The Social Sustainability of the Use of Information and Communication Technologies by Frail Older People Ageing in Place Alone in Italy: Barriers and Impact on Loneliness and Social Isolation

Abstract

Older people often report functional limitations and low digital skills, with the latter hampering the use of Information and Communication Technologies (ICTs) and having potentially negative consequences on their social isolation and loneliness. Against this background, we present some findings from the “Inclusive ageing in place” (IN-AGE) study, carried out in 2019 in Italy. This study explored seniors’ abilities and difficulties with the independent use of mobile phones, smartphones, and tablets/personal computers (PCs). Qualitative/semi-structured interviews involved 120 seniors aged 65 years and over, living alone in three Italian regions (Lombardy, Marche, and Calabria). Purposive sampling was conducted, and quantitative/qualitative analyses were performed. The main results showed that smartphones and PCs/tablets were used by older respondents living mainly in the north and in urban sites to talk with family members and less for other functionalities (e.g., internet). Those more educated and without serious functional limitations were more capable of utilising ICTs. Seniors using ICTs reported mainly low/moderate loneliness and less social isolation. Therefore, technological tools have the potential to mitigate both, even though some barriers (e.g., poor health, low education) can hinder this opportunity. These results can offer insights for policymakers to design adequate policies (e.g., e-training programs) for seniors, to facilitate their inclusion in digital society, thus enabling social sustainability in an ageing population.

1. Introduction

In Italy, older people aged 65 years and over represent 24.4% of the total population as of 1 January 2024 [1]. In addition, approximately two and a half million people over 65 live alone [2], and, among these, 44% have severe functional limitations [3]. The latter, when combined with illnesses and disabilities impacting one’s ability to perform daily living activities, can lead to frailty among seniors, as an overall geriatric syndrome involving physical, psychological, and social long-term care (LTC) needs [4,5]. The prevalence of frailty among seniors is different across European countries (average value 12.3%), with lower levels in the north, e.g., Sweden, Germany, and Denmark (respectively, 6%, 7%, and 9%), and higher levels in the south, e.g., Portugal, Spain, and Italy (respectively, 21%, 19%, and 16%) [6].

For frail seniors, the possibility of ageing in place alone represents a great challenge, especially when available support, i.e., from relatives and public and private services, including personal care assistants (PCAs), is lacking or not close to them. Informal/family care represents 80% of the total LTC provision in Europe, especially in southern countries, whereas in northern ones, a more effective role of public services has been established [7]. In this regard, the opportunities offered by technology, in particular by Information and Communication Technologies (ICTs), can be of help [8]. ICT is an umbrella term covering a set of technological tools/electronic devices and smart applications in an overall network of hardware and software to create, transmit/share, and store information via computers, the Internet, and telephony [9,10,11]. In this work, we use the term ICTs to refer to mobile phones, smartphones, and personal computers (PCs)/tablets/laptops, all considered important tools for potentially supporting seniors living alone and facilitating their remote, even daily, social interactions [12]. This may help their potential objective social isolation, due to a paucity of interactions, e.g., the low number and frequency of intimate/supportive contacts/relations with their respective social networks [13,14]. This may also help to mitigate their potential subjective loneliness, which is the perceived absence of meaningful relations, a disparity between their desired and actual social contacts, and the consequent neglect and feeling of being alone [15,16,17]. ICT use seems to positively impact the social sustainability and quality of life of older people, enhancing their connection with family and friends, thus reinforcing both their social relationships and community engagement/social inclusion, with greater potential independence [18,19], as well as supporting their so-called “digital well-being” [20].

This potential of ICTs is even more important in light of some statistics regarding the “social situation” of older people in Italy. According to ISTAT [21], 40% of those aged over 74 years live alone in the community, and it is close to 50% among those aged over 80 [22]. An older person’s sense of loneliness is often exacerbated by the experience of living alone, which is a condition very frequent and probable in later life. In addition, living alone in old age is very often the condition of those who survive the death of their spouse. As many as 85% of seniors who live alone in Italy are widow(er)s [2]. Moreover, according to the ISS [23], in the four-year period of 2016–2019, it is estimated that approximately two out of ten Italians aged over 65 years lived in a condition of social isolation; in particular, 20% declared that, during a usual week, they had no social contact, even just by telephone, and 70% did not participate in social activities. The condition of social isolation was more frequent among those aged over 85 (32%), with a low level of education (24%), with greater economic difficulties (28%), and those in southern regions (20%).

ICT devices are not used to a large extent by older people, as reported by some authors [24] who indicated how, in 2018, among seniors aged 68–77 years, only 28% used a PC/tablet and 8% a smartphone. Recent data from the OECD [25] show that, in 2023, the percentage of individuals aged 55–74 years, who accessed and used ICTs in Europe (in the last 12 months before the survey), was greater in Norway (99%) and The Netherlands and lower in Croatia (62%) and Bulgaria (65%), with 76% in Italy and 83% as the European Union (27 countries) average. Moreover, smartphones are used by seniors mainly for talking and sending short text messages (SMSs) (39%). On average, about 49% of them do not engage in activities possible via ICTs, i.e., social networking, video calls, sharing photos, shopping, playing games, and reading the news or seeking information (“ignored”, respectively, by 87%, 83%, 78%, 70%, 68%, and 50%) [24].

The fact is that older people are not “empowered” to use ICT, and their frequent poor digital literacy can affect also their quality of life [19]. Seniors often report low digital skills and difficulties in using digital tools and overall ICT [26]. In 2019, 70% and 45% of older Italians aged 65 years and over used mobile phones/smartphones and PCs, respectively, with 60% having basic e-competences [27]. Older people also frequently report worries regarding the complexity/intricacy of technology [28]. Moreover, they sometimes have a negative opinion of the internet as being dangerous for their health and safety, and their low digital literacy leads them to remain rarely connected [29]. In particular, one study [30] found a correlation between the education level and acceptance of technology by seniors, with those more highly educated showing more positive attitudes in this respect. This author also reported that disabilities and functional limitations affect seniors’ ability to use the mouse of a PC or a smartphone, thus expanding further the digital divide regarding seniors [31,32]. Other authors found that older people with higher educational levels and higher incomes were more likely to have and know how to use ICTs, e.g., PCs and mobile phones, with increased life satisfaction [33]. Further studies indicated that seniors with disabilities used ICT tools less than those without disabilities, with the former being particularly vulnerable regarding technology adoption [34]. In particular, older adults generally have poor health status and are prone to disabilities such as cognitive/neurological problems and visual and hearing impairment. These circumstances may impact their usage of mobile devices and the internet [35].

Following the above considerations, the necessity to understand better how the use of ICT impacts social sustainability in the time of an ageing population has emerged, especially with regard to loneliness and the social isolation of older persons. Thus, this work aims to explore seniors’ abilities and difficulties in the independent use of mobile phones, smartphones, and tablets/PCs, in order to answer the following research questions: (1) To what extent do older people use ICTs? (2) What are the most used functionalities? (3) Are there links between ICT use by older people and their levels of education and functional limitations? (4) Are there links between ICT use by older people and their social isolation and loneliness? It is hypothesised that the independent use of ICTs is not widespread among older adults, especially with regard to the more complex features, with low educational levels and functional limitations acting as possible barriers in this respect. In turn, this context could negatively impact loneliness and the social isolation experienced by seniors. The exploration of these aspects can provide insights into the opportunities offered by ICTs to frail older people living alone, in addition to the difficulties faced by them in this respect, to be appropriately managed to facilitate their ageing in place.

