption among previously offline older adults was associated with a statistically significant greater increase in cognitive function score compared to consistent non-use.
The longitudinal analysis included 3,346 baseline offline-only participants, of whom 1,699 became new internet adopters by 2020.
Cognitive function was measured using a 10-point Minimum Mental State Examination (MMSE)-derived cognitive function score.
The association was β = 0.28 (95% CI: 0.11 to 0.44, p < .001).
This association remained consistent in propensity-score-weighted and baseline-adjusted sensitivity analyses.
Data were drawn from the 2018 and 2020 waves of CHARLS, spanning the COVID-19 period.
Results
New internet adoption was not significantly associated with change in depressive symptoms in the primary longitudinal model.
Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10).
The primary model yielded β = -0.18 (95% CI: -0.59 to 0.22, p = .40).
The authors described evidence for depressive symptom improvement as 'weaker and less consistent' compared to cognitive outcomes.
The longitudinal sample included 3,346 baseline offline-only participants observed across the 2018 and 2020 CHARLS waves.
Methods
The study used a longitudinal change-score analysis design leveraging the COVID-19 period as a unique social context for examining first-time internet adoption.
Data came from the 2018 and 2020 waves of the China Health and Retirement Longitudinal Study (CHARLS).
The COVID-19 period was used as a naturalistic context in which older adults may have been prompted to adopt internet use for the first time.
Propensity-score-weighting and baseline-adjusted sensitivity analyses were conducted to address confounding.
Baseline offline-only participants (n = 3,346) were the longitudinal analytic sample, with 1,699 becoming new internet adopters by 2020.
Conclusions
The authors concluded that digital inclusion may be relevant to cognitive health promotion in older adults, but should be complemented by offline social and community support.
The finding that Dual-mode participants (internet plus offline social participation) had the most favorable profiles supports the value of combining digital and in-person engagement.
The authors noted that internet adoption alone was insufficient to demonstrate consistent mental health benefits.
The recommendation to complement digital inclusion with offline social and community support was drawn from both the cross-sectional and longitudinal findings.
What This Means
This research suggests that older adults who started using the internet for the first time during the COVID-19 pandemic experienced greater improvements in cognitive functioning compared to those who remained offline. The study followed over 3,300 older Chinese adults between 2018 and 2020, tracking whether they began using the internet and how their memory and thinking abilities, as well as their mood, changed over that period. Those who adopted the internet showed meaningfully better cognitive scores, and this finding held up even after the researchers used statistical techniques to account for differences between groups.
However, the research also found that internet adoption alone did not significantly improve depressive symptoms. Notably, older adults who combined internet use with in-person social activities had the best overall mental and cognitive health profiles, suggesting that online engagement works best alongside — not instead of — real-world social connection. The COVID-19 period provided a unique window for this study because social restrictions may have pushed many older adults to try the internet for the first time, creating a natural comparison group.
This research matters because it suggests that encouraging older adults to get online could be a meaningful strategy for supporting brain health as populations age, but that digital access alone is not a complete solution. Programs aimed at reducing the 'digital divide' for older adults may have cognitive benefits, but policymakers and community organizations should also ensure that offline social and community support structures remain in place.
Xu J, Zhu Z, Sun X, Lu L, Yao Z, Cai H, et al.. (2026). Internet adoption and health trajectories in older adults during COVID-19: a longitudinal study.. Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists. https://doi.org/10.1093/arclin/acag064