Top

BMC Public Health

Published in:

Open Access 01-12-2020 | Research article

How do lifestyle choices affect the link between living alone and psychological distress in older age? Results from the AgeHeaPsyWel-HeaSeeB study

Authors: Razak M. Gyasi, Kabila Abass, Samuel Adu-Gyamfi

Published in: BMC Public Health | Issue 1/2020

Abstract

Background

Social isolation is widespread and strongly associated with worsening health-related outcomes across the life-course. Despite this broad base of knowledge, there is a paucity of research on the interactive effect of lifestyle choices and living arrangements on later life psychological state particularly in low- and middle-income settings. The aim of this study is to examine the influence of living alone on psychological distress in older people and to explore the protective roles of social participation and physical activity participation.

Methods

We used cross-sectional data from the 2016—17 Aging, Health, Psychological Well-being and Health-seeking Behavior Study (AgeHeaPsyWel-HeaSeeB) involving a representative sample of 1200 adults aged 50+ years in Ghana. The study focused on a latent measure of Kessler Psychological Distress Scale (K10) and on the General Practice Physical Activity Questionnaire (GPPAQ). Ordinary Least Squares (OLS) regression models evaluated the interactive effects of living arrangements and lifestyle choices on the K10 score.

Results

Living alone was independent predictor of psychological distress in the overall sample, among females, urban dwellers and all age groups. However, lifestyle choices of physical activity and social participation significantly moderated these associations. Moreover, in the stratified analysis, physical activity moderated the association for males, rural-dwellers and those 65+ years whilst social participation moderated the association for females, urban-dwellers and those 50–64 years.

Conclusions

Lifestyle choices i.e. social participation and physical activity, and demographic factors i.e. age, gender, and residential status strongly attenuate the positive association of living alone with the risk of psychological distress in older age. These findings may inform intervention initiatives targeted at improving mental health of chronically detached and isolated older people.

WHO. Aging and health: key fats. Geneva: WHO; 2018. https://www.who.int/news-room/fact-sheets/detail/ageing-and-health.

Gyasi RM, Phillips DR. Risk of psychological distress among community-dwelling older adults experiencing spousal loss in Ghana. Gerontologist. 2019. https://doi.org/10.1093/geront/gnz052.

Mazzuco S, Meggiolaro S, Ongaro F, Toffolutti V. Living arrangement and cognitive decline among older people in Europe. Ageing Soc. 2016;37:1–23.

UNDESA. Population Division. New York: World Population Ageing; 2017. Highlights (ST/ESA/SER.A/397). https://www.un.org/en/development/desa/population/publications/pdf/ageing/WPA2017_Hi hlights.pdf.

Schwartz E. H. Litwin, Social network changes among older Europeans: the role of gender. Eu J Ageing. 2018. https://doi.org/10.1007/s10433-017-0454-z.

Gyasi RM, Phillips DR, Abass K. Social support networks and psychological wellbeing in community-dwelling older Ghanaian cohorts. Int Psychogeriatr. 2019;31(7):1047–57. https://doi.org/10.1017/S1041610218001539.CrossRefPubMed

Yang YC, Boen C, Gerken K, Li T, Schorpp K, Harris KM. Social relationships and physiological determinants of longevity across the human life span. Proc Natl Acad Sci U S A. 2016;113:578–83. https://doi.org/10.1073/pnas.1511085112.CrossRefPubMedPubMedCentral

Steptoe A, Shankar A, Demakakos P, Wardle J. Social isolation, loneliness, and all-cause mortality in older men and women. Proc Natl Acad Sci U S A. 2013;110:5797–801 https://doi.org/10.1073/pnas.CrossRefPubMedPubMedCentral

Stoeckel KJ, H Litwin H. The impact of social networks on the relationship between functional impairment and depressive symptoms in older adults. Int Psychogeriatr. 2016;28:39–47.CrossRefPubMed

10.

