Internet-use frequency, leisure-time exercise, and offline social interaction among older adults in China: rural–non-rural differences

IntroductionInternet use may be associated with more active later life, but these associations may differ between rural and non-rural settings and between exercise and social interaction. We examined whether Internet-use frequency was associated with leisure-time physical exercise and offline interaction with friends and neighbors among older adults in China.MethodsThis cross-sectional analysis included 2,284 adults aged 60 years or older from the in-person 2023 Chinese General Social Survey. Weighted regression models adjusted for sociodemographic and health covariates and province; standard errors were clustered by county/district code.ResultsThe adjusted overall associations of Internet-use frequency with exercise (B = 0.066; standardized β = 0.062) and offline social interaction (B = 0.115; standardized β = 0.094) were small. The Internet-use frequency × rural-residence interaction for exercise was negative [B = −0.170, 95% CI (−0.256, −0.084), p < 0.001]: the conditional association was positive among non-rural respondents (B = 0.168) and near zero among rural respondents (B = −0.002). The corresponding interaction for offline social interaction was not statistically significant (B = −0.050, p = 0.488).DiscussionAssociations between Internet-use frequency and measured offline activities varied by activity and residence. Cross-sectional, frequency-based measures do not establish causal pathways or explain the contextual difference. A weighted ordinal-logit sensitivity analysis retained the negative exercise interaction, although its evidence was weaker than in the linear model.