AFLE-HIV: developing an age-friendly living environment assessment framework for elderly HIV-infected individuals in China.

The smartphone has revolutionized modern communication and information access, but its pervasive use has concurrently given rise to significant public health concerns, particularly regarding addictive usage patterns []. A Saudi university sample found about 70% screened at risk for smartphone addiction using the smartphone addiction scale-short version criteria []. An undergraduate study in China assessed mobile-phone-related measures as factors associated with poor sleep and found that mobile phone addiction index (MPAI) scores were associated with worse sleep quality []. A community adolescent sample in China also documented meaningful levels of mobile-phone addiction and linked it to increased negative emotions []. Taken together, these data show that problematic phone use is common among youth and university students across diverse cultural contexts [–]. A systematic review and meta-analysis reported a high pooled prevalence of problematic smartphone use and highlighted smartphone overdependence as an important public‑health signal []. Multiple primary studies across different countries find that higher scores on smartphone‑addiction scales are associated with lower physical activity levels or greater sedentary time [–]. In matched adolescent samples, those classed as smartphone‑dependent had, on average, fewer days of moderate‑to‑vigorous activity and more sitting time []. University and college student studies also report negative correlations between smartphone‑addiction scores and validated physical‑activity measures [, ]. Large meta‑analytic summaries of observational studies report a consistent negative correlation between physical activity and mobile‑phone addiction — that is, people who report higher levels of physical activity tend to report lower levels of problematic phone use []. A separate meta‑analysis focused on sedentary behaviour shows that smartphone addiction is associated with a substantially higher odds of reduced physical activity or sedentary patterns, underlining the link in the other direction: heavy phone use clusters with inactivity []. Smartphone addiction is associated with a lower quality of life. Across the reviewed literature, individuals with higher levels of problematic smartphone use consistently report poorer outcomes in overall quality of life and in specific areas such as physical health, psychological health, social relationships, and school performance [–]. Several large samples of students and cohorts of children and adolescents found that those meeting criteria for scoring higher on addiction scales had lower scores on validated QoL instruments, even after controlling for age, socioeconomic status, and other factors [–]. Overall, this provides moderate observational evidence that greater smartphone addiction is associated with poorer quality of life in young people.