Takesue Atsuhide, Hiratsuka Yoshimune, Kondo Katsunori, Aida Jun, Nakagomi Atsushi, Nakao Shintaro
Department of Ophthalmology, Juntendo Nerima Hospital, Tokyo, Japan.
Department of Ophthalmology, Juntendo University School of Medicine, Tokyo, Japan.
JMIR Form Res. 2024 Dec 9;8:e58729. doi: 10.2196/58729.
Older adults might not use computers due to psychological barriers, environmental barriers such as not owning a computer or lack of internet access, and health-related barriers such as difficulties with fine motor skills, low cognitive function, or low vision. Given the health benefits of internet use among older adults, inadequate use of the internet is an urgent public health issue in many countries.
We aimed to determine whether visual impairment is associated with internet use in a population-based sample of older adults.
This cross-sectional study sourced data for the year 2016 from the Japan Gerontological Evaluation Study. It included functionally independent community-dwelling individuals aged ≥65 years (N=19,452) in Japan. The respondents reported their visual status by answering the question, "Is your eyesight (without or with usual glasses or corrective lenses) excellent, very good, good, fair, or poor?" We defined "internet user" as a person who uses the internet "almost daily." We used multivariate logistic regression with multiple imputations to analyze visual status, daily internet use, and any correlations between them.
We observed that 23.6% (4599/19,452) of respondents used the internet almost daily. Respondents with good visual status notably tended to use the internet more frequently than those with poor visual status. Specifically, 13% and 31% of respondents with poor and excellent vision, respectively, used the internet almost daily. In contrast, 66% and 45% of respondents with poor and excellent vision, respectively, did not use the internet. Even after adjusting for several covariates (age, sex, equivalized income, years of education, marital status, depression, history of systemic comorbidities, frequency of meeting friends, and total social participation score), significant associations persisted between visual status and daily internet usage. The odds ratios (ORs) tended to increase as visual status improved (P for trend <.001). The adjusted ORs for individuals with excellent and very good visual status who used the internet almost daily were 1.38 (95% CI 1.22-1.56) and 1.25 (95% CI 1.15-1.36), respectively. Conversely, the adjusted OR for those with fair or poor visual status was 0.73 (95% CI 0.62-0.86).
In this study, we reaffirmed what several previous studies have pointed out using a very large dataset; visual impairment negatively impacted daily internet use by older adults. This highlights the need to address visual impairments to promote web use as health care services become more easily accessed on the web.
老年人可能由于心理障碍、环境障碍（如没有电脑或缺乏网络接入）以及与健康相关的障碍（如精细运动技能困难、认知功能低下或视力不佳）而不使用电脑。鉴于互联网使用对老年人健康有益，在许多国家，互联网使用不足是一个紧迫的公共卫生问题。
我们旨在确定在以人群为基础的老年人样本中，视力障碍是否与互联网使用有关。
这项横断面研究使用了来自日本老年学评估研究2016年的数据。研究对象包括日本年龄≥65岁、功能独立的社区居住个体（N = 19452）。受访者通过回答“您的视力（不戴眼镜或戴普通眼镜或矫正镜片）是极佳、很好、好、一般还是差？”这一问题来报告他们的视力状况。我们将“互联网用户”定义为“几乎每天”使用互联网的人。我们使用多重插补的多元逻辑回归来分析视力状况、每日互联网使用情况以及它们之间的任何相关性。
我们观察到23.6%（4599/19452）的受访者几乎每天使用互联网。视力状况良好的受访者明显比视力差的受访者更频繁地使用互联网。具体而言，视力差和极佳的受访者中，分别有13%和31%的人几乎每天使用互联网。相比之下，视力差和极佳的受访者中，分别有66%和45%的人不使用互联网。即使在调整了几个协变量（年龄、性别、等效收入、受教育年限、婚姻状况、抑郁、全身性合并症病史、与朋友见面的频率以及社会总参与得分）之后，视力状况与每日互联网使用之间仍存在显著关联。随着视力状况的改善，优势比（OR）往往会增加（趋势P <.001）。几乎每天使用互联网的视力极佳和很好的个体的调整后OR分别为1.38（95%CI 1.22 - 1.56）和1.25（95%CI 1.15 - 1.36）。相反，视力一般或差的个体的调整后OR为0.73（95%CI 0.62 - 0.86）。
在本研究中，我们使用一个非常大的数据集再次证实了之前几项研究指出的内容；视力障碍对老年人的日常互联网使用产生了负面影响。这凸显了在网络上更易获取医疗保健服务的情况下，解决视力障碍以促进网络使用的必要性。
