Abstract
BACKGROUND: Depression, a prevalent mental illness among older people, is associated with some adverse health problems and lower quality of life. Against the backdrop of a growing aging population, coping with late-life depression has become an important public health priority. Emerging evidence suggests that short video addiction tendency may be a new risk factor for depression. However, there has been limited discussion on the potential association between short video addiction tendency and depression among older adults. OBJECTIVE: We aimed to investigate the relationship between short video addiction tendency and depression in a sample of rural older adults. In addition, we aimed to examine the mediating roles of asthenopia and sleep efficiency in the relationship between short video addiction tendency and depression. METHODS: A face-to-face interview design was used to collect valid data from 872 rural older adults aged ≥60 years from October 2024 to January 2025 in 2 provinces of China. Participants were requested to complete self-report measures on short video addiction tendency (Short Video Addiction Scale), asthenopia (11-item Asthenopia Survey Questionnaire), sleep efficiency (actual sleep time and time in bed at night), and depression (Center for Epidemiologic Studies Depression Scale). Linear regression analyses were performed using model 6 of the PROCESS 4.1 macro in SPSS 26.0 to assess the relationship between short video addiction tendency and depression and to examine the mediating roles of asthenopia and sleep efficiency in this relationship, adjusting for sex, age, education, and marital status. RESULTS: We observed that the prevalence of depression was 27.8% (242/872) in this study. There was a significant positive relationship between short video addiction tendency and depression (β=.263; P<.001). Short video addiction tendency affected depression through 3 different pathways: the mediating role of asthenopia (β=.084, 95% CI .059-.114); the mediating role of sleep efficiency (β=.021, 95% CI .001-.043); and the chain mediating role of asthenopia and sleep efficiency (β=.017, 95% CI .010-.026). The effect values of the 3 pathways accounted for 31.94%, 7.99%, and 6.46% of the total effect, respectively. CONCLUSIONS: We highlighted a direct and statistically substantial relationship between short video addiction tendency and depression, with asthenopia and sleep efficiency serving as potential mediating factors. Our findings predicted that guiding and assisting rural older adults to use short video apps appropriately, addressing asthenopia, and enhancing sleep efficiency may be a valuable approach to improve their mental health, preventing and delaying the occurrence and development of depression.