2. Materials and Methods

2.1. Study Design, Recruitment of Participants, and Ethical Issues

This paper presents some findings from the “Inclusive ageing in place” (IN-AGE) study carried out in 2019 in Italy, the overall aim of which was to explore how frail older people with functional limitations age in place alone. This study included 120 older people living in three Italian regions (Lombardy in the north, Marche in the centre, and Calabria in the south), as representative of different socioeconomic levels of development in this country (respectively, high, medium, and low), with greater availability and delivery of support services for seniors in the north [36] (Figure 1 and Figure 2).

In each region, the survey was carried out in one medium-sized urban city (according to a population size of 100,000–200,000 residents, respectively, Brescia, Ancona, and Reggio Calabria) [1], and in one inner area, as defined by the National Strategy for Inner Areas [37], i.e., an area that is not easily accessible, with progressive depopulation and an ageing process, socioeconomic depression, and the low provision of services (respectively, Oltrepò Pavese, Appennino Basso Pesarese Anconetano, and Area Grecanica). In total, 72 urban and 48 rural interviews were conducted, the latter involving a total of eight rural municipalities.

A criterion-based/purposive sampling (not probabilistic) was carried out [38], with participants recruited for their characteristics to enable a deep exploration of the study topics. The sample was built according to the following inclusion criteria: men and women aged 65 years and over; living alone at home without cohabiting family members, or having a private PCA (living in, or hourly); intermediate mobility between limited within the home and outside with help (of a person or aids); absence of cognitive impairment in order to answer questions independently; and the absence of very close and supporting family members (living in the same urban block/rural building).

Seniors were recruited with the help of the local sections of Auser (voluntary association for active ageing), professionals/operators of municipal/public home services, and other local/voluntary associations (Anteas—National Association All Ages Active for Solidarity; Caritas, i.e., the pastoral body of the Italian Bishops’ Conference (CEI) for the promotion of charity). These channels identified older persons who could meet the inclusion criteria, in particular, verifying their cognitive capacity and intermediate mobility/degree of autonomy, and provided them with fundamental information on the study aims. Then, contact details of potential respondents (name/surname, address, and telephone number) were passed to the research team as information on potential preliminary participants, which were then verified and confirmed via telephone contact by the interviewers.

Before starting the data collection, the study protocol was approved by the Ethics Committee of the Polytechnic of Milan (POLIMI), Support Services Area for Research and Didactic Innovation (Project identification code n. 5/2019, approved on 14 March 2019). In addition, a written informed consent form was signed by the participants, with attention to privacy/confidentiality and anonymity of the information collected and the freedom of seniors to withdraw from the study at any time. This occurred in accordance with the ethical guidelines indicated by the European General Data Protection Regulation (GDPR) n. 679, of 27 April 2016 [39]. In particular, codes were used to replace and anonymise the sensitive information of respondents (i.e., name, address, and telephone number).

2.2. Instruments and Data Collection

A qualitative/semi-structured interview/topic guide was administered, containing quick-scan/closed questions on sociodemographic characteristics, type of physical mobility (inside/outside the home), functional limitations in performing daily living activities, and social support (mainly by family members and services). Open-ended questions were used to explore some further dimensions: “technological skills”, in terms of the use of ICTs, i.e., mobile phones, smartphones, and tablets/PCs; loneliness, in terms of feeling alone and neglected by others; and social isolation, in terms of lacking contacts with family, friends, and others.

The issues were explored with questions that were both ad hoc and adapted from previous studies [40]. The level of physical/functional limitations was based on the 12 Basic and Instrumental Activities of Daily Living (ADLs-IADLs) [41], two mobility limitations (going up/down the stairs and bending to pick up an object), and two sensory limitations, hearing and seeing [42]. The familiarity with ICTs was explored by asking which types of devices seniors were able to use independently or with help, e.g., a mobile phone (e.g., for calls with relatives/children and to send and/or receive SMS); a smartphone (e.g., for audio/video calls with relatives/children, WhatsApp); and a PC or tablet (e.g., for e-mail, Skype). In addition, the use of the internet to search for information or make reservations/purchases was explored. Perceived loneliness was explored via two open questions: “Do you feel alone/abandoned?”; “How much does it seem that others are attentive to what happens to you?” [43]. Social isolation was assessed with questions on the methods (e.g., face-to-face or by telephone) and frequency (e.g., daily/weekly/monthly/annual) of meetings and contacts with one’s own family, friendships, and neighbourhood networks, for intimate confidence and requesting practical/psychological support or just for talking [43].

The face-to-face interviews were conducted in May–December 2019 at the homes of the participants by six interviewers with deep expertise in qualitative data collection (psychologists and sociologists). They audio-recorded and transcribed the narratives in full/verbatim (from audio to electronic text format), replacing the identity of the respondents with alphanumeric codes for privacy reasons.

2.3. Data Analysis

An overall mixed-methods analysis (mainly descriptive) of the 120 interviews was performed. The quantitative data collected by means of close questions (e.g., sociodemographic) were elaborated (univariate and bivariate analyses) using Microsoft Excel 2023 (Microsoft Corporation, Washington, DC, USA), with the calculation of the respective percentages for the total and regional samples. Regarding physical limitations, three levels of difficulty were considered, i.e., activity performed in autonomy, with help, or not performed (i.e., senior “not able”). Then, four grades were fixed: mild limitations for seniors able to carry out all daily activities, although with help (no activities “not able”); moderate, high, and very high, for those unable to perform respectively one or two, three or four, and five or more daily activities [44].

A qualitative analysis of open questions was conducted following the phases of the Framework Analysis Technique [45]: in-depth reading of the transcribed interviews, identification of macro/subcategories and codes, construction of the thematic chart (a two-way matrix) to break down the narratives, and interpretation of the results [46]. A thematic content analysis [47,48] was carried out manually, without using dedicated software, as discussed in the literature [49,50].

The use of ICTs was analysed, for this research, only as the independent use/not use of a basic mobile phone, a smartphone, and a PC/tablet (type of device), with regard to calls and the overall functionalities enabled by the internet (as mentioned above). However, from the statements, information on landline telephones also emerged and was categorised. Regarding the overall use and functionalities of ICTs, some comparisons between rural/urban sites and the three regions included in the survey (Lombardy, Marche, and Calabria, also named in the text as north, centre, and south) were provided. The subjective dimension of perceived loneliness was analysed as the presence/absence of this feeling at four levels: absent/mild, if the person never or rarely felt alone; moderate, if the person felt lonely sometimes (a rainy day, at night or a weekend, major holiday periods, i.e., Christmas and Easter); high, if the person often felt intensively alone; very high, if the person often felt alone with psycho-physical effects (e.g., insomnia, depression, suicidal thoughts) [43,51]. Herein, the objective dimension of social isolation was analysed as the presence/absence of confidants (no confidants, including family, friends, and neighbours; no family confidants; family confidants) [43]. Moreover, the overall presence/absence of daily contacts and the number of confidants with whom one had daily contact were considered (both face-to-face and by smartphone, as a whole). The overall process of categorisation/identification of the main themes and the codification/labelling of the qualitative findings is summarized in

Table 1. The process of the categorisation of the qualitative findings.

