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)peer-review

44 Citations (Scopus)


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. 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 for 1200 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 the interaction between them (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 engagements strongly buffer against the risk of later life mental disorders in the context of loneliness, and living alone. Moderate-to-rigorous physical activity and social cohesion should be effectively and strategically included in interventions targeted to improve older age mental health.

Original languageEnglish
Pages (from-to)154-163
Number of pages10
JournalJournal of Affective Disorders
Issue number1
Early online date15 Aug 2019
Publication statusPublished - Dec 2019

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.


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


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