Online Communication Attitudes and Video Game Co-Play in Older Adults: Cross-Sectional Mediation Study.

Background: Social isolation among older adults is a growing public health concern. While information and communication technologies offer opportunities for social engagement, few studies have examined how video game co-play, a form of interactive digital media, supports intergenerational connection and perceived social support among older adults. Objective: Guided by uses and gratifications theory, this study investigates whether older adults' online communication attitudes predict video game co-play with younger family members and whether such co-play enhances perceived social support. Methods: A total of 433 older adults (aged ≥60 years) were recruited using a snowball sampling approach facilitated by undergraduate students. Participants completed an online survey assessing online social connection; online self-disclosure (OSD); video game co-play with younger family members; and perceived informational, instrumental, and emotional support. Regression analyses predicting co-play behavior (H1) were conducted using the full sample (N=433), with participants reporting no co-play coded as 0 to indicate the absence of engagement. Hierarchical regression analyses examining associations between co-play and social support (H2) were restricted to participants reporting video game co-play (n=71). Mediation analyses testing indirect effects (H3-H4) were also conducted among co-players (n=71), controlling for age, gender, and race. Mediation models were estimated using PROCESS Model 4, with 5000 bootstrap samples to generate 95% CIs. Results: OSD was positively associated with video game co-play behavior (b=0.12, SE=0.03; P<.001), whereas online social connection was not significantly related to co-play (b=0.06, SE=0.03; P=.08). Video game co-play was positively associated with perceived informational (b=0.11, SE=0.04; P=.01) and instrumental (b=0.16, SE=0.04; P<.001) social support but not emotional support (b=0.07, SE=0.04; P=.053). Among 71 participants reporting co-play, mediation analyses indicated that video game co-play mediated the association between OSD and informational support (indirect effect b=0.01, 95% CI .001-0.03) and instrumental support (indirect effect b=0.02, 95% CI 0.005-0.03), with partial mediation for informational support and full mediation for instrumental support. Conclusions: While not interventional, these findings suggest that video game co-play may function as a culturally relevant, digitally mediated relational practice through which older adults engage in intergenerational connection and perceive informational and instrumental support. The results inform digital health efforts aimed at reducing social isolation and underscore the importance of integrating digital literacy and attitudinal readiness into age-inclusive policy and program design. However, the small subsample of older adults who reported co-play behavior warrants caution in generalizing the findings and highlights the need for broader inclusion in future research.