Neighborhood, Social Isolation and Mental Health Outcome among Older People in Ghana

Razak M GYASI, Abigail Assuamah YEBOAH, Charlotte Monica MENSAH, Ramatou OEUDRAOGO, Evelyn Aboagye ADDAE

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

Abstract

Objective Loneliness and living alone have been strongly related to mental health but limited empirical evidence of these relationships exists among older people in Ghana. This understanding may contribute to successful aging agenda. We examine the pathways of independent and interactive impacts of loneliness and living alone on psychological distress (PD) risk among older people in Ghana and to investigate whether the associations are moderated by neighborhood characteristics. Methods Data were analyzed from 1,200 community-dwelling adults aged ≥50 years from a 2016/2017 Aging, Health, Psychological Wellbeing and Health-seeking Behavior Study. Mental health and loneliness were respectively assessed using the Kessler Psychological Distress Scale (KPDS-10) and the Three-Item Loneliness Scale of the University of California, Los Angeles. OLS models estimated the associations and interactions. Results Participants were mostly women (63.3% [95%CI: 60.5%-66.0%]) with a mean age of 66.2±11.9. Mean scores for PD and loneliness were 15.9±4.7 and 5.3±3.9 respectively whilst the prevalence of living alone was 38.2% (95%CI: 35.4%-41.0%). After full adjustment, the OLS regressions showed that loneliness (β= 1.474, SE= 0.151, p < 0.001), living alone (β= 0.381, SE= 0.162, p < 0.05) and their interactions (β= 0.917, SE= 0.308, p < 0.05) significantly increased the PD risk. However, engagement in regular physical activity, family contacts and social participation decreased PD outcomes among the socially isolated. Limitation The cross-sectional nature of the data may prohibit any causal and directional inferences. Conclusions Social connectedness and neighborhood engagement strongly attenuate the positive association between loneliness, living alone and psychological distress in later life. Physical activity and social cohesion interventions may improve older people's mental health outcomes.
Original languageEnglish
Pages (from-to)154-163
Number of pages10
JournalJournal of Affective Disorders
Volume259
Issue number1
Early online date15 Aug 2019
DOIs
Publication statusE-pub ahead of print - 15 Aug 2019

Fingerprint

Social Isolation
Ghana
Loneliness
Mental Health
Psychology
Exercise
Social Participation
Independent Living
Social Adjustment
Los Angeles
Health

Bibliographical note

The corresponding author (RM Gyasi) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by Lingnan University, Hong Kong, through its Studentship Package for Research Postgraduates [RPG1129310]. The funders, however, played no role in designing the study, collecting and analysing data, manuscript preparation and the decision to publish the manuscript.

Keywords

  • Mental health
  • Neighborhood characteristics
  • Older people
  • Physical activity
  • Psychological distress
  • Social isolation

Cite this

GYASI, Razak M ; YEBOAH, Abigail Assuamah ; MENSAH, Charlotte Monica ; OEUDRAOGO, Ramatou ; ADDAE, Evelyn Aboagye . / Neighborhood, Social Isolation and Mental Health Outcome among Older People in Ghana. In: Journal of Affective Disorders. 2019 ; Vol. 259, No. 1. pp. 154-163.
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abstract = "Objective Loneliness and living alone have been strongly related to mental health but limited empirical evidence of these relationships exists among older people in Ghana. This understanding may contribute to successful aging agenda. We examine the pathways of independent and interactive impacts of loneliness and living alone on psychological distress (PD) risk among older people in Ghana and to investigate whether the associations are moderated by neighborhood characteristics. Methods Data were analyzed from 1,200 community-dwelling adults aged ≥50 years from a 2016/2017 Aging, Health, Psychological Wellbeing and Health-seeking Behavior Study. Mental health and loneliness were respectively assessed using the Kessler Psychological Distress Scale (KPDS-10) and the Three-Item Loneliness Scale of the University of California, Los Angeles. OLS models estimated the associations and interactions. Results Participants were mostly women (63.3{\%} [95{\%}CI: 60.5{\%}-66.0{\%}]) with a mean age of 66.2±11.9. Mean scores for PD and loneliness were 15.9±4.7 and 5.3±3.9 respectively whilst the prevalence of living alone was 38.2{\%} (95{\%}CI: 35.4{\%}-41.0{\%}). After full adjustment, the OLS regressions showed that loneliness (β= 1.474, SE= 0.151, p < 0.001), living alone (β= 0.381, SE= 0.162, p < 0.05) and their interactions (β= 0.917, SE= 0.308, p < 0.05) significantly increased the PD risk. However, engagement in regular physical activity, family contacts and social participation decreased PD outcomes among the socially isolated. Limitation The cross-sectional nature of the data may prohibit any causal and directional inferences. Conclusions Social connectedness and neighborhood engagement strongly attenuate the positive association between loneliness, living alone and psychological distress in later life. Physical activity and social cohesion interventions may improve older people's mental health outcomes.",
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Neighborhood, Social Isolation and Mental Health Outcome among Older People in Ghana. / GYASI, Razak M; YEBOAH, Abigail Assuamah; MENSAH, Charlotte Monica; OEUDRAOGO, Ramatou; ADDAE, Evelyn Aboagye .

