The prevalence of non-users of Internet decreased over time. However, it is still higher (60.1%) than in high-income countries, as shown in a study conducted in 27 countries in Europe with 51% of people aged 50 and older, and the USA with 25% of individuals aged 65 years and older still do not use the Internet [6, 15, 16].
The increased number of internet users was predominantly among women, but studies vary between most women and men who are internet users [16, 17, 18, 19].
The average years of study and family income were higher (more than ten years on average) in users compared to the non-user in all waves. In studies in high-income countries, 65–77% of internet users had some postsecondary education [17, 19].
In this study, older adults who use the Internet had better family income than non-users. The study about changes in internet use shows that 35% of older adult internet users reported having a higher than average income[17]. Another study shows that the average annual household income of the older adults who uses the Internet was highest among urban residents, followed by suburban and rural residents [20].
There were a few studies about race and internet use, even more among older adults. In all the studies that compound this study that indicates race/skin color, most participants and internet users were white [11, 19]. A study realized with all age groups (36.3% with 65 years and over) about report posting COVID-19 content on social media shows that Latino respondents were significantly more likely than white respondents across all age groups (18 to 29 years: P = .01, 30 to 49 years: P = .04, 50 to 64 years: P < .001, ≥ 65 years: P = .001). And respondents aged 65 years or older were less likely to post COVID-19 content than respondents aged 18 to 29 years; those who did post content were likely to identify as Latino [11]. Another study shows that being black and living in a rural area further decrease the odds of internet use by 36% [20].
This study was carried out with older adults in an urban area. When studies show the area of residence of the older adults, user or not of the Internet, it is referred the difference between urban (and suburban) and rural areas. In this study, the older adult internet user was centered downtown since Wave 1. Although few studies indicate the geographic area of residents of those participants, a study about the use of health applications shows that the minority lives in urban areas (24.4%) compared with suburban (42.3%) and rural (33.3%) [19]. In a study about the association between internet use and patterns of lifestyle self-rated health among older Polish adults, 22.5% live in urban areas, and 27.2% live in rural areas [16]. A study about the interaction between race and residence area shows that older adults living in urban areas use the Internet more than those who live in suburban and rural areas [20].
Since the COVID-19 pandemic onset (2019), telehealth and digital health utilization rates have further increased. Several studies about older adults and internet users in the last three years are based on the application for healthcare or social media [18, 21, 22, 23, 24]. Although the percentage of older adults using apps is lower than that of young people, studies show that the older age group has more engagement in health care apps [18].
The study that analyzes the burden of exclusion in times of COVID-19 shows that older adults risk feeling excluded: physical contact and digital exclusion [15]. The study "stress induced by Information and Communication Technology (ICT) use" shows that the technostress level in 2020 was significantly higher than in 2016. Despite people's digital participation worldwide during the COVID-19 pandemic, older adults were still excluded [15, 25]. Some studies show the association between internet use and well-being during the COVID-19 pandemic. A study about the online functions that can improve well-being showed that, during the period of isolation caused by the COVID-19 pandemic, only the use of the Internet for leisure, precisely those whose use, has increased little [17]. A study with older Polish adults shows that internet use is not associated with favorable lifestyle patterns [16].
While the pandemic may have had adverse effects on older adults without the Internet, studies with pre-pandemic data have shown that older adults who use the Internet may have better mental and cognitive health and social networking [26, 27].
An interesting study that discusses "When Going Digital Becomes a Necessity" indicated two crucial points: digitalization is insufficient in reaching older adults, and combining online and offline strategies is invaluable in addressing the challenges older adults face [28].
Limitations and strengths
Most studies on the use of the Internet by the elderly were carried out in the United States or Europe. In Latin America, especially Brazil, there are few studies on older adult internet users. The use of applications in our research was not explored, only the use of the Internet. Device type and usage time were investigated only in waves 2 and 3.
This study has strengths such as data collection was performed by household interviews, a cohort with three waves with follow-up, and one phone interview during the pandemic. It prepares for the following Wave with the household interview in 2023. In addition, the methodology involves quality control, qualified training, and monitoring of interviewers.