{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:56:38Z","timestamp":1790751398591,"version":"4.1.0"},"reference-count":52,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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\u20132020 interval provided an earlier-window replication. Half-longitudinal (Cole-Maxwell) mediation tested four social-connection mediators, moderated by hukou, living arrangement, and gender.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After adjustment for baseline depression, only the usage-variety divide\u2014a narrower range of online activity\u2014predicted higher subsequent depressive symptoms (b = 0.069, 95% CI 0.008\u20130.131). Of four mediators, only instrumental support mediated this association (indirect 0.019, bootstrap 95% CI 0.010\u20130.033), replicating in the 2018\u20132020 window (indirect 0.014, bias-corrected 95% CI 0.005\u20130.028). The pathway was stronger among urban and co-resident adults, with baseline instrumental support far higher in urban than rural areas (difference 0.82,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001), consistent with resource multiplication rather than substitution.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Conditioning on baseline depression, only the usage-variety divide\u2014not access, proficiency, or outcomes\u2014is 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1895216","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:06:04Z","timestamp":1790748364000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond access: usage variety, instrumental support, and later-life depression in a prospective study of Chinese older adults"],"prefix":"10.3389","volume":"14","author":[{"given":"Ningyi","family":"Hou","sequence":"first","affiliation":[{"name":"Nottingham University Business School China, University of Nottingham Ningbo China","place":["Ningbo, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianyuan","family":"Chen","sequence":"additional","affiliation":[{"name":"Nottingham University Business School China, University of Nottingham Ningbo China","place":["Ningbo, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhixian","family":"Yu","sequence":"additional","affiliation":[{"name":"Nottingham University Business School China, University of Nottingham Ningbo China","place":["Ningbo, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"103417","DOI":"10.1016\/j.ajp.2022.103417","article-title":"Global prevalence of depression in older adults: a systematic review and meta-analysis of epidemiological surveys","volume":"80","author":"Cai","year":"2023","journal-title":"Asian J Psychiatr"},{"key":"B2","doi-asserted-by":"publisher","first-page":"293","DOI":"10.25259\/IJMR_153_2025","article-title":"Prevalence of depressive symptoms, anxiety, sleep & substance use disorders among older adults in LMICs: a systematic review & meta-analysis","volume":"162","author":"Das","year":"2025","journal-title":"Indian J Med Res"},{"key":"B3","volume-title":"Ageing and Health","year":"2024"},{"key":"B4","volume-title":"United Nations Decade of Healthy Ageing (2021-2030). 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