Macro-Categories	Sub-Categories	Codes/Labels for the Analysis
Use of Information and Communication Technologies (ICTs)	Type: - none (only landline phone) - mobile phone - smartphone - personal computer (PC)/tablet	Yes, used independently No, not used independently
	Functionalities: - to make/receive calls (audio/video) - to send/receive short text messages (SMS) - to send/receive e-mail - to use WhatsApp, Skype - to use internet for other (information, purchases)	Yes, used independently No, not used independently
Perceived Loneliness	Presence/absence of the feeling	Absent/mild Moderate High Very high
Social Isolation	Presence/absence of (family) confidants	No confidants at all No family confidants Family confidants
	Overall confidants with whom one had daily contacts (in person and via smartphone)	Daily contact with no confidants Daily contact with 1–2 confidants Daily contact with 3+ confidants

.

Qualitative dimensions were also quantified as the count/frequency of statements/main categories [52], to provide an introductory picture/summary of the explored dimensions/categories while maintaining the qualitative dominance of this study [53]. These quantitative analyses were not used as primary findings with statistical value but as a guide for interpreting the recurring patterns of meaning [54]. This quantification also allowed some further simple bivariate analyses in order to understand some possible links of ICT use (for this specific analysis, independent use of a smartphone and a PC/tablet, excluding a mobile phone since it does not imply surfing the internet) with levels of both education and physical limitations, objective social isolation, and the subjective perceived loneliness of the study participants. These analyses were, however, carried out without further distinction between urban/rural sites and among regions, since there were few “smartest” seniors (only 24).

The quantified data are presented in tables and show both absolute and percentage values (n. and %). Sometimes these data do not correspond to the respective totals (of participants and 100%) when more responses/statements of a single case were recorded and sometimes following the rounding of individual figures. Moreover, the tables do not include p (significance level) and SD (standard deviation) values, since this paper has a qualitative dominant approach with a purposive sample, and the quantitative data are not presented as primary results with some degrees of statistical representativeness.

The analysis of the findings was integrated with relevant quotations/verbatim statements that emerged in the transcription of the interviews [55,56]. Besides supporting the main results, which are summarised in the tables, quotations are also used to detail them, for instance, to better distinguish the type of use for each device, as clearly mentioned by participants in their narratives. Moreover, they are used to report further findings, i.e., some ‘outliers’ mentioned only by a few seniors (e.g., use of the internet to play games), without a reference table, aiming to integrate the full understanding of the phenomenon [38]. For this purpose, each quotation was classified/coded with IT (for Italy) and the progressive interview number (1–120). An additional code, regarding the region and rural/urban site, was not included for privacy reasons, as potentially identifying information, when in combination with detailed quotations of the respondents (especially with regard to social isolation and loneliness). Further details on the methods (setting, sampling, participants, data collection, measures, and data analysis) can be found in a previous publication [54], from which this section has been partly adapted.

3. Results

3.1. Sociodemographic Characteristics of the Sample

Overall, the following characteristics of the sample emerged (

Table 2. Sample characteristics (n and %).

Characteristics		Regions
	Lombardy	Marche	Calabria	Total	%
Age Groups (years)
67–74	9	4	4	17	14
75–79	7	6	6	19	16
80–84	10	11	7	28	23
85 and over	14	19	23	56	47
Gender
Male	9	8	13	30	25
Female	31	32	27	90	75
Education
No title	1	9	4	14	12
Primary school (5 years)	16	15	24	55	46
Middle school (3 years)	8	9	3	20	17
High school (3–5 years)	15	7	6	28	23
University/similar (3–5 years)	-	-	3	3	2
Marital Status
Single	7	5	4	16	13
Divorced/separated 1	10	3	3	16	13
Widowed	23	32	33	88	73
Living Situation
Alone	36	32	25	93	78
With personal care assistant (PCA)	4	8	15	27	22
Mobility
Only in the home 2	12	17	19	48	40
Also outside the home with help 3	28	23	21	72	60
Level of physical limitations 4
Mild	13	12	5	30	25
Moderate	8	12	13	33	28
High	10	8	9	27	23
Very high	9	8	13	30	24
Support 5
Family (Children)	27 (21)	33 (23)	34 (27)	94 (71)	78 (60)
Public service (Home care)	14 (12)	23 (11)	6 (5)	43 (28)	36 (23)
Total cases/respondents	40	40	40	120	100

¹ This includes two male respondents still married but not cohabiting with their spouses (de facto separated). ² This also includes respondents able to move outside the home very rarely, i.e., less than two times a week and only if accompanied or with aids (cane, walker). ³ Respondents are able to move within the home and also outside at least two times a week, only if accompanied or with aids (cane, walker). ⁴ The level of physical/functional limitations is based on the 12 Basic and Instrumental Activities of Daily Living (ADLs-IADLs), two mobility limitations (going up/down the stairs and bending to pick up an object), plus sensory limitations in hearing and seeing. Mild = no activities “not able”, Moderate = one or two, High = three or four, Very high = five or more. ⁵ In some cases, both supports are possible (the sums of the absolute and percentage values are higher, respectively, than 120 and 100).

).

The participants were mainly people over 85 years old (especially in Calabria); women (more in Lombardy and Marche); with an elementary educational level (particularly in Calabria); widowed (especially in Calabria and Marche); and living alone (only 27 respondents lived with a PCA, especially in the south). In addition, seniors had mobility mainly outside the home with help (especially in the north), and both low and high levels of physical limitations were found. Help for providing the activities of daily living mainly came from the family, especially children, and less from public services, e.g., professional home care (with higher and lower values in the south, respectively). More details on the sample are available in a previous publication [54].

3.2. Independent Use of ICTs

The results indicate that few seniors used smartphones and PCs/tablets independently, especially in rural sites and in the centre–south of Italy, where, conversely, the mobile phone was most widespread (used overall by 67%). In 13% of cases, older people only used a traditional/home telephone, even though they owned a mobile/smartphone. Only 10% used a PC/tablet without help (especially in Lombardy and urban sites) (

Table 3. Independent use of ICTs, according to sites and regions (n and %).

ICTs 1	Urban		Rural		Lombardy		Marche		Calabria		Total
	n	%	n	%	n	%	n	%	n	%	n	%
None (only landline phone)	6	8	10	21	4	10	6	15	6	15	16	13
Mobile 2	40	56	40	83	21	53	32	80	27	68	80	67
Smartphone	17	24	4	8	9	23	7	18	5	13	21	18
PC/tablet	10	14	2	4	6	15	2	5	4	10	12	10
Total cases/respondents	72	100	48	100	40	100	40	100	40	100	120	100

¹ In some cases, multiple tools are used by each respondent, with sums of both the absolute and percentage values not corresponding to the respective totals (of participants and 100%); ² the mobile is a basic phone for making calls and sending SMS; the smartphone has an internet connection and the functions of a PC.

