{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T23:42:07Z","timestamp":1790638927472,"version":"4.1.0"},"reference-count":55,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n The effects of smartphone use on mental health and brain activity in adolescents have received much attention; however, the effects on older adults have received little attention. As more and more older adults begin to use smartphones, exploring the effects of nonaddictive smartphone use on mental health, cognitive function, and brain activity in older adults is imperative.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to examine differences in cognitive performance, emotional symptoms (depression, anxiety, and insomnia), and brain functional activity between older adults who use smartphones and those who do not.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A total of 1014 community-dwelling older adults aged 60 years and above were surveyed in a rural area of China. Participants were categorized into 2 groups based on their smartphone use status. The Patient Health Questionnaire, Generalized Anxiety Disorder Scale, Insomnia Severity Index, and Montreal Cognitive Assessment-Basic were used to evaluate the symptoms of depression, anxiety, insomnia, and cognitive function of the participants by trained medical staff. To explore neural mechanisms, a subsample of 130 participants (89 smartphone users and 41 nonusers) was selected using stratified random sampling for resting-state functional magnetic resonance imaging scanning. Participants with contraindications for magnetic resonance imaging (eg, metal implants or claustrophobia) or who refused to participate were excluded. Functional brain activity was analyzed and compared between groups.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among all 1015 older adults, 641 reported using smartphones, while 373 reported never using smartphones. Older adults who use smartphones exhibited better cognitive function compared with those who never use smartphones (\n z<\/jats:italic>\n =3.806,\n P<\/jats:italic>\n <.001), especially in the domains of fluency (\n z<\/jats:italic>\n =3.025,\n P<\/jats:italic>\n =.002) and abstraction (\n z<\/jats:italic>\n =5.311,\n P<\/jats:italic>\n <.001). However, there were no significant differences in levels of depression (\n z<\/jats:italic>\n =0.689,\n P<\/jats:italic>\n =.49), anxiety (\n z<\/jats:italic>\n =0.934,\n P<\/jats:italic>\n =.35), and insomnia (\n z<\/jats:italic>\n =0.340,\n P<\/jats:italic>\n =.73). In terms of the magnetic resonance imaging findings, a total of 130 participants completed functional magnetic resonance imaging scanning, including 89 who use smartphones and 41 who never use smartphones, and results showed that older adults who were smartphone users exhibited higher degree centrality values in the left parahippocampal gyrus.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n These findings suggest that smartphone use among older adults is associated with better cognitive performance and fewer emotional symptoms, potentially linked to enhanced brain activity in key cognitive regions. Promoting digital engagement may offer cognitive and emotional benefits for aging populations. Longitudinal studies are warranted to examine causal relationships.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/63485","type":"journal-article","created":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T09:50:08Z","timestamp":1747043408000},"page":"e63485-e63485","source":"Crossref","is-referenced-by-count":3,"title":["Cognitive and Spontaneous Brain Activity in Nonaddictive Smartphone Users Among Older Adults in China: Cross-Sectional Study"],"prefix":"10.2196","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0280-7310","authenticated-orcid":false,"given":"Zhenyu","family":"Wan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6896-5429","authenticated-orcid":false,"given":"Xucong","family":"Qin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5961-5605","authenticated-orcid":false,"given":"Qirong","family":"Wan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4891-3928","authenticated-orcid":false,"given":"Baohua","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7141-9750","authenticated-orcid":false,"given":"Hong","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6675-2174","authenticated-orcid":false,"given":"Fangcheng","family":"Ouyang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8947-9921","authenticated-orcid":false,"given":"Gaohua","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,7,24]]},"reference":[{"key":"R1","unstructured":"World Population Prospects 2022: summary of results. United Nations; 2022. URL: https:\/\/www.un.org\/development\/desa\/pd\/sites\/www.un.org.development.desa.pd\/files\/wpp2022_summary_of_results.pdf [Accessed 20-06-2025]"},{"issue":"2","key":"R2","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1111\/j.1540-4560.2005.00402.x","article-title":"Ageism: prejudice against our feared future