Digital Exclusion Increases Risk of Depression Among Older Adults Across 24 Countries

Peer-Reviewed Publication

Health Data Science

FacebookXLinkedInWeChatBlueskyMessageWhatsAppEmail

 

image: 

Across the various countries, there was a notable variation in the prevalence of depressive symptoms and digital exclusion.

view more 

Credit: Xinran Lu, Harvard T.H. Chan School of Public Health

Older adults who lack internet access are at a significantly higher risk of developing depressive symptoms, especially those with limited familial support or lower income levels, according to a new study published in Health Data Science. Conducted by an international team of researchers, this study analyzed data from five major aging cohort studies covering 24 countries, revealing a strong link between digital exclusion and mental health.

The researchers, led by Dr. Yinzi Jin from Peking University, investigated how digital exclusion—defined as the lack of internet access—affects the mental health of older adults. Using data from the Health and Retirement Study (HRS), the English Longitudinal Study of Aging (ELSA), the Survey of Health, Ageing and Retirement in Europe (SHARE), the China Health and Retirement Longitudinal Study (CHARLS), and the Mexican Health and Aging Study (MHAS), they examined trends from 2010 to 2018 among 122,242 participants.

Their findings indicate that digital exclusion is widespread among older adults, with prevalence rates ranging from 21.1% in Denmark to 96.9% in China. More crucially, digitally excluded older adults exhibited a significantly higher likelihood of experiencing depressive symptoms across all studied cohorts. The association remained robust even after adjusting for demographic and socioeconomic factors such as age, gender, retirement status, education, household wealth, social activities, and regular contact with children.

The impact of digital exclusion was found to be most pronounced among two vulnerable groups: individuals with infrequent contact with their children and those in lower wealth quintiles. Among participants who did not maintain regular weekly contact with their children, the negative effect of digital exclusion on mental health was particularly strong. Similarly, older adults in the lowest wealth quintiles were disproportionately affected, with the most significant association observed in the CHARLS cohort in China.

"Our study highlights a pressing public health concern—older adults who lack digital access are at greater risk of depression, particularly if they also face social isolation or financial difficulties," said co-author Dr. Jingjing Wang. "Bridging the digital divide should be a priority to improve mental well-being among aging populations."

The study underscores the importance of digital inclusion as a means to enhance the mental health and quality of life for older adults. The authors advocate for policies that promote internet access and digital literacy among seniors, particularly in low- and middle-income countries, where digital exclusion remains most pervasive.

"Ensuring equitable access to digital technologies is not just a technological issue but a crucial component of social well-being and mental health support for the elderly," added Dr. Yinzi Jin. "Future interventions should focus on making digital tools more accessible, affordable, and user-friendly for aging populations."

As digitalization continues to shape social interactions and access to resources, the study calls for coordinated efforts from governments, community organizations, and families to integrate older adults into the digital world. The researchers stress that addressing digital exclusion is not only a matter of convenience but a critical step toward improving mental health outcomes for the elderly worldwide.

The full study is available in Health Data Science. https://spj.science.org/doi/10.34133/hds.0218

---

Journal

Health Data Science

DOI

10.34133/hds.0218 

Article Title

Digital Exclusion and Depressive Symptoms among Older People: Findings from Five Aging Cohort Studies across 24 Countries

The negative effect of digital exclusion on depressive symptoms was more pronounced among older people who do not have regular weekly contact with their children.

Credit

Xinran Lu, Harvard T.H. Chan School of Public Health

The association between digital exclusion and depressive symptoms was strongest among those in the lower wealth quintiles across all cohorts. The most significant association was observed in the lowest two quintiles in CHARLS.

Credit

News organizations may use or redistribute this image, with proper attribution, as part of news coverage of this paper only.