).

With regard to the functionalities allowed by ICTs, seniors reported mainly using the ICTs to make/receive calls and less to send SMS, with similar percentage values in urban and rural sites and differences among regions, with a greater overall intake in Lombardy (83% for calls and 25% for SMS). The use of ICTs for e-mail, Skype, WhatsApp, and other possibilities enabled through the internet, was reported only by some seniors, especially in cities and again in Lombardy (

Table 4. Independent use of ICT functionalities by sites and regions (n and %).

ICTs 1	Urban		Rural		Lombardy		Marche		Calabria		Total
	n	%	n	%	n	%	n	%	n	%	n	%
To make/receive calls	51	76	35	76	30	83	26	63	30	83	86	76
To send/receive SMS	9	13	6	13	9	25	4	10	2	6	15	13
To send/receive e-mail	2	3	-	-	1	3	-	-	1	3	2	2
To use WhatsApp, Skype	8	12	2	4	4	11	2	5	4	11	10	9
To use internet for other 2	9	13	2	4	5	14	3	7	3	8	11	10
Total cases using ICTs 3	67	100	46	100	36	100	41	100	36	100	113	100

¹ In some cases, multiple uses are reported by each respondent, with sums of both the absolute and percentage values not corresponding to the respective totals (of participants and 100%); also, some respondents indicated only a general use without specifying the main functionalities they used; ² for information/purchases; ³ % is calculated only on the total number of seniors reporting use of ICTs.

).

3.2.1. Mobile Phone and Smartphone

Quotations from the narratives help to explain and clarify the overall context that is preliminarily presented/synthesised as the count of statements in the tables. Mobile phones/smartphones, even though available, are often no longer used or kept turned off, due to a lack of desire/interest in using it.

I closed my mobile time ago, I never open it. I only use my landline phone. I do not need to take the mobile with me to go out.

(IT-103)

I have a mobile closed in a drawer. I do not like to use it.

(IT-29)

Some seniors even consider the mobile/smartphone harmful to their health.

I have a smartphone, but I do not like it. I use the home phone. I am afraid of the smartphone because in my opinion it is dangerous for my health, my eyesight, and everything. In my opinion it does more harm than good. My children call on the home phone, and I call them on the home phone. I do not care about the smartphone.

(IT-111)

Others do not know how to use a mobile phone or smartphone or find them unnecessary.

I do not know how to use a mobile phone. I cannot do the numbers.

(IT-116)

I only use the landline phone. It is a cordless. I do not need to use a smartphone. My children call me, I do not call them, I only answer their call when the PCA brings me the home phone.

(IT-119)

However, sometimes there are also economic difficulties preventing seniors from using ICTs.

I have a smartphone but due to economic difficulties I had the internet shut down! Thus, its use is limited.

(IT-54)

It is also worth highlighting the case of a lady who does not use her smartphone because there is no telephone coverage/internet connection available in her residence.

No, I do not have a mobile phone. Because where I live there is no antenna, and the mobile does not get reception. I have to go outside and look for the right place to make a phone call, and I cannot do those things there.

(IT-25)

A mobile phone is mainly used to talk with family members, whose phone numbers have been stored in the top positions of the phone address book.

I use the mobile phone to call my children and nephews, the family. I memorised all the numbers in the phone.

(IT-109)

I need the mobile only to receive calls. I have no other need in this respect.

(IT-94)

A mobile phone is less used for other functions such as SMS, due to a lack of interest, or because seniors do not consider themselves capable in this regard.

I only use my mobile to make calls. Messages, no! I do not care about messages.

(IT-28)

I am not able to make messages by mobile, I am not able to read them, and, moreover, I am not interested in learning how to manage them.

(IT-27)

Sometimes the alarm function of the mobile is used as a reminder to take medicines.

I take a lot of medicines. Thus, the alarm on my phone gets my attention, and I do not forget them.

(IT-5)

The smartphone is used, without help, mainly to contact children and relatives but also, in some cases, to view photos arriving on WhatsApp or even to surf the internet, read news, and “explore” possible online purchases.

My children live abroad. Thus, I use WhatsApp to read their messages and see the photos they send me.

(IT-98)

I use my smartphone; I send messages; I use WhatsApp. I use my smartphone to read the news online.

(IT-95)

With my smartphone I can find everything I want on the internet. Today I looked there for medical slippers.

(IT-15)

3.2.2. PC and Tablet

Seniors use a PC or tablet for surfing the internet, for Skype calls with children and nephews, especially to see them if they live far away, and for shopping.

My daughter lives abroad. She taught me to use the PC. I struggled to learn some new things, but I forced myself to do it and now I am happy. I can do it!

(IT-58)

I learned to use Skype to see my nephews. I like the possibility to talk and see each other on the phone! Also, I bought a walking stick online for 15 euros

(IT-87)

A PC is also used for the electronic management of one’s own bank account.

I use my laptop for bank practices, because I have abolished paper communication. I can see all the expenses whenever I want, and I save 3 euros each time.

(IT-91)

There are also those who use the tablet only for recreational purposes.

I use the tablet to play buraco.

(IT-92)

However, sometimes the ability to use digital technologies and the related access “at home” to multiple forms of information, as well as recreational and cultural resources, represent a deterrent to carrying out recreational activities outside and with other people.

I almost never go out. I go to the cinema if my daughter drags me there. With the PC, I go wherever I want. So, I spend the day in front of the PC.

(IT-17)

Some older people refuse to use a PC, declaring themselves not interested, incapable, and inadequate, considering their age as a limit in this regard.

I am not interested in learning how to use a PC. I am too old.

(IT-67)

Once my relatives put me in front of the PC, but my old brain refused to learn it!

(IT-97)

3.3. ICT Use, Possible Barriers, Loneliness, and Social Isolation

In the following paragraphs, the independent use of a smartphone and/or a PC/tablet is explored, in addition to the educational level and physical limitations as possible barriers to their use. Further, the potential impact of using these devices on perceived loneliness and social isolation is analysed, the latter as lacking the presence of both a family network for confidences and overall confidants (family, friends, others) with whom one has daily contact (

Table 5. Independent use of ICTs and the education level (n and %).

Education	Use of Smartphone/PC–Tablet
	n	%
No title	1	4
Primary school (5 years)	2	8
Middle school (3 years)	5	21
High school (3–5 years)	13	54
University/similar (3–5 years)	3	13
Total cases using smartphone, PC/tablet	24 1	100

¹ Among 24 seniors, 12 use only a smartphone, 3 only a PC/tablet, and 9 both. Overall, 21 use a smartphone and 12 a PC/tablet (as indicated in Table 3).

,

Table 6. Independent use of ICTs and the level of physical limitations (n and %).

