Longitudinal associations between smartphone use and risks of diseases among middle-aged and older Chinese adults: The mediating role of quality of life

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Smartphones have been widely integrated into daily life. However, the relationships of smartphone use with the quality of life and health remain unclear. This study included 6,724 middle-aged and older Chinese from the Dongfeng-Tongji cohort who were followed up every 5 years since 2008. Cross-lagged panel analyses (CLPA) were performed to examine longitudinal temporal relationships between smartphone use and quality of life. Survival analyses were conducted to explore the longitudinal association of smartphone use with the risks of 13 diseases. The potential mediating role of quality of life in the above associations was analyzed by exploratory mediation analysis. The average age of participants was 60.69 years at baseline, and nearly half (3,166, 47.09%) of them were smartphone users in 2018. CLPA showed that participants’ smartphone use could predict their high quality of life, but not vice versa. Survival analyses indicated that smartphone use was significantly associated with lower risks of several diseases, including hypertension ( HR =0.910, 95% CI : 0.877–0.943), hyperlipidemia ( HR =0.894, 95% CI : 0.858–0.932), diabetes ( HR =0.871, 95% CI : 0.828–0.917), coronary heart disease ( HR =0.879, 95% CI : 0.841–0.919), myocardial infarction ( HR =0.836, 95% CI : 0.770–0.906), stroke ( HR =0.874, 95% CI : 0.816–0.937), tumor ( HR =0.902, 95% CI : 0.852–0.954), emphysema ( HR =0.896, 95% CI : 0.824–0.973), asthma ( HR =0.894, 95% CI : 0.808–0.989), gallstones ( HR =0.920, 95% CI : 0.874–0.968), nephritis ( HR =0.842, 95% CI : 0.756–0.938). And quality of life showed significant positive mediating effects in the above associations. Smartphone use was associated with lower risks of several diseases among middle-aged and older Chinese adults, and quality of life may mediate the above longitudinal associations.

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