\

New research explores mental health costs of emotional labor at work

Maintaining work personas may lead to burnout, reduced mental health

The interplay of morality, emotional labor, and customer injustice: How salesperson experiences shape job satisfaction

University of Mississippi

Facebook

XLinkedInWeChatBlueskyMessageWhatsAppEmail

 

image: 

Faking emotions at work could lead to burnout and negatively affect mental health, according to a recent study.

view more 

Credit: Photo illustration by Stefanie Goodwiller/University Marketing and Communications

Kash Afshar, University of Mississippi assistant professor of marketing, and Omar Itani, associate professor of marketing at Lebanese American University, recently published their team’s findings in Industrial Marketing Management. The study looks at how image management – curating a work persona – can affect mental health and well-being in the long run.  

“We are all under a lot of pressure, a lot of deadlines at work, right?” Afshar said. “We wanted to look at the different factors that threaten employee's mental health and lead to emotional exhaustion.  

“One such factor that is very interesting to us was emotional labor.” 

The term emotional labor is managing emotions to fulfill the expectations of a job or social role, or pretending to feel differently than you actually do. Afshar and Itani’s research looked specifically at salespersons.  

“Managing emotions to meet job demands can lead to exhaustion, dissatisfaction and negative customer reactions,” Itani said. “Job satisfaction is essential for overall well-being, emphasizing the need for supportive workplace cultures.  

“Employees should not be forced to act but encouraged to be genuine, as authentic interactions foster better customer relationships and contribute to long-term organizational success.” 

In sales roles, where employees often face rejection, the pressure to perform can lead to significant emotional strain. More than 70% of people working in sales also reported struggling with mental health in the 2024 State of Mental Health in Sales report.  

“Salespeople are expensive employees,” Afshar said. “They bring in money for the organization. So, if they miss an opportunity, it means that there's no money coming in.  

“When a salesperson burns out, it's not just a loss of the person, but it's also everything they bring to the company.”  

The researchers identified two key drivers of burnout and mental health struggles: emotional labor and customer injustice, or when a customer treats a salesperson poorly.  

“We are limited in terms of the resources that we have, both cognitive resources and emotional resources,” Afshar said. "That emotional regulation spends a lot of resources, which leads to job dissatisfaction and emotional burnout.”  

 While there is no one solution, Afshar’s upcoming research will look at the benefit of mindfulness exercises in dealing with emotional burnout and the mental strain of work.  

“Mindfulness is distancing yourself from the situation without judging your feelings,” the Ole Miss researcher said. “Looking at the situation for what it is, not internalizing it.” 

But managers, too, can play a role in helping employees be more authentic – and less likely to "fake it" – at work, Itani said.  

“A supportive work environment with mental health resources, autonomy and regular check-ins is essential,” he said. “Enhancing emotional intelligence through training helps employees manage emotions effectively, fostering authentic interactions.  

“Ethical leadership, recognition and self-regulation strategies, such as mindfulness and stress management, further support employee well-being.” 

Having an open relationship with employees so that they feel comfortable sharing problems or stresses with managers is also key to helping them feel supported, Afshar said.  

“Communication is the key here,” Afshar said. “When employees can communicate their problems, they aren’t dealing with problems alone. When they feel safe talking to their managers, their colleagues, it tends to remove some of that burden.” 

Afshar’s last recommendation for a person who may be experiencing burnout or mental strain is simple: Make sure the goals of your workplace align with yours.  

“There are two entities at play here: your individual self and your organizational self,” he said. “The best way forward would be when these two different identities are aligned.  

“Look for those jobs that are in agreement in terms of who you are and what your job requires you to be.” 

The publication’s authors also include Colin Gabler, associate professor of marketing at Auburn University; Ashish Kalra, assistant professor of management and marketing at the University of Dayton and Raj Agnihotri, assistant dean of industry engagement at Iowa State University.  

---

Journal

Industrial Marketing Management

DOI

10.1016/j.indmarman.2024.11.014 

Article Title

The interplay of morality, emotional labor, and customer injustice: How salesperson experiences shape job satisfaction

 

Cannabis terpenes offer potential new way to treat fibromyalgia pain

A recently completed study found that certain terpenes in Cannabis sativa are effective at relieving post-surgical and fibromyalgia pain in preclinical models.

