Internet use and frailty in middle-aged and older adults: Findings from developed and developing countries

Abstract Background With increasing trend of internet use in all age groups, whether internet use can prevent frailty in middle-aged and older adults remains unclear. Methods Five cohorts across the United States, England, 28 Europe countries, China and Mexico were used in this study. Frailty status was assessed by frailty index based on a standard procedure. Generalized estimating equations models, random effects meta-analysis, and mediation analysis were utilized. Results In the multicohort study, a total of 155,695 participants were included. The proportion of internet use was varied across countries, ranging from 5.56% in China to 83.46% in Denmark. According to the generalized estimating equations models and meta-analysis, internet use was inversely associated with frailty, with the pooled ORs (95%CIs) of 0.72 (0.67,0.79). Additionally, the association was partially mediated by social activities and slightly pronounced in participants aged 65 and over, male, not working for payment, not married or partnered, not smoking, drinking, and not co-residence with children. Conclusions Our findings highlight the important role of internet use in the incidence of frailty and recommend more engagements in social activities among middle-aged and older adults. Grasping the opportunity to spread health information and increase social activities by the internet would decrease the incidence of frailty.