DeWall C, Deckman T, Pond RJ, Bonser I. Belongingness as a core personality trait: how social exclusion influences social functioning and personality expression. J Pers. 2011;79(6):979–1012. https://doi.org/10.1111/j.1467-6494.2010.00695.x.CrossRef

11.

Gyasi RM, Buor D, Adu-Gyamfi S, Adjei PO-W, Amoah PA. Sociocultural hegemony, gendered identity, and use of traditional and complementary medicine in Ghana. Women Health. 2018;58(5):598–615. https://doi.org/10.1080/03630242.2017.1321608.CrossRefPubMed

12.

Gyasi RM. Social support, physical activity and psychological distress among community-dwelling older Ghanaians. Arch Gerontol Geriatr. 2019;81:142–8. https://doi.org/10.1016/j.archger.2018.11.016.CrossRefPubMed

13.

Litwin H, Schwartz E, Damri N. Cognitively stimulating leisure activity and subsequent cognitive function: a SHARE-based analysis. The Gerontologist. 2017;57:940–8. https://doi.org/10.1093/geront/gnw084.CrossRefPubMed

14.

Gyasi RM, Phillips DR. Gender, self-rated health and functional decline among community-dwelling older persons. Arch Gerontol Geriatr. 2018;77:174–83. https://doi.org/10.1016/j.archger.2018.05.010.CrossRefPubMed

15.

Gyasi RM. Ageing, health and health-seeking behavior in Ghana (PhD thesis). Hong Kong: Lingnan University; 2018. Retrieved December 9, from https://commons.ln.edu.hk/otd/41/.

16.

Gyasi RM, Phillips DR, Amoah PA. Multidimensional social support and health services utilization among noninstitutionalized older persons in Ghana. J Aging Health. 2018. https://doi.org/10.1177/0898264318816217.

17.

Gyasi RM, Yeboah AA, Mensah CM, Ouedraogo R, Addae EA. Neighborhood, social isolation and mental health outcome among older people in Ghana. J Affect Disord. 2019;159:154–63. https://doi.org/10.1016/j.jad.2019.08.024.CrossRef

18.

Lwanga S, Lemeshow S. Sample size determination in health studies: A practical manual. Geneva: World Health Organization; 1991. p. 23–30.

19.

Üstun TB, Chatterji S, Mechbal A, Murray CJL, WHS collaborating groups. Chapter X: quality assurance in surveys: standards. Guidelines and procedures. Geneva: World Health Organization; 2005.

20.

Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand SL, Walters EE, Zaslavsky AM. Short screening scales to monitor population prevalence and trends in nonspecific psychological distress. Psychol Med. 2002;32(6):959–76..CrossRefPubMed

21.

Department of Health and Social Care, General Physical Activity Questionnaire (2013). Retrieved from h t t p s : / / w w w. g o v. u k / g o v e r n m e n t / p u b l i c a t i o n s /general-practice-physical-activity-questionnaire-gppaq.

22.

Abdul Manaf MR, Mustafa M, Abdul MR, Rahman KHY, Aziz NAA. Factors Influencing the Prevalence of Mental Health Problems among Malay Elderly Residing in a Rural Community: A Cross-Sectional Study. PLoS One. 2016;11:e0156937. https://doi.org/10.1371/journal.pone.0156937 PMID: 27280529.CrossRefPubMedPubMedCentral

23.

Hughes ME, Waite LJ, Hawkley LC, Cacioppo JT. A short scale for measuring loneliness in large surveys: results from two population-based studies. Res Aging. 2004;26(6):655–72.CrossRefPubMedPubMedCentral

24.

WHO, The World Health Organization Disability Assessment Schedule II (WHODAS II) (2012) Retrieved from, http://www.who.int/icidh/whodas/index.html.

25.