University of Arizona Health Sciences

Facebook

LinkedInWeChatBlueskyMessageWhatsAppEmail

 

image: 

Cannabis terpenes may offer a new avenue for treating post-surgical and fibromyalgia pain, according to a new paper published in Pharmacology Reports.

view more 

Credit: Photo by Kris Hanning, U of A Health Sciences Office of Communications

TUCSON, Arizona — Terpenes from the Cannabis sativa plant may be a viable medication for fibromyalgia and post-surgical pain relief, according to University of Arizona Health Sciences research published in Pharmacological Reports.

The paper builds on previous research led by Comprehensive Center for Pain & Addiction member John Streicher, PhD, that showed the pain-relieving properties of terpenes in models of inflammation and chemotherapy-induced neuropathic pain.

“Our research is showing that terpenes are not a good option for reducing acute pain resulting from an injury, such as stubbing your toe or touching a hot stove; however, we are seeing significant reductions in pain when terpenes are used for chronic or pathological pain,” said Streicher, who is a professor in the U of A College of Medicine – Tucson’s Department of Pharmacology. “This study was the first to investigate the impact of terpenes in preclinical models of fibromyalgia and post-operative pain and expand the scope of potential pain-relieving treatments using terpenes.”

Terpenes, the compounds that give plants their aroma and taste, offer an alternative path to pain relief without the unwanted psychoactive side effects of tetrahydrocannabinol, or THC.

Streicher and the research team tested four terpenes found in moderate to high levels in Cannabis sativa: geraniol, linalool, beta-caryophyllene and alpha-humulene.

They found that each of the terpenes resulted in high levels of pain relief in mouse models of post-operative pain and fibromyalgia. Geraniol provided the most significant level of pain relief, followed by linalool, beta-caryophyllene and alpha-humulene.

“With fibromyalgia, there isn’t much understanding of what the pain state is, and there are not a lot of great options for treating it,” Streicher said. “Our findings show that terpenes may be a viable treatment option for fibromyalgia pain, which could potentially have a large impact and make a difference for an under-treated population.”

Fibromyalgia is a chronic musculoskeletal disorder that affects up to 5% of the world’s population, according to research published in Healthcare (Basel) in 2023. The U.S. Department of Health and Human Services’ Office on Women’s Health estimates about 4 million U.S. adults have fibromyalgia, which affects women more than men.

Post-surgical pain straddles the line between acute pain and chronic pain. It is usually short in duration, but it also involves physiological changes such as increased inflammation and sensitization of the body’s pain system that contribute to the pain.

“Opioids do a good job controlling post-surgical pain, but they can cause constipation that can increase the chances of post-surgical complications such as adhesions,” Streicher said. “We are always looking for better options, and this study suggests that terpenes could be a novel therapeutic for post-operative pain.”

Globally, approximately 310 million major surgeries are performed each year, according to 2020 research published in the International Journal of Surgery.

“The research that is being done by Dr. Streicher's lab on terpenes and their potential to help those who suffer from chronic pain demonstrates the importance of basic research. There are hundreds of unique chemicals that plants make, including the Cannabis plant, that are undiscovered,” said Todd Vanderah, PhD, director of the Comprehensive Center for Pain & Addiction at the U of A Health Sciences and professor and head of the Department of Pharmacology at the U of A College of Medicine – Tucson. “Nature is incredible at making unique chemical structures, and many of these chemicals are unknowns when it comes to their abilities to aid in human health, diseases and disorders. A great current example is medication semaglutide, sold under the brand name Ozempic, which has a chemical structure that was isolated not from a plant, but from an animal that is prevalent in the Southwest, the Gila monster. These discoveries from natural products through research such as Dr. Streicher’s can result in very useful medications.”

