Ageing Happily in Ghana: How Does Social Inclusion Contribute?
Ghana
depressive symptoms
happiness
psychosocial mechanisms
sleep problems
social inclusion
Journal
Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society
ISSN: 1479-8301
Titre abrégé: Psychogeriatrics
Pays: England
ID NLM: 101230058
Informations de publication
Date de publication:
Sep 2023
Sep 2023
Historique:
revised:
15
06
2023
received:
17
04
2023
accepted:
28
06
2023
medline:
5
9
2023
pubmed:
13
7
2023
entrez:
12
7
2023
Statut:
ppublish
Résumé
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.
Sections du résumé
BACKGROUND
BACKGROUND
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.
METHODS
METHODS
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.
RESULTS
RESULTS
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%).
CONCLUSIONS
CONCLUSIONS
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.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
821-830Subventions
Organisme : Lingnan University
Informations de copyright
© 2023 Japanese Psychogeriatric Society.
Références
Hajek A, Kretzler B, Gyasi RM, König HH. Community centers for older adults and psychosocial factors: evidence from the German ageing survey. Int J Geriatr Psychiatry 2023; 38: e5901. https://doi.org/10.1002/gps.5901.
Gyasi RM, Accam BT, Forkuor D et al. Emotional and physical-related experiences as potential mechanisms linking physical activity and happiness: evidence from the Ghana aging, health, psychological well-being, and health-seeking behavior study. Arch Psychiatr Nurs 2023; 42: 113-121. https://doi.org/10.1016/j.apnu.2022.12.023.
Veenhoven R. Healthy happiness, effects of happiness on physical health and the consequences for preventive health care. J Happiness Stud 2006; 9: 449-469.
Helliwell JF, Layard R, Sachs JD et al. World Happiness Report. New York: Sustainable Development Solutions Network, 2022.
Lawrence EM, Rogers RG, Wadsworth T. Happiness and longevity in the United States. Soc Sci Med 2015; 145: 115-119.
Liu B, Floud S, Pirie K et al. Does happiness itself directly affect mortality? The prospective UK million women study. Lancet 2016; 387: 874-881. https://doi.org/10.1016/S0140-6736(15)01087-9.
Chei C-L, Lee JM-L, Ma S, Malhotra R. Happy older people live longer. Age Ageing 2018; 47: 860-866. https://doi.org/10.1093/ageing/afy128.
Steptoe A, Diez Roux AV. Happiness, social networks, and health. BMJ 2008; 337: a2781. Published 2008 Dec 4. https://doi.org/10.1136/bmj.a2781.
Steptoe A. Happiness and health. Annu Rev Public Health 2019; 40: 339-359. https://doi.org/10.1146/annurev-publhealth-040218-044150.
WHO. Regional Office for South-East Asia. Promotion of Mental Well-Being: Pursuit of Happiness: WHO Regional Office for South-East Asia, New Delhi, India, 2013; https://apps.who.int/iris/handle/10665/205709.
Luchesi BM, de Oliveira NA, de Morais D, de Paula Pessoa RM, Pavarini SCI, Chagas MHN. Factors associated with happiness in the elderly persons living in the community. Arch Gerontol Geriatr 2018; 74: 83-87. https://doi.org/10.1016/j.archger.2017.10.006.
Krzeczkowska A, Spalding DM, McGeown WJ, Gow AJ, Carlson MC, Nicholls LAB. A systematic review of the impacts of intergenerational engagement on older adults' cognitive, social, and health outcomes. Ageing Res Rev 2021; 71: 101400. https://doi.org/10.1016/j.arr.2021.101400.
Lee S. Social exclusion and subjective well-being among older adults in Europe: findings from the European social survey. J Gerontol B Psychol Sci Soc Sci 2021; 76: 425-434. https://doi.org/10.1093/geronb/gbaa172.
Dahlberg L, McKee KJ. Social exclusion and well-being among older adults in rural and urban areas. Arch Gerontol Geriatr 2018; 79: 176-184. https://doi.org/10.1016/j.archger.2018.08.007.