self","volume":"61","author":"Nelson","journal-title":"J Soc Issues"},{"issue":"10","key":"R3","doi-asserted-by":"publisher","first-page":"1535","DOI":"10.2105\/AJPH.2020.305798","article-title":"Leisure activity engagement among the oldest old in China, 1998-2018","volume":"110","author":"Feng","journal-title":"Am J Public Health"},{"issue":"1","key":"R4","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1016\/j.neuron.2017.02.004","article-title":"Sleep and human aging","volume":"94","author":"Mander","journal-title":"Neuron"},{"issue":"101232","key":"R5","doi-asserted-by":"publisher","first-page":"101232","DOI":"10.1016\/j.arr.2020.101232","article-title":"Combined physical and cognitive training for older adults with and without cognitive impairment: a systematic review and network meta-analysis of randomized controlled trials","volume":"66","author":"Gavelin","journal-title":"Ageing Res Rev"},{"issue":"1","key":"R6","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/j.jsmc.2017.09.009","article-title":"Sleep and cognition in older adults","volume":"13","author":"Dzierzewski","journal-title":"Sleep Med Clin"},{"issue":"1","key":"R7","doi-asserted-by":"publisher","first-page":"699","DOI":"10.3233\/ADR-230011","article-title":"The impact of loneliness and social isolation on cognitive aging: a narrative review","volume":"7","author":"Guarnera","journal-title":"J Alzheimers Dis Rep"},{"issue":"20","key":"R8","doi-asserted-by":"publisher","first-page":"2114","DOI":"10.1001\/jama.2017.5706","article-title":"Management of depression in older adults: a review","volume":"317","author":"Kok","journal-title":"JAMA"},{"issue":"8","key":"R9","doi-asserted-by":"publisher","DOI":"10.1007\/s10916-022-01839-7","article-title":"Smartphone use, digital addiction and physical and mental health in community-dwelling older adults: a population-based survey","volume":"46","author":"Bertocchi","journal-title":"J Med Syst"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2022.101742","article-title":"Digital media use and sleep in late adolescence and young adulthood: a systematic review","volume":"68","author":"Brautsch","journal-title":"Sleep Med Rev"},{"issue":"5","key":"R11","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1177\/0020764020960207","article-title":"Smart phone usage, sleep quality and depression in university students","volume":"67","author":"Kaya","journal-title":"Int J Soc Psychiatry"},{"key":"R12","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2023.1126815","article-title":"A comprehensive review on emerging trends in the dynamic evolution of digital addiction and depression","volume":"14","author":"Karakose","journal-title":"Front Psychol"},{"key":"R13","doi-asserted-by":"publisher","DOI":"10.1016\/j.janxdis.2018.11.005","article-title":"The relationship between anxiety symptom severity and problematic smartphone use: a review of the literature and conceptual frameworks","volume":"62","author":"Elhai","journal-title":"J Anxiety Disord"},{"key":"R14","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2022.152346","article-title":"Advances in problematic usage of the internet research - a narrative review by experts from the European network for problematic usage of the internet","volume":"118","author":"Fineberg","journal-title":"Compr Psychiatry"},{"key":"R15","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2021.107109","article-title":"A two-generation study: the transmission of attachment and young adults\u2019 depression, anxiety, and social media addiction","volume":"124","author":"Arikan","journal-title":"Addict Behav"},{"issue":"3","key":"R16","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1556\/2006.8.2019.50","article-title":"Lateral orbitofrontal gray matter abnormalities in subjects with problematic smartphone use","volume":"8","author":"Lee","journal-title":"J Behav Addict"},{"issue":"4","key":"R17","doi-asserted-by":"publisher","first-page":"1048","DOI":"10.1556\/2006.2021.00085","article-title":"Altered connectivity in the right inferior frontal gyrus associated with self-control in adolescents exhibiting problematic smartphone use: a fMRI study","volume":"10","author":"Pyeon","journal-title":"J Behav Addict"},{"issue":"9","key":"R18","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: validity of a brief depression severity measure","volume":"16","author":"Kroenke","journal-title":"J Gen Intern Med"},{"issue":"10","key":"R19","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: the GAD-7","volume":"166","author":"Spitzer","journal-title":"Arch Intern Med"},{"issue":"4","key":"R20","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1016\/s1389-9457(00)00065-4","article-title":"Validation of the Insomnia Severity Index as an outcome measure for insomnia research","volume":"2","author":"Bastien","journal-title":"Sleep Med"},{"issue":"12","key":"R21","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare9121709","article-title":"Psychometric properties of the Generalized Anxiety Disorder Scale-7 Item (GAD-7) in a large sample of Chinese