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