Murray L, Nguyen H, Lee Y-F, Remmenga MD, Smith WD. Variance inflation factors in regression models with dummy variables. Conf Appl Stat Agric. 2012. https://doi.org/10.4148/2475-7772.1034.

26.

Nemes S, Jonasson JM, Genell A, Steineck G. Bias in odds ratios by logistic regression modelling and sample size. BMC Med Res Methodol. 2009;9:56. https://doi.org/10.1186/1471-2288-9-56.CrossRefPubMedPubMedCentral

27.

Szumilas M. Explaining Odds Ratios. J Can Acad Child Adolesc Psychiatry. 2010;19(3):227–9 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2938757/pdf/ccap19_3p227.pdf.CrossRefPubMedPubMedCentral

28.

Jacob L, Haro JM, Koyanagi A. Relationship between living alone and common mental disorders in the 1993, 2000 and 2007 National Psychiatric Morbidity Surveys. PLoS One. 2019;14(5):e0215182. https://doi.org/10.1371/journal.pone.0215182.CrossRefPubMedPubMedCentral

29.

McKinnon B, Harper S, Moore S. The relationship of living arrangements and depressive symptoms among older adults in sub-Saharan Africa. BMC Public Health. 2013;13:682. https://doi.org/10.1186/1471-2458-13-682.CrossRefPubMedPubMedCentral

30.

Cole SW, Capitanio JP, Chun K, Arevalo JMG, Ma J, Cacioppo JT. Myeloid differentiation architecture of leukocyte transcriptome dynamics in perceived social isolation. Proc Natl Acad Sci. 2015;14249. https://doi.org/10.1073/pnas.1514249112.

31.

Huxhold O, Fiori KL, Windsor TD. The dynamic interplay of social network characteristics, subjective well-being, and health: The costs and benefits of socio-emotional selectivity. Psychol Aging. 2013;28:3–16. https://doi.org/10.1037/a0030170.CrossRefPubMed

32.

Stone J, Evandrou M, Falkngham J. The transition to living alone and psychological distress in later life. Age Ageing. 2013;42:366–72.CrossRefPubMedPubMedCentral

33.

Chou K-L, Liang K, Sareen J. The association between social isolation and DSM-IV mood, anxiety, and substance use disorders: wave 2 of the National Epidemiologic Survey on alcohol and related conditions. J Clin Psychiatry. 2011;72:1468–76.CrossRefPubMed

34.

Beekman AT, Penninx BW, Deeg DJ, Ormel J, Braam AW, Van Tilburg W. Depression and physical health in later life: results from the longitudinal aging study Amsterdam (LASA). J Affect Disord. 1997;46:219–31.CrossRefPubMed

35.

Robinettea JW, Charlesa ST, Mogleb JA, Almeidab DM. Neighborhood cohesion and daily well-being: results from a diary study. Soc Sci Med. 2013;96:174–82. https://doi.org/10.1016/j.socscimed.2013.07.027.CrossRef

Title: How do lifestyle choices affect the link between living alone and psychological distress in older age? Results from the AgeHeaPsyWel-HeaSeeB study
Authors: Razak M. Gyasi
Kabila Abass
Samuel Adu-Gyamfi
Publication date: 01-12-2020
Publisher: BioMed Central
Published in: BMC Public Health / Issue 1/2020
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-020-08870-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

How do lifestyle choices affect the link between living alone and psychological distress in older age? Results from the AgeHeaPsyWel-HeaSeeB study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2020

Educational differences in labor market marginalization among mature-aged working men: the contribution of early health behaviors, previous employment histories, and poor mental health

Integrated cervical cancer screening in Mayuge District Uganda (ASPIRE Mayuge): a pragmatic sequential cluster randomized trial protocol

Regional differences in the global burden of age-related macular degeneration

Association between economic development level and tuberculosis registered incidence in Shandong, China

Occupational post-traumatic stress disorder: an updated systematic review

Health demands and care of children with congenital Zika syndrome and their mothers in a Brazilian state