Abstract
Living arrangement has been reported to have a significant influence on several mental health statuses of older adults, but their social network may confound this association. This study is aimed at examining the interactive effect of living arrangements and social network on the mental health status among older adults in Malaysia. A total of 2,188 Malaysian older adults living nationwide were included in this cross-sectional study. Participants were classified into four groups according to their living arrangements (living alone or not living alone) and social network size (assessed using Lubben's Social Network Scale-6). Poor social network was defined as the lowest quartile (fourth quartile) of the score. Mental health statuses, which include flourishing in life, life satisfaction, cognitive functions, loneliness, depression, and perceived stress, were measured. Multiple linear regression models, adjusted for age, gender, education, and comorbidities, revealed that a good social network was significantly associated with an increase on the flourishing scale scores, regardless of living arrangements. Not living alone and having good social network was significantly associated with increased Montreal Cognitive Assessment scores and decreased loneliness scores. This study found that living arrangements are not always a risk factor for the mental health status of older adults. However, it may be confounded by the level of their social networks. The results suggested that the effects of social network may exceed the impact of living arrangements. It is recommended that health professionals pay more attention to the social networks of older Malaysians to harness its benefits in improving their mental health status.
Highlights
The proportion of older adults in the overall population has been increasing substantially in the developed countries and in many developing nations [1, 2]
We have examined the interaction effects of living arrangements and social network on the mental health status of older adults in Malaysia
The study found that the interaction between living arrangements and social network has a significant impact on psychological well-being (Flourishing in Life Scale), cognitive function (MOCA), and loneliness
Summary
The proportion of older adults in the overall population has been increasing substantially in the developed countries and in many developing nations [1, 2]. A body of literature has documented the role of type of living arrangements and networks in shaping the mental health and life satisfaction of older adults [5,6,7,8,9,10,11,12]. The existing evidence revealed different aspects of an individual’s social relationships that indicated that the structural deficits or abundance of one’s network [10] has an effect on mental health outcomes. Most of the existing studies investigate specific aspects of social relationships and its effect on individuals’ mental health like the deficits of social network [15, 21, 22]
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