The study also demonstrated that the mechanism of action of terpenes on post-surgical and fibromyalgia pain was the same as in previous studies. Its action through the adenosine A2a receptor – a receptor that caffeine targets and blocks – suggests a sedative effect that could be the subject of future research.

Streicher’s co-authors were Caleb Seekins, who worked in Streicher’s lab as an undergraduate biochemistry student and is now pursuing a medical degree at the College of Medicine – Tucson; Alyssa Welborn, who graduated with a Bachelor of Science in Pharmaceutical Sciences in 2024; and Abigail Schwarz, who finished her doctorate in Streicher’s lab in 2024.

This study was funded by the National Institutes of Health under award no. R01AT011517.

---

Journal

Pharmacological Reports

DOI

10.1007/s43440-024-00687-1 

Method of Research

Randomized controlled/clinical trial

Subject of Research

Animals

Article Title

Select terpenes from Cannabis sativa are antinociceptive in mouse models of post-operative pain and fibromyalgia via adenosine A2a receptors

COI Statement

Declarations. Competing interests: JMS is an equity holder in Teleport Pharmaceuticals, LLC and Botanical Results, LLC, a local cannabidiol company. He is further a consultant for Black Rock Nutraceuticals, LLC. None of these companies were involved in this study in any way. The authors have no other relevant conflicts of interest to declare.

Robotics and spinal stimulation restore movement in paralysis

Ecole Polytechnique Fédérale de Lausanne

Facebook

XLinkedInWeChatBlueskyMessageWhatsAppEmail

 

image: 

Common robotic devices to safely automate and augment gait rehabilitation across the continuum of care for people suffering from traumatic spinal cord injury interfaced with spinal cord stimulation.

view more 

Credit: .NeuroRestore / EPFL / CHUV 2025

Spinal cord injuries are life-altering, often leaving individuals with severe mobility impairments. While rehabilitation robotics—devices that guide movement during therapy—have improved training for those with spinal cord injuries, their effectiveness remains limited. Without active muscle engagement, robotic-assisted movement alone does not sufficiently retrain the nervous system.

A team at .NeuroRestore, led by Grégoire Courtine and Jocelyne Bloch, has now developed a system that seemlessly integrates an implanted spinal cord neuroprosthesis with rehabilitation robotics. The researchers’ device delivers well-timed electrical pulses to stimulate muscles in harmony with robotic movements, resulting in natural and coordinated muscle activity during therapy. The neuroprosthetics innovation leveraged the the robotic expertise of Professor Auke Ijspeert’s lab at EPFL. This advancement not only enhances immediate mobility but also fosters long-term recovery.

“The seamless integration of spinal cord stimulation with rehabilitation or recreational robotics will accelerate the deployment of this therapy into the standard of care and the community of people with spinal cord injury,” says Courtine. This adaptability ensures that rehabilitation professionals can incorporate this technology into existing rehabilitation protocols worldwide. Combining therapies also presents significant challenges, as each requires precise synchronization. Spinal cord stimulation strategies must be modulated in both space and time to match the patient’s movement, and integrating them with widely used robotic rehabilitation systems requires a flexible and adaptable framework. 

The technology relies on a fully implanted spinal cord stimulator that delivers biomimetic electrical epidural stimulation (electrical epidural stimulation). Unlike traditional functional electrical stimulation, this method activates motor neurons more efficiently by mimicking natural nerve signals. 

The researchers integrated electrical epidural stimulation with various robotic rehabilitation devices—including treadmills, exoskeletons, and stationary bikes—ensuring that stimulation is precisely timed with each phase of movement. The system uses wireless sensors to detect limb motion and automatically adjust stimulation in real time, allowing for a seamless user experience.

In a proof-of-concept study involving five individuals with spinal cord injuries, the combination of robotics and electrical epidural stimulation resulted in immediate and sustained muscle activation. Not only did participants regain the ability to engage muscles during robotic-assisted therapy, but some also improved their voluntary movements even after the stimulation was turned off.