Physical Limitations	Use of Smartphone/PC–Tablet
	n	%
Mild	8	33
Moderate	8	33
High	7	29
Very high	1	4
Total cases using smartphone, PC/tablet	24 1	100

¹ Among 24 seniors, 12 use only a smartphone, 3 only a PC/tablet, and 9 both. Overall, 21 use a smartphone and 12 a PC/tablet (as indicated in Table 3).

,

Table 7. Independent use of ICTs and perceived loneliness (n and %).

Perceived Loneliness	Use of Smartphone/PC–Tablet
	n	%
Absent/mild	8	33
Moderate	8	33
High	6	25
Very high	2	8
Total cases using smartphone, PC/tablet	24 1	100

¹ Among 24 seniors, 12 use only a smartphone, 3 only a PC/tablet, and 9 both. Overall, 21 use a smartphone and 12 a PC/tablet (as indicated in Table 3).

,

Table 8. Independent use of ICTs and family confidants (n and %).

Network of Family Confidants	Use of Smartphone/PC–Tablet
	n	%
No confidant at all	5	21
No family confidant	5	21
Family confidants	14	58
Total cases using smartphone, PC/tablet	24 1	100

¹ Among 24 seniors, 12 use only a smartphone, 3 only a PC/tablet, and 9 both. Overall, 21 use a smartphone and 12 a PC/tablet (as indicated in Table 3).

and

Table 9. Independent use of ICTs and daily contacts with confidants (n and %).

Daily Contact with Confidants	Use of Smartphone/PC–Tablet
	n	%
No confidant at all	5	21
No daily contact with confidants	4	17
Daily contact with 1–2 confidants	12	50
Daily contact with 3+ confidants	3	12
Total cases using smartphone, PC/tablet	24 1	100

¹ Among 24 seniors, 12 use only a smartphone, 3 only a PC/tablet, and 9 both. Overall, 21 use a smartphone and 12 a PC/tablet (as indicated in Table 3). Moreover, in Table 9, the label “no confidant at all” is also reported (as in Table 8) for completeness of the total calculation (n = 24).

).

3.3.1. ICT Use and Educational Level

The “smartest” seniors, those who use a smartphone and/or a PC/tablet (24 units) and their related internet/social media functionalities, are mainly those with a higher school education (67%), with a low educational level representing a possible obstacle to use (Table 5).

Quotations from the interviews clarify the above findings, i.e., greater difficulties in using ICTs are reported by seniors with a lower level of education and vice versa.

I go on Instagram, on WhatsApp, I go on the internet. I am good with this!

(IT-58; high school)

I am very capable of using the PC.

(IT-92; university)

I am only able to dial the number and talk. I do not understand anything else.

(IT-75; primary school)

Some seniors would like to learn more about the smartphone’s capabilities; however, they need support that is not always available. Moreover, sometimes they do not know how to use a PC but would learn, even though it seems rather difficult. This gap makes seniors feel a little “marginalised” because it is believed that nowadays not using the internet is equivalent to being cut off from the current world.

I have a new smartphone, but no one has time to teach me how to use it properly. I only use it for calling. Moreover, I would have a PC or a tablet, to keep up with the times, so as not to be left out. But I am not able to use them. I could learn, but it is difficult!

(IT-69; no title)

3.3.2. ICT Use and Level of Physical Limitations

Among the study participants, greater independent use of ICTs was reported by 66% with mild/moderate levels of physical limitations, with poor functional status thus acting as a possible barrier in this respect. However, 29% with a high level of limitations reported the same (Table 6).

As verbatim reported by those interviewed, precarious health conditions do not allow them to use a PC, e.g., when they cannot use a digit or sit for a long time.

At the PC, I am good, but I must have the help of someone. Now I feel better with my hands, but before I could not even type. I struggle to use the PC, because I cannot sit very much; my knees hurt!

(IT-95; very high limitations)

In addition, poor eyesight represents a large obstacle to ICT use, but a smartphone with large keys and characters, in addition to a magnifying glass for the PC, can be of help.

I have a video magnifier to see the PC, but after 10 min my eyes burn. For the PC, I also have the voice assistant. But it is so unpleasant to hear that metallic voice! Moreover, to see a telephone number on the smartphone, I need to have very big characters!

(IT-43; high limitations)

Conversely, when an almost good functional status is reported, both smartphones and PCs are used daily, without difficulties.

I use these tools very much; they have several positive aspects, for instance, to be in contact with persons wherever you are. This is a great thing for older people.

(IT-87; moderate limitations)

However, in some cases, a moderate level of limitations can impact the use of a smartphone; for instance, speaking and understanding each other on the telephone can be problematic when there are hearing impairments.

My brother and I have hearing problems and so even talking to each other on the phone is a bit tiring!

(IT-59; moderate limitations)

3.3.3. ICT Use and Perceived Loneliness

Among seniors reporting the use of ICTs, 66% had an absent–mild/moderate level of perceived loneliness, and only 33% reported higher levels (Table 7).

The words of the participants highlight these different conditions. On the one hand, those with less loneliness consider the smartphone as a positive device to reduce negative feeling.

I have no problem! I have the music, the smartphone, I have all. I do not feel too much alone.

(IT-31; absent/mild loneliness)

I am fine; I do not feel alone, because I talk by phone with my children all the time.

(IT-66; absent/mild loneliness)

I overcome moments of loneliness by listening to some classical music on YouTube on the smartphone, especially at night.

(IT-95; moderate loneliness)

On the other hand, for older persons who feel very alone, having a smartphone is not enough to counter loneliness.

I feel so alone! I have the smartphone, but I have no telephone contacts with a family. I have no children, no brothers, and I am divorced.

(IT-91; very high loneliness)

Conversely, despite deep loneliness, this device can help a person feel more socially connected.

I am alone, but I spend whole days with Facebook, and this helps! It is the only communication I have. Nobody comes here! My friends live elsewhere, and every time they have to move, it seems like they have to go to the moon!

(IT-14; very high loneliness)

Some seniors would like to have a “friendly telephone/line” for older people “who want to talk”, that is a dedicated toll-free number for lonely people, to combat loneliness. It is important to have someone who can listen in moments of greatest need.

I would like a free telephone line for older people who want just to talk with someone!

(IT-52; high loneliness)

3.3.4. ICT Use and Social Isolation

When assessing social isolation through the network of family confidants, overall, 58% of respondents using ICTs reported having them, whereas 21% reported no confidants at all, and 21% reported no family confidant. (Table 8).

Relevant quotations from the narratives support these findings. Older persons with family confidants frequently use a smartphone to talk/confide with children and sisters/brothers.

I confide with my children and a sister, who live in other cities and even abroad, thanks to the smartphone.

(IT-18; having family confidants)

Seniors without family confidants use the phone to call some friends.

I have no confidences with my son. I confide in a friend. I can tell her many things with a phone call.

(IT-43; no family confidants)

When I want to talk, I have always someone listening to me on the phone. They are two ladies with whom I am in good relationships.

(IT-54; no family confidants)

Sometimes, however, no confidant at all is reported.