United Nations. World Population Ageing 2019 Highlights. World Popul Ageing, Published online 2019.
Hunt X, Shakespeare T, Vilyte G et al. Effectiveness of social inclusion interventions for anxiety and depression among adolescents: a systematic review. Int J Environ Res Public Health 2023; 20: 1895. https://doi.org/10.3390/ijerph20031895.
Tengku Mohd TAM, Yunus RM, Hairi F, Hairi NN, Choo WY. Social support and depression among community-dwelling older adults in Asia: a systematic review. BMJ Open 2019; 9: e026667. https://doi.org/10.1136/bmjopen-2018-026667.
Yang L, Wang H, Cheng J. Association between social capital and sleep duration among rural older adults in China. BMC Public Health 2022; 22: 12. https://doi.org/10.1186/s12889-021-12441-w.
Gyasi RM. Ageing, Health and Health-Seeking Behavior in Ghana. Ph.D. Thesis: Lingnan University, Hong Kong, China, 2018; https://commons.ln.edu.hk/otd/41/.
Abdel-Khalek AM. Measuring happiness with a single-item scale. Soc Behav Personality 2006; 34: 139-150.
Ali A, Ambler G, Strydom A et al. The relationship between happiness and intelligent quotient: the contribution of socio-economic and clinical factors. Psychol Med 2013; 43: 1303-1312. https://doi.org/10.1017/S0033291712002139.
Berkman LF, Syme SL. Social networks, host resistance, and mortality: a nine-year follow-up study of Alameda County residents. Am J Epidemiol 1979; 109: 186-204.
Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1977; 1: 385-401.
Baron EC, Davies T, Lund C. Validation of the 10-item Centre for Epidemiological Studies Depression Scale (CES-D-10) in Zulu, Xhosa and Afrikaans populations in South Africa. BMC Psychiatry 2017; 17: 6. https://doi.org/10.1186/s12888-016-1178-x/.
Kilburn K, Prencipe L, Hjelm L, Peterman A, Handa S, Palermo T. Examination of performance of the Center for Epidemiologic Studies Depression Scale Short Form 10 among African youth in poor, rural households. BMC Psychiatry 2018; 18: 201. https://doi.org/10.1186/s12888-018-1774-z.
Spitzer RL, Kroenke K, Williams Williams JBW, Löwe B. A brief measure for assessing generalized anxiety disorder. Arch Intern Med 2006; 166: 1092-1097.
Rutter LA, Brown TA. Psychometric properties of the generalized anxiety disorder Scale-7 (GAD-7) in outpatients with anxiety and mood disorders. J Psychopathol Behav Assess 2017; 39: 140-146. https://doi.org/10.1007/s10862-016-9571-9.
Senaratna CV, Perret JL, Matheson MC et al. Validity of the Berlin questionnaire in detecting obstructive sleep apnea: a systematic review and meta-analysis. Sleep Med Rev 2017; 36: 116-124.
Pengpid S, Peltzer K. Sedentary behavior and 12 sleep problem indicators among middle-aged and elderly adults in South Africa. Int J Environ Res Public Health 2019; 16: 1422. https://doi.org/10.3390/ijerph16081422.
Vancampfort D, Stubbs B, Firth J. Sedentary behavior and sleep problems among 42,489 community-dwelling adults in six low-and middle-income countries. J Sleep Res 2018; 27: e12714.
Dfarhud D, Malmir M, Khanahmadi M. Happiness & Health: the biological factors- systematic review article. Iran J Public Health 2014; 43: 1468-1477.
Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992; 30: 473-483.
Hayes AF. Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach: Guilford Press, USA, 2003.
Moeini B, Barati M, Farhadian M, Ara MH. The association between social support and happiness among elderly in Iran. Korean J Fam Med 2018; 39: 260-265. https://doi.org/10.4082/kjfm.17.0121.
Zhang Z, Zhang J. Social participation and subjective well-being among retirees in China. Soc Indic Res 2015; 123: 143-160. https://www.jstor.org/stable/24721595.