The researchers also worked closely with rehabilitation centers to test how well the stimulation system integrated with widely used robotic devices. “We visited multiple rehabilitation centers to test our stimulation technology with the robotic systems they routinely use, and it was incredibly rewarding to witness their enthusiasm,” say .NeuroRestore researcher Nicolas Hankov and BioRob researcher Miroslav Caban, the study’s first authors. “Seeing firsthand how seamlessly our approach integrates with existing rehabilitation protocols reinforces its potential to transform care for people with spinal cord injury by providing a technological framework that is easy to adopt and deploy across multiple rehabilitation environments.”

The study also showed the potential of this approach beyond clinical settings, as participants used the system to walk with a rollator and cycle outdoors, validating its real-world impact.

This innovative technology offers new hope for individuals with spinal cord injuries, presenting a more effective rehabilitation approach than robotics alone. By making rehabilitation more dynamic and engaging, it has the potential to significantly enhance recovery outcomes. Future clinical trials will be needed to establish long-term benefits, but the initial results suggest that integrating neuroprosthetics with rehabilitation robotics could redefine mobility restoration after paralysis.

List of contributors

• EPFL Neuro X
• Lausanne University Hospital (CHUV) and University of Lausanne (UNIL)
• Defitech Center for Interventional Neurotherapies (.NeuroRestore)
• EPFL Biorobotics Laboratory
• ONWARD Medical
• Bern University of Applied Sciences
• VAMED Management and Service Switzerland AG
• ETH Zurich Sensory-Motor Systems Lab
• University of Zurich Spinal Cord Injury Center
• Hocoma AG
• Medtronic
• Oxford University
• GBY (Go-by-Yourself) SA
• Université de Bordeaux Institut des Maladies Neurodégénératives
• Zurich University of Applied Sciences (ZHAW)
• MyoSwiss AG

Reference

Nicolas Hankov, Miroslav Caban, Robin Demesmaeker, Margaux Roulet, Salif Komi, Michele Xiloyannis, Anne Gehrig, Camille Varescon, Martina Rebeka Spiess, Serena Maggioni, Chiara Basla, Gleb Koginov, Florian Haufe, Marina D’Ercole, Cathal Harte, Sergio D. Hernandez-Charpak, Aurelie Paley, Manon Tschopp, Natacha Herrmann, Nadine Intering, Edeny Baaklini, Francesco Acquati, Charlotte Jacquet, Anne Watrin, Jimmy Ravier, Frédéric Merlos, Grégoire Eberlé, Katrien Van den Keybus, Hendrik Lambert, Henri Lorach, Rik Buschman, Nicholas Buse, Timothy Denison, Dino De Bon, Jaime E. Duarte, Robert Riener, Auke Ijspeert, Fabien Wagner, Sebastian Tobler, Leonie Asboth, Joachim Von Zitzewitz, Jocelyne Bloch, Grégoire Courtine. Augmenting rehabilitation robotics with spinal cord neuromodulation: a proof of concept. Science Robotics 12 March 2025. DOI: 10.1126/scirobotics.adn5564

---

Journal

Science Robotics

DOI

10.1126/scirobotics.adn5564 

Article Title

Augmenting rehabilitation robotics with spinal cord neuromodulation: a proof of concept

Article Publication Date

12-Mar-2025

Close view of the EES triggered legs activation during walking in the robotics exoskeleton Lokomat.

Credit

Copyright: .NeuroRestore / EPFL / CHUV 2025

EES can engage the neuromuscular system during cycling activities in the lab and also in ecological environment.
We developed an algorithm that detected upper-limb forces and timing to trigger stimulation. The degree of effort detected from the combined forces of both upper-limbs scaled the amplitude of EESGO-TRYKE which translated into a proportional increase in the force produced by the lower limbs in outdoor cycling activity.

Credit

Copyright: .NeuroRestore / EPFL / CHUV 2025