My brother does not want to hear complaints. We speak very rarely on the phone. Once upon a time, there were several persons I confided in on the phone outside the region. They were old friends but now are dead. Now, I have no one!

(IT-95; no confidant at all)

When assessing social isolation, in terms of the daily contact with confidants (not only relatives and by both phone or/and face-to-face), 62% of respondents using ICTs report at least one or more daily confidants, 21% had no confidants at all, and 17% had no daily contacts. It is important to specify that there were a higher number of seniors with 1–2 daily confidants, who used ICTs, than those with 3+ daily confidents (62 vs. 28); thus, the use of ICTs is not to be interpreted as more widespread when fewer daily confidants are available (Table 9).

Again, some excerpts from the narratives support these results. Daily contacts are mainly via smartphone with relatives or friends.

I talk to my nephew by smartphone every day. Another niece who lives abroad also calls me every day.

(IT-87; 2 daily confidants)

I no longer travel to meet the people I love; we have become old. So, daily telephone contacts are enough for us.

(IT-82; 3+ daily confidants)

When no daily contact is reported, the preferred and most used device remains the smartphone, although it is used less frequently.

I have fortnightly/monthly contact with a friend, mainly by phone, but also in person sometimes.

(IT-43; no daily contact)

4. Discussion

This study aimed to explore seniors’ abilities and difficulties using ICTs, in particular, smartphones and tablets/PCs, in addition to possible links with their levels of education and physical limitations, objective social isolation, and subjective perceived loneliness. The results highlighted (apart from wider use of a mobile phone) that older respondents living in the north of Italy and in urban sites more frequently used smartphones and PCs/tablets, especially to talk with family members, and, to a lesser extent, for other aims (e.g., sending SMS, using WhatsApp to chat with other people, surfing the internet, and Skype to communicate with sons living abroad). The “smarter” seniors, who are willing and able to adopt ICTs, are those more educated and without serious functional limitations. Moreover, those who use smartphones, tablets, and/or PCs report mainly low/moderate loneliness and less social isolation, as explained in detail below.

4.1. Independent Use of ICT Functionalities

The independent use of smartphones and PCs/tablets among seniors, especially with regard to internet-enabled functionalities (e.g., WhatsApp, Skype, e-mail, and shopping online), is not as frequent, since most of them prefer the easier mobile phone (even a traditional landline) mainly to talk with family members/children. This emerged from our results, as also supported by the literature, indicating that older people do not often use ICT devices, especially PCs, which represents a barrier to benefiting from the related opportunities [57]. In particular, those aged 75 years and over are more likely to decline to use the internet [58,59]. Data from the OECD [25] show that, in 2023, the percentage of individuals aged 55–74 years using internet functionalities (in the last three months before the survey) in Italy were distributed as follows: telephoning/video calling 51%, finding information about goods and services 47%, seeking health information 46%, reading/downloading online newspapers/news magazines 45%, internet banking 40%, online purchasing 33%, and social networking 32%. With regard to those aged 75 years and over, the proportions were much lower (respectively, 14%, 11%, 13%, 13%, 9%, 5%, and 6%) However, the literature indicates that seniors primarily use ICTs to connect with their relatives [19].

It is worth highlighting that some respondents are not interested in using ICTs, do not know how to use them, and also consider digital devices unnecessary and harmful to their health. This negative attitude has also been reported by some authors [60] who indicated how ICTs have the potential to support seniors, even though their inability to use them or even a general “noninterest”, as well as scepticism in this respect, often emerges, thus highlighting the necessity to provide adequate means to facilitate their approach to the new technologies. In this regard, a previous author [61] showed that motivational access was a factor potentially impacting non-use, while other scholars [62] highlighted the negative role of cautious and risk-averse attitudes when seniors face innovations, which negatively affects the acceptance and adoption of ICTs. The perceived usefulness and the perceived ease of use are indeed important key determinants for the intention to use ICTs [63]. Selwyn et al. [64] indicated that older people do not use a PC when they do not envisage a great advantage/benefit in their daily lives from this device. Charles and Carstensen [65] found that seniors were not interested in learning and using new technological tools since they consider themselves too old and near the end of their lives. More recent studies mention the fear of new technologies, e.g., being the target of cyber-attacks or being defrauded or swindled on the internet [66], no need to use ICT, and self-marginalisation from information society [67], as obstacles in this regard. Marston et al. [68] indicate the feeling of apprehension as a detractor from technology. However, our results also show there are also economic difficulties preventing seniors from using ICTs. This is also underlined by Tomczyk et al. [67], who mention economic determinants, i.e., insufficient financial resources, as potentially leading to the digital exclusion of seniors, with internet charges becoming a crucial barrier. Ihm and Hsieh [69] also highlight how socioeconomic status may play a key role in the digital disparity among older people.

Moreover, the results of our study indicate that older respondents living in the north and urban sites were more familiar with ICTs. Some authors [70] also found that urban seniors were more likely to use digital devices than rural ones, in particular, with a notable territorial digital divide, indicating only 6 out of 56 frequent PC users resided in the latter. This could be linked to the scarcity of mobile phone antennas or digital/internet and broadband connections in the south and rural/internal areas of Italy, where the disadvantaged structural conditions of these territories hamper good internet access [43]. In particular, digital connectivity in some internal areas of the south is insufficient, with about 100% of the population not covered by Asymmetric Digital Subscriber Line (ADSL) [17]. However, differing abilities to use ICTs characterise older people living in urban and rural areas, since smartphones, PCs, and/or tablets are more used in the former [43]. In turn, this could be linked to a lower educational level and a higher degree of functional limitation of older people living in both the southern regions and inner areas [54]. A notable north–south gradient in Italy highlights a strong regional differentiation, with greater welfare opportunities in the north, e.g., better response to the needs of older people via the provision of adequate public social and health care services and greater expenditure of the municipalities in this respect [54]. Territorial differences in Italy are thus very significant and accentuated through the regional welfare systems, with the three regions selected for the survey presenting several differences regarding (aside from the provision of services) the productive and employment structure, the sources and levels of income, and the use of modern communication technologies; all this significantly influences the quality of life and the risks of loneliness and the isolation of seniors [22]. Moreover, rural inner areas suffer from geographical, economic, and service-related marginality, lacking a supply of essential services, e.g., health, education, and mobility [36], as well as digital. Vainieri et al. [71] reported that older Italian people living in remote/inner areas suffer from a digital health gap following existing infrastructural deficiencies and low/lacking digital skills, with the latter also positively associated with the educational level.

4.2. Low Educational Level and High Functional Limitations as Barriers to Using ICTs

As anticipated above, it is supposed that a low educational level could hamper the use of ICT by seniors living in the south and in rural zones of Italy. This is supported by our further analyses, considering a more general link between education and the use of ICTs among our respondents. These results indicate how the “smartest” seniors are mainly those with a higher school education. This is confirmed by Leukel et al. [72], who found that seniors with a higher educational status were more willing to use the internet in later life. The educational background also has an impact on the use of PCs by seniors [64]. Recent data [25] show that, in 2023, the percentage of individuals aged 55–74 years in the EU-27 who accessed and used the internet in the 12 months before the survey was 97% for those with a high level of education, 85% for those with a middle level of education, and 68% for those with a low educational level. These values for Italy were 94%, 87%, and 61%, respectively. Further, authors have [73] highlighted the importance of education in improving life expectancy, with increased schooling positively linked to better health and socioeconomic improvement. In addition, educational qualification and technological skills could be considered proxies of the older person’s degree of agency, defined as the capacity to make decisions and to address situations [74].

