With accelerating population aging, smart health devices hold potential for supporting mental well-being in later life. This study evaluated the association between the use of smart health devices and depressive symptoms while elucidating the mediating roles and interaction effects of digital integration and social participation. We analyzed 8,573 respondents from the 2020 wave of the China Longitudinal Aging Social Survey (CLASS). To assess the relationship between depressive symptoms and smart health devices, including monitoring tools, wearable trackers, and assistive technologies, we employed multivariable logistic regression. Analysis included propensity score matching, Heckman two-step correction, and quantile regression. Mechanistic pathways were examined using four-way decomposition within mixed effects models across demographic strata. Smart health device ownership or use was associated with lower odds of depression (OR = 0.745, 95%CI: 0.674–0.824). Quantile regression indicated protective associations at the lower and upper tails of the depression distribution. Four-way decomposition identified digital integration and social participation as significant mediators, while self-rated health comparison shaped the association through interaction effects. Subgroup analyses showed more pronounced associations among women (OR = 0.671, 95%CI:0.580, 0.776) and rural residents (OR = 0.727, 95% CI: 0.613, 0.862) and those without a spouse (OR = 0.633, 95% CI: 0.502, 0.796). Smart health device use is associated with lower depressive symptoms among older adults, while the effectiveness of the devices depends on digital integration and social participation. Policy and practice should pair device dissemination with efforts to expand digital access and to strengthen community level social engagement to realize the mental health potential of smart health device.
Fan et al. (Thu,) studied this question.