In: Journal of Affective Disorders, Vol. 259, No. 1, 12.2019, p. 154-163.

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

TY - JOUR

T1 - Neighborhood, Social Isolation and Mental Health Outcome among Older People in Ghana

AU - GYASI, Razak M

AU - YEBOAH, Abigail Assuamah

AU - MENSAH, Charlotte Monica

AU - OEUDRAOGO, Ramatou

AU - ADDAE, Evelyn Aboagye

N1 - The corresponding author (RM Gyasi) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by Lingnan University, Hong Kong, through its Studentship Package for Research Postgraduates [RPG1129310]. The funders, however, played no role in designing the study, collecting and analysing data, manuscript preparation and the decision to publish the manuscript.

PY - 2019/8/15

Y1 - 2019/8/15

N2 - Objective Loneliness and living alone have been strongly related to mental health but limited empirical evidence of these relationships exists among older people in Ghana. This understanding may contribute to successful aging agenda. We examine the pathways of independent and interactive impacts of loneliness and living alone on psychological distress (PD) risk among older people in Ghana and to investigate whether the associations are moderated by neighborhood characteristics. Methods Data were analyzed from 1,200 community-dwelling adults aged ≥50 years from a 2016/2017 Aging, Health, Psychological Wellbeing and Health-seeking Behavior Study. Mental health and loneliness were respectively assessed using the Kessler Psychological Distress Scale (KPDS-10) and the Three-Item Loneliness Scale of the University of California, Los Angeles. OLS models estimated the associations and interactions. Results Participants were mostly women (63.3% [95%CI: 60.5%-66.0%]) with a mean age of 66.2±11.9. Mean scores for PD and loneliness were 15.9±4.7 and 5.3±3.9 respectively whilst the prevalence of living alone was 38.2% (95%CI: 35.4%-41.0%). After full adjustment, the OLS regressions showed that loneliness (β= 1.474, SE= 0.151, p < 0.001), living alone (β= 0.381, SE= 0.162, p < 0.05) and their interactions (β= 0.917, SE= 0.308, p < 0.05) significantly increased the PD risk. However, engagement in regular physical activity, family contacts and social participation decreased PD outcomes among the socially isolated. Limitation The cross-sectional nature of the data may prohibit any causal and directional inferences. Conclusions Social connectedness and neighborhood engagement strongly attenuate the positive association between loneliness, living alone and psychological distress in later life. Physical activity and social cohesion interventions may improve older people's mental health outcomes.

AB - Objective Loneliness and living alone have been strongly related to mental health but limited empirical evidence of these relationships exists among older people in Ghana. This understanding may contribute to successful aging agenda. We examine the pathways of independent and interactive impacts of loneliness and living alone on psychological distress (PD) risk among older people in Ghana and to investigate whether the associations are moderated by neighborhood characteristics. Methods Data were analyzed from 1,200 community-dwelling adults aged ≥50 years from a 2016/2017 Aging, Health, Psychological Wellbeing and Health-seeking Behavior Study. Mental health and loneliness were respectively assessed using the Kessler Psychological Distress Scale (KPDS-10) and the Three-Item Loneliness Scale of the University of California, Los Angeles. OLS models estimated the associations and interactions. Results Participants were mostly women (63.3% [95%CI: 60.5%-66.0%]) with a mean age of 66.2±11.9. Mean scores for PD and loneliness were 15.9±4.7 and 5.3±3.9 respectively whilst the prevalence of living alone was 38.2% (95%CI: 35.4%-41.0%). After full adjustment, the OLS regressions showed that loneliness (β= 1.474, SE= 0.151, p < 0.001), living alone (β= 0.381, SE= 0.162, p < 0.05) and their interactions (β= 0.917, SE= 0.308, p < 0.05) significantly increased the PD risk. However, engagement in regular physical activity, family contacts and social participation decreased PD outcomes among the socially isolated. Limitation The cross-sectional nature of the data may prohibit any causal and directional inferences. Conclusions Social connectedness and neighborhood engagement strongly attenuate the positive association between loneliness, living alone and psychological distress in later life. Physical activity and social cohesion interventions may improve older people's mental health outcomes.

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