Objective To understand the influencing factors of digital literacy and the difficulties of integration into the digital society among older adults in Qiqihar city in order to provide a reference for enhancing the adaptability of older adults in the digital society and promoting the realization of healthy aging goals.

Methods Using stratified cluster sampling and a self-developed questionnaire, face-to-face interviews were conducted in October 2023 with 390 residents aged 60 years and older from 3 urban and 4 rural communities in Qiqihar city, Heilongjiang province. Multiple linear regression models were used to analyze the main factors influencing older adults' digital literacy. Older adults' difficulties in using digital devices were also analyzed.

Results  For all participants, the crude and standardized total digital literacy scores were 17.72±14.08 and 1.11±0.88, with crude and standardized dimensional scores of 7.31±4.68 and 1.83±1.17 for cognition, 6.07±6.55 and 0.86±0.94 for information acquisition skills, and 4.35±4.61 and 0.87±0.92 for operational skills, respectively. Of the 390 participants, 191 (49.0%) were classified as high digital literacy and 199 (51.0%) as low digital literacy. Multiple linear regression analysis showed that higher education level (β=3.476), average monthly personal income (β=5.213), perceived usefulness (β=4.452), and perceived ease of use of digital devices (β=5.330) were associated with higher digital literacy among the participants, while older age (β= –2.303) was associated with lower digital literacy (all P<0.05). For participants with low digital literacy, the main difficulties in using digital devices were scanning codes to enter or exit public places (the selected number accounted for 23%), registering for medical care (22.4%), buying tickets for commuting or travel (18.4%), and making mobile payments (18.4%); for participants with high digital literacy, the main difficulties were registering for medical care (28.8%), buying tickets for commuting or travel (26.3%), and using a ride-hailing service online (22.2%).

Conclusions Digital literacy among older adults in Qiqihar City is relatively low and was mainly influenced by age, education, average monthly personal income, and perceived usefulness and ease of use of digital devices. The older adults have greater difficulties in registering for medical care and buying tickets for commuting or travel. The results suggest that several measures should be taken to improve the adaptability of older adults in the digital society.