adolescents","volume":"9","author":"Sun","journal-title":"Healthcare (Basel)"},{"issue":"3","key":"R22","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18031082","article-title":"Measuring subjective sleep quality: a review","volume":"18","author":"Fabbri","journal-title":"Int J Environ Res Public Health"},{"issue":"12","key":"R23","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0083558","article-title":"The smartphone addiction scale: development and validation of a short version for adolescents","volume":"8","author":"Kwon","journal-title":"PLoS ONE"},{"issue":"12","key":"R24","doi-asserted-by":"publisher","first-page":"2550","DOI":"10.1111\/jgs.13820","article-title":"The Montreal Cognitive Assessment-Basic: a screening tool for mild cognitive impairment in illiterate and low-educated elderly adults","volume":"63","author":"Julayanont","journal-title":"J Am Geriatr Soc"},{"issue":"1","key":"R25","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1002\/mrm.1910140108","article-title":"Oxygenation-sensitive contrast in magnetic resonance image of rodent brain at high magnetic fields","volume":"14","author":"Ogawa","journal-title":"Magn Reson Med"},{"issue":"4","key":"R26","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1002\/mrm.1910340409","article-title":"Functional connectivity in the motor cortex of resting human brain using echo-planar MRI","volume":"34","author":"Biswal","journal-title":"Magn Reson Med"},{"key":"R27","unstructured":"Statistical parametric mapping. Wellcome Centre for Human Neuroimaging. URL: http:\/\/www.fil.ion.ucl.ac.uk\/spm [Accessed 20-06-2025]"},{"issue":"3","key":"R28","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1007\/s12021-016-9299-4","article-title":"DPABI: Data Processing & Analysis for (Resting-State) Brain Imaging","volume":"14","author":"Yan","journal-title":"Neuroinformatics"},{"issue":"9","key":"R29","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0184661","article-title":"MRIQC: advancing the automatic prediction of image quality in MRI from unseen sites","volume":"12","author":"Esteban","journal-title":"PLoS ONE"},{"issue":"1","key":"R30","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-14675-4","article-title":"A study of the brain functional network of post-stroke depression in three different lesion locations","volume":"7","author":"Shi","journal-title":"Sci Rep"},{"key":"R31","unstructured":"China statistical report on internet development (no.49) [Report in Chinese]. CNNIC; 2022. URL: https:\/\/www.cnnic.net.cn\/NMediaFile\/2023\/0807\/MAIN1691372884990HDTP1QOST8.pdf [Accessed 20-06-2025]"},{"issue":"1","key":"R32","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-019-1151-x","article-title":"Joint associations of smartphone use and gender on multidimensional cognitive health among community-dwelling older adults: a cross-sectional study","volume":"19","author":"Yuan","journal-title":"BMC Geriatr"},{"key":"R33","unstructured":"Chen K Chan AHS Tsang SNH . Usage of mobile phones amongst elderly people in Hong Kong. Presented at: Proceedings of the International MultiConference of Engineers and Computer Scientists 2013; Mar 13-15, 2013; Hong Kong. URL: https:\/\/www.iaeng.org\/publication\/IMECS2013\/IMECS2013_pp1016-1019.pdf [Accessed 04-07-2025]"},{"key":"R34","unstructured":"Bresnick E . Intensified play: cinematic study of TikTok mobile app. ResearchGate. 2019. URL: https:\/\/www.researchgate.net\/profile\/Ethan-Kurzrock\/publication\/335570557_Intensified_Play_Cinematic_study_of_TikTok_mobile_app\/links\/5dd3443d299bf1b74b4e2832\/Intensified-Play-Cinematic-study-of-TikTok-mobile-app.pdf [Accessed 20-06-2025]"},{"key":"R35","doi-asserted-by":"publisher","DOI":"10.1016\/j.chb.2021.106783","article-title":"Smartphone usage among older adults","volume":"121","author":"Busch","journal-title":"Comput Human Behav"},{"issue":"51","key":"R36","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2214285119","article-title":"A smartphone intervention that enhances real-world memory and promotes differentiation of hippocampal activity in older adults","volume":"119","author":"Martin","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"2","key":"R37","doi-asserted-by":"publisher","DOI":"10.1093\/geroni\/igac002","article-title":"A systematic review of smartphone and tablet use by older adults with and without cognitive impairment","volume":"6","author":"Wilson","journal-title":"Innov Aging"},{"issue":"1","key":"R38","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1111\/j.1745-6916.2006.00005.x","article-title":"Mental exercise and mental aging: evaluating the validity of the \u201cuse it or lose it\u201d hypothesis","volume":"1","author":"Salthouse","journal-title":"Perspect Psychol Sci"},{"issue":"2","key":"R39","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1007\/s11065-020-09440-w","article-title":"The effects of cognitive training on brain network activity and connectivity in aging and neurodegenerative diseases: a systematic review","volume":"30","author":"van Balkom","journal-title":"Neuropsychol