In light of the positive link between the educational level and the use of ICTs, our result of few seniors using ICTs should be read in conjunction with the fact that, in our sample, the majority of participants had a primary school level of education (about 60%), and about 50% were over 85 years old. However, some respondents expressed both the desire to learn to use digital devices and the need to be supported in this regard, in order to feel more integrated in society. Some authors [75] reported similar findings since they found that older adults are interested in learning to use a PC for several reasons, including the possibility of being up to date and thus communicating with non-cohabiting people, with illiteracy indicated as a difficulty in this respect. Thus, the need to know new technologies expressed by seniors represents an opportunity for improving their quality of life. Carenzio et al. [76] analysed this aspect in Italy and reported “media literacy” as a crucial issue for seniors, even though they are often willing to improve their e-competences, learn how to use digital media, and, thus, benefit from the related opportunities. Moreover, Petersen et al. [28] indicated that learning to use ICTs has the potential to improve the self-efficacy, self-esteem, and autonomy of older people. In this respect, some authors [77] found that the use of ICTs was higher among seniors who were trained to use them.

Among the participants in our study, precarious health conditions, leading to a high level of functional limitations, represented a barrier to using ICTs. This is largely supported by the literature [78,79], stressing how physical (e.g., visual and hearing impairment) and cognitive (e.g., memory loss) abilities impact ICT adoption, especially in later life [59,80]. Sims et al. [11] also found an association between the higher use of ICTs and fewer functional limitations. Quatro et al. [30] highlighted further changes occurring in older age such as greater sensitivity to light, reduced hand–eye coordination, and decreased dexterity of fingers, all leading to difficulties in using ICTs. Charness and Boot [10] similarly stressed the consequences of arthritis on the control and coordination of movements and the crucial impact of a “natural” reduced memory on cognitive capacity, resulting in potential errors when seniors interact with technological devices. Overall, in later life, “changes in bodily function have an effect on ICT use and on the ability to learn about ICT. The deterioration of the senses and of fine motor skills can become a factor that inhibits the use of ICT” [67] (p. 14).

Other authors have considered the combination of low educational level (e.g., low e-competencies) and high functional limitations (e.g., low health) as a crucial barrier hampering the independent use of ICTs [78]. Researchers found that education is a crucial determinant of active ageing, with a low educational level and illiteracy being linked to the increased risks of disability in ageing people, following reduced opportunities to access health information and services [57]. Interestingly, Sims et al. [11] indicated a positive relation between the use of ICTs to gather new information and better subjective health.

4.3. ICTs as Mitigating Factors for Loneliness and Social Isolation

The majority of respondents reporting ICT use had an absent–mild/moderate level of perceived loneliness, and only one-third reported higher levels. This could mean that those using digital devices feel less lonely, with ICTs representing a key support in this respect. Fritz et al. [81] supported this result and underscored that ICT use was correlated with reduced loneliness in older populations, as digital devices facilitate communication with other persons. Sims et al. [11] also reported that using digital devices in old age was associated with higher life satisfaction and lower loneliness. In particular, they stressed how social networking (e.g., sending SMS to relatives/friends or chatting) can mitigate loneliness and depression, and surfing the internet to search for health information can promote healthy behaviours. Findings from a recent scoping review indicated a general positive link between ICT use among older people and reduced loneliness. In particular, the frequent use of web-based ICTs was associated with lower levels of loneliness in seniors, when compared to non-web ICT users (e.g., non-smart TV) and non-users [28]. This scoping review also highlighted how ICTs can positively affect the psychosocial well-being of seniors by offering opportunities for leisure [28]. Gunnes et al. [82] pointed out the positive effects of reducing loneliness by participating in virtual communities and video-mediated friendly visits. Further authors highlighted that when older people are “computer literate”, this has a positive impact on reducing loneliness and improving the quality of life [83]. The overall use of ICTs can support seniors’ involvement in digital social networks to connect with relatives and friends, thus feeling less alone [84]. Moreover, findings from a recent review on the role of ICTs in older adults’ decision-making [85] indicated how communication with healthcare professionals via ICT was extremely important for those living alone, as this provides them with a feeling of safety and confidence to manage their own health despite being at home.

However, our findings also indicate how, in some cases of very high loneliness, having a smartphone is not reported as a sufficient “buffer”; conversely, it can help one to have company, albeit virtually. This shows how loneliness is a personal feeling, and seniors can feel a sense of loneliness even when a family support network is present [86]. Loneliness is also reported in the literature as an unstable feeling, potentially occurring more in some moments of the day, e.g., at night [87]. In this respect, other authors [88] indicated that older users of social networking did not differ in terms of loneliness from non-users and that higher use of the internet did not predict less loneliness or higher life satisfaction [89]. Marston et al. [68] added that loneliness could be perceived more by older people in rural sites than in urban–metropolitan ones, although the opposite can also be found.

With regard to social isolation, the majority of our respondents reported both using ICTs and the presence of family confidants with whom they talk mainly via smartphone. Moreover, the majority of them reported both using ICTs and having daily contact (e.g., via smartphone or/and face-to-face, with relatives or friends). The literature indicates that older adults using ICTs have the opportunity to share narratives, photographs, overall communication, and information through several forms of social media (e.g., Facebook, WhatsApp) and also by virtual gaming, which all may limit social isolation [68]. ICTs can thus reinforce social relationships, limit social and spatial barriers, and reduce social–domestic isolation [90]. In particular, the use of ICTs can reduce the impact of social and geographical isolation among seniors living in rural areas [19]. Similarly, Petersen et al. [28] indicated that regular internet use can reduce isolation among older adults, especially when allowing frequent communication with distant children and friends. Some authors [11] also found that using ICT was linked to the motivation of seniors to use technology to keep in touch/connect frequently with their loved ones wherever they are. Alibhai [91] added that technology can reduce social isolation and enhance connectedness among senior citizens, expanding their social capital in terms of their increased communication with relatives and friends and adding an intergenerational perspective.

Our results also showed that the use of ICTs might substitute for “in-person” social/recreational activities. Marston et al. [68] also reported that some seniors negatively consider the use of technology as an anti-social factor that increases social isolation. Gunnes et al. [82] even stressed the concept of the “negative impact of ICT”, i.e., there can be a paradoxical context where ICTs, especially social networking sites and virtual communities, could increase rather than reduce the social isolation and loneliness of seniors, including through the possible negative emotions produced by the use of such digital technologies. Other research [92] indicated that high use of ICTs can also produce a sense of social isolation. In addition, the existence of complex technological devices can make seniors feel more socially isolated when they are not able to use them [93].

