How does neighborhood psychosocial interventions affect the link between living alone and psychological disorders in later life?
Abstract Background: Social isolation is widespread and strongly associated with deleterious health-related outcomes across the life course in low- and middle-income settings. Despite this broad base of knowledge, there is little reported research on the pathways linking living alone to later life psychological state. Thus, the aim of this study was to examine the influence of living alone on psychological disorder in middle- aged and older people and to explore the protective role of potential psychosocial strategies such as social participation and physical activity. Methods: We used cross-sectional data from a 2016/2017 Aging, Health, Psychological Wellbeing and Health-seeking Behavior Survey involving nationally 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 Scale (GPPAS). Ordinary Least Squares (OLS) regression models evaluated the effect of living alone interactively with neighborhood engagement measures on the indicator of mental disorder. Results: The results showed that living alone was independent predictor of psychological distress in the overall sample, among females, urban dwellers and all age groups. However, physical activity and social participation significantly buffered against these associations. In the stratified analysis, physical activity moderated the association for males, rural-dwellers and those 65+ years whilst social participation modified the association for females, urban-dwellers and those 50-64 years. Conclusions: Psychosocial mechanisms 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.