Rev"},{"key":"R40","doi-asserted-by":"publisher","DOI":"10.1016\/j.arr.2019.100912","article-title":"Cognitive and neural plasticity in old age: a systematic review of evidence from executive functions cognitive training","volume":"53","author":"Nguyen","journal-title":"Ageing Res Rev"},{"issue":"1","key":"R41","doi-asserted-by":"publisher","first-page":"109","DOI":"10.31887\/DCNS.2013.15.1\/dpark","article-title":"The aging mind: neuroplasticity in response to cognitive training","volume":"15","author":"Park","journal-title":"Dialogues Clin Neurosci"},{"issue":"1","key":"R42","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1007\/s10433-016-0383-2","article-title":"Accelerated increase and relative decrease in subjective age and changes in attitudes toward own aging over a 4-year period: results from the health and retirement study","volume":"14","author":"Bodner","journal-title":"Eur J Ageing"},{"issue":"2","key":"R43","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1097\/JGP.0b013e3181953a02","article-title":"Your brain on Google: patterns of cerebral activation during internet searching","volume":"17","author":"Small","journal-title":"Am J Geriatr Psychiatry"},{"issue":"6","key":"R44","doi-asserted-by":"publisher","first-page":"1860","DOI":"10.1523\/JNEUROSCI.5062-08.2009","article-title":"Cortical hubs revealed by intrinsic functional connectivity: mapping, assessment of stability, and relation to Alzheimer\u2019s disease","volume":"29","author":"Buckner","journal-title":"J Neurosci"},{"issue":"8","key":"R45","doi-asserted-by":"publisher","first-page":"1862","DOI":"10.1093\/cercor\/bhr269","article-title":"Network centrality in the human functional connectome","volume":"22","author":"Zuo","journal-title":"Cereb Cortex"},{"issue":"8","key":"R46","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1016\/j.tics.2013.06.009","article-title":"The role of the parahippocampal cortex in cognition","volume":"17","author":"Aminoff","journal-title":"Trends Cogn Sci"},{"issue":"1","key":"R47","doi-asserted-by":"publisher","DOI":"10.1038\/s41398-021-01246-5","article-title":"The neural basis underlying impaired attentional control in problematic smartphone users","volume":"11","author":"Choi","journal-title":"Transl Psychiatry"},{"key":"R48","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2020.556060","article-title":"Cue-reactivity among young adults with problematic instagram use in response to instagram-themed risky behavior cues: a pilot fMRI study","volume":"11","author":"Nasser","journal-title":"Front Psychol"},{"key":"R49","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.669042","article-title":"Excessive smartphone use is associated with health problems in adolescents and young adults","volume":"12","author":"Wacks","journal-title":"Front Psychiatry"},{"issue":"93-101","key":"R50","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/j.socscimed.2015.11.037","article-title":"Bedtime mobile phone use and sleep in adults","volume":"148","author":"Exelmans","journal-title":"Soc Sci Med"},{"issue":"2","key":"R51","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1142\/S1013702518300010","article-title":"Musculoskeletal disorder and pain associated with smartphone use: a systematic review of biomechanical evidence","volume":"38","author":"Eitivipart","journal-title":"Hong Kong Physiother J"},{"issue":"1","key":"R52","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-024-17873-8","article-title":"Smartphone usage and overdependence risk among middle-aged and older adults: a cross-sectional study","volume":"24","author":"Kim","journal-title":"BMC Public Health"},{"issue":"16","key":"R53","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18168291","article-title":"Smartphone addiction and sleep quality on academic performance of university students: an exploratory research","volume":"18","author":"Rathakrishnan","journal-title":"Int J Environ Res Public Health"},{"issue":"1","key":"R54","doi-asserted-by":"publisher","DOI":"10.1192\/j.eurpsy.2022.2316","article-title":"European Psychiatric Association guidance on assessment of cognitive impairment in schizophrenia","volume":"65","author":"Vita","journal-title":"Eur Psychiatry"},{"key":"R55","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2022.1002096","article-title":"25 years of neurocognitive aging theories: what have we learned?","volume":"14","author":"McDonough","journal-title":"Front Aging Neurosci"}],"container-title":["Journal of Medical Internet Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.jmir.org\/2025\/1\/e63485","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T22:31:01Z","timestamp":1785537061000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jmir.org\/2025\/1\/e63485"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,24]]},"references-count":55,"URL":"https:\/\/doi.org\/10.2196\/63485","relation":{},"ISSN":["1438-8871"],"issn-type":[{"value":"1438-8871","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,24]]},"article-number":"v27i2e63485"}}