Apart from this last issue, overall, our findings indicated that ICTs can help seniors feel less alone and more socially connected, serving as mitigating factors for both loneliness and social isolation. In particular, Foong et al. [94] stressed how seniors rate both a high-quality relationship to reduce perceived loneliness and social engagement to enhance well-being as important. Some authors [95,96] proposed the definition of “social technology” to indicate, for instance, social networking and online/phone communications, as potential activities mitigating both isolation and loneliness in later life. This is distinguished from the so-called ‘physical ICT’, e.g., robots, smart houses, and wearable devices [16]. A scoping “review of reviews” [97] highlighted the importance of technology to improve communication and social contact among older people, including computer and internet training, thus reducing their loneliness and social isolation. Further literature supported this double impact of ICT use on both social isolation and loneliness, with different nuances. Thangavel et al. [98] indicated that ICTs play an important role in mitigating both social isolation and loneliness through increasing social communication and participation, thus reducing social isolation, and through developing a sense of belonging, companionship, and of “being seen”, in contrast to the perceived loneliness. The possession of individual technological skills and the ability to autonomously use modern digital tools (smartphones, tablets, and/or PCs) could thus represent a “tool” to facilitate the maintenance of relationships, even at a distance, and access to information resources. This allows one to “actively” deal with the perception of loneliness. In particular, Rolandi et al. [77] indicated that seniors trained in the use of social networking sites reported reduced feelings of “being left out”, potentially improving the social inclusion of those who are self-isolated and more vulnerable. Moreover, these authors highlighted how seniors able to use ICTs were more preserved from feeling loneliness and isolation during the lockdown following the COVID-19 pandemic. Findings from further authors supported relations between ICTs, loneliness, and social connectedness [28], with technological tools having a high potential to reduce both the isolation and loneliness of older people, increasing their social relationships [99,100] and reducing social exclusion in later life [101].

Overall, ICTs improve daily life, offering new opportunities for communication and relationships, thus sustaining the sociality of seniors with LTC needs [102]. ICTs can simplify and enrich (through video calls, instant messaging, and social networks) daily contacts at a distance, therefore reducing isolation. However, the role of mobile devices in family communication may be ambivalent, that is, both connecting, leading to overcoming the physical distance and reinforcing ties, and also disconnecting, for instance, when they create occasions for misunderstandings and negative feelings [103]. Site et al. [104] proposed a further perspective on ICTs’ effect on the loneliness and isolation of older people, suggesting technological systems, i.e., wearable devices to monitor and manage; however, this implies the necessity to assess and increase their acceptability among seniors.

4.4. Limitations of This Study

This study has some limitations. The recruitment of the sample was supported by various intermediaries (e.g., voluntary associations, municipal/public home services), and this approach potentially excluded seniors who were not “visible” to these organizations. Older people with cognitive impairments were excluded in order to recruit participants able to answer questions independently. Moreover, the cognitive status of seniors involved in this study was assessed via the recruitment channels and supported via the respective relatives, without using a specific test as preliminary screening. The frailty definition was limited to those aged 65 years and over, with functional limitations, living alone, and needing support for performing daily activities. Loneliness was not assessed using a validated scale but with general/ad hoc open questions. Social isolation assessment was limited to two dimensions: a network of family confidants and daily contact with confidants (including friends and neighbours). The purposive sample of this study was selected to be typologically representative; thus, its generalisation is limited [105,106]. In addition, the tables show percentage values that should be interpreted with caution, sometimes coming from very small absolute values. Moreover, an in-depth quantitative analysis of the findings, considering some degree of statistical representativeness of the data (p and SD values), was not carried out, following the qualitative nature of this study. This could however represent a future step for additional analyses.

Despite these limitations, the trustworthiness of the qualitative analysis, in particular, was assured according to Lincoln and Guba [107]. Credibility and transferability were achieved through the following: an in-depth preliminary literature review as background data for building the starting conceptual multidimensional framework and the questionnaire/topic guide; frequent peer de-briefing sessions among researchers and interviewers to define the overall protocol; and dissemination seminars with stakeholders to validate the preliminary results. In addition, dependability and confirmability were supported by detailed notes on both the data collection and analysis, which corroborated the use of transparent procedures and replicable methods aiming at safety and the duration of the results over time.

5. Implications and Possible Insights for Policymakers

The results suggest that digital communications can positively impact both loneliness and the social isolation of older people, thus enhancing their social connections, even though barriers regarding health and literacy can reduce this benefit. In this respect, developing adequate e-training programs is necessary, in order to better manage the digital divide emerging in later life. In particular, it could be useful to combine education in early and later life, in order to ensure lifelong learning and promote ICT-related learning opportunities (even intergenerational), thus leading to developing the necessary skills to use ICTs [57]. However, we need to consider the different starting educational levels and knowledge backgrounds of older people [108], as well as the different levels of functional limitations and disabilities [34]. In particular, vision/hearing impairment and memory problems can hamper the use of digital devices, and, in this respect, adequate ICTs should be implemented. In addition, maintaining affordable costs, e.g., for internet use, and reassuring seniors on the privacy of personal data, could counter their resistance towards new technologies. Moreover, there needs to be telephone coverage/internet connection available where seniors live. Keeping in mind all these aspects could allow the targeting of digital policies to different seniors, in order to design better ICT products for them, following their ICT preferences and reasons for use or non-use, mainly—for most seniors—to be in contact with relatives and friends. Such an approach could be supported and guided by inputs on interactions between changes in ageing and technology, as indicated by the modern “gerontechnology” [10]. It is thus important to design inclusive/for-all technologies but also to differentiate them according to the diverse needs of older adults, thus leading to improved digital equity across age groups [109].

6. Conclusions

This work addresses the current use of ICTs by older people in Italy, and their abilities to adopt them to meet daily needs, in the light of their own e-competencies and difficulties in this respect. Older people who are able to independently use smartphones and PCs/tablets to stay in contact with relatives and friends and benefit from the overall opportunities offered by the internet live mainly in the north of Italy and in rural areas. Overall, these seniors also report a higher educational level, lower functional limitations, and a positive impact in counteracting loneliness and social isolation. Our study confirms and also expands the existing knowledge on the topic, addressing some regional differences; it also underlines some aspects emerging from the semi-structured/qualitative interviews, regarding the motivation of respondents for using/not using ICTs and their concerns linked to loneliness and social isolation. These results can offer useful insights for policymakers on adequate policies for supporting frail seniors with functional limitations and low education, thus mitigating their possible loneliness and social isolation with the help of ICTs, which can facilitate their social connectivity and inclusion in digital society [110].

Future research could focus more on the overall societal impact of digital technologies [111], in order to develop better social and healthcare services, also creating a sustainable e-learning approach for older people, who need adequate skills to use ICTs. Research could focus on the preferences and needs of seniors, considering the positive value of the co-design of ICTs with users, in light of their literacy/e-literacy and level of functional limitations. Moreover, in order to achieve and maintain social sustainability for older people in the context of population ageing trends [112], further research could explore more regional and urban/rural environments and possible different territorial, socioeconomic, and welfare barriers and opportunities for seniors in using ICTs.