Khodabakhsh S. Factors affecting life satisfaction of older adults in Asia: a systematic review. J Hap Stud 2022; 23: 1289-1304. https://doi.org/10.1007/s10902-021-00433-x.
Sjåstad H, Zhang M, Masvie AE, Baumeister R. Social exclusion reduces happiness by creating expectations of future rejection. Self and Identity 2020; 20: 116-125. https://doi.org/10.1080/15298868.2020.1779119.
Choi E, Han KM, Chang J et al. Social participation and depressive symptoms in community-dwelling older adults: emotional social support as a mediator. J Psychiatr Res 2021; 137: 589-596. https://doi.org/10.1016/j.jpsychires.2020.10.043.
Hostinar CE, Gunnar MR. Social support can buffer against stress and shape brain activity. AJOB Neurosci 2015; 6: 34-42. https://doi.org/10.1080/21507740.2015.1047054.
Smith SM, Vale WW. The role of the hypothalamic-pituitary-adrenal axis in neuroendocrine responses to stress. Dialogues Clin Neurosci 2006; 8: 383-395. https://doi.org/10.31887/DCNS.2006.8.4/ssmith.
Thoits A. Mechanisms linking social ties and support to physical and mental health. J Health Soc Behav 2011; 52: 145-161.
Santini ZI, Koyanagi A, Tyrovolas S, Mason C, Haro JM. The association between social relationships and depression: a systematic review. J Affect Disord 2015; 175: 53-65. https://doi.org/10.1016/j.jad.2014.12.049.
Egeljić-Mihailović N, Brkić-Jovanović N, Krstić T, Simin D, Milutinović D. Social participation and depressive symptoms among older adults during the Covid-19 pandemic in Serbia: a cross-sectional study. Geriatr Nurs 2022; Mar-Apr;44: 8-14. https://doi.org/10.1016/j.gerinurse.2021.12.014.
Al Balushi M, Al Balushi S, Javaid S et al. Association between depression, happiness, and sleep duration: data from the UAE healthy future pilot study. BMC Psychol 2022; 10: 235. https://doi.org/10.1186/s40359-022-00940-3.
Kokubun K, Nemoto K, Yamakawa Y. Brain conditions mediate the association between aging and happiness. Sci Rep 2022; 12: 4290. https://doi.org/10.1038/s41598-022-07748-6.
Gyasi RM, Hajek A, Owusu R et al. Sleep and happiness in urban-dwelling older adults in Ghana: a serial multiple mediation model of generalized anxiety and depressive symptoms. Am J Geriatr Psychiatry. 2023. https://doi.org/10.1016/j.jagp.2023.05.004.
Kent RG, Uchino BN, Cribbet MR, Bowen K, Smith TW. Social relationships and sleep quality. Ann Behav Med 2015; 49: 912-917. https://doi.org/10.1007/s12160-015-9711-6.
Lu H, Tong P, Zhu R. Longitudinal evidence on social trust and happiness in China: causal effects and mechanisms. J Happiness Stud 2020; 21: 1841-1858. https://doi.org/10.1007/s10902-019-00159-x.
Bartels M, Nes RB, Armitage JM, van de Weijer MP, de Vries LP, Haworth CMA. Exploring the Biological Basis for Happiness, in World Happiness Report 2022, https://worldhappiness.report/ed/2022/exploring-the-biological-basis-for-happiness/#:~:text=30%2D40%25%20of%20the%20differences,by%20genetic%20differences%20between%20people.
Loonen AJ, Ivanova SA. Circuits regulating pleasure and happiness-mechanisms of depression. Front Hum Neurosci 2016; 10: 571. https://doi.org/10.3389/fnhum.2016.00571.
Phillips DR, Gyasi RM. Global aging in a comparative context. Gerontologist 2021; 61: 476-477. https://doi.org/10.1093/geront/gnaa155.
United Nations. The Sustainable Development Goals Report, The WHO, Geneva, 2022. https://unstats.un.org/sdgs/report/2022/.
WHO. Social Cohesion for Mental Well-Being among Adolescents. Copenhagen: WHO Regional Office for Europe, 2008.