Ageing Happily in Ghana : How Does Social Inclusion Contribute?

Razak M. GYASI*, André HAJEK, Felix ASANTE, Burnett Tetteh ACCAM, Solomon OSEI-TUTU, Masoud RAHMATI, Vyda Mamley HERVIE, Kabila ABASS, David R. PHILLIPS

*Corresponding author for this work

Research output: Journal PublicationsJournal Article (refereed)peer-review


Promoting happiness has become increasingly important in old age for a wide range of reasons. In this study, we aim to examine the association between social inclusion (SI) and happiness among older adults in Ghana and identify the mediating factors.

The study included 1201 community-dwelling adults aged ≥50 (mean age = 66.4 ± SD 11.9 years; 63.3% female) from the 2016–2018 Ageing, Health, Psychological Well-being, and Health-seeking Behaviour Study. We assessed happiness with a self-rated and cross-culturally validated item on a five-point scale. SI was operationalised using the modified Berkman–Syme Social Network Index. The hypothesised associations were evaluated by hierarchical regressions and bootstrapping techniques from Hayes' PROCESS macro programme.

The prevalence of happiness was 24.3% (all of the time), 43.6% (most of the time), 28.3% (little of the time), and 3.7% (none of the time). After controlling for potential confounders, higher SI was associated with increased levels of happiness (odds ratio (OR) = 1.36; 95% confidence interval (CI) = 1.16–2.51). Aside from family/friends contacts, all other SI domains positively influenced happiness (OR = 1.45–1.81). The link between SI and happiness was mediated by depressive symptoms (65.2%), generalised anxiety (30.1%), and sleep problems (9.5%).

Our data suggest that psychological factors may largely explain the positive SI-happiness link. Efforts should target these factors to promote happiness in old age. Longitudinal analysis may confirm our findings.
Original languageEnglish
Pages (from-to)821-830
Number of pages10
Issue number5
Early online date12 Jul 2023
Publication statusPublished - Sept 2023

Bibliographical note

Funding Information:
This work was supported by Lingnan University, Hong Kong [grant number RPG1129310]. The sponsor played no role in the design, execution, analysis, and interpretation of data and preparation of the manuscript.

Publisher Copyright:
© 2023 Japanese Psychogeriatric Society.


  • depressive symptoms
  • Ghana
  • happiness
  • psychosocial mechanisms
  • sleep problems
  • social inclusion


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