Social Frailty and Depression Among Older Adults in Ghana: Insights from the WHO SAGE Surveys

Abstract

In this study, we examine the association between social frailty and depression among older adults in Ghana over time. We employed longitudinal data analysis to examine the association between social frailty, socioeconomic status and depression using data from the WHO-SAGE survey. Our descriptive and cross-tabulation analyses show that the prevalence of depression and social frailty among older adults decreased considerably in 2014/2015 compared to 2007/2008. The finding also reveals a huge reduction in social frailty among older adults in northern Ghana–the most deprived regions in Ghana–compared to those in southern Ghana. The multivariate panel data analysis reveals that depression was significantly associated with social isolation, financial needs, and physical needs. The findings suggest an over time decline in social frailty and depression among older adults, as well as, reduction in regional dif ferences in social frailty and depression among older adults in Ghana. Keywords longitudinal analysis, financial needs, food security, social isolation, physical needs, Ghana Background Research has established links between socioeconomic status and psychosocial wellbeing (Collins & Goldman, 2008; Mar mot et al., 2008). The evidence suggests that older adults with limited social support and those of lower socioeconomic status have worse mental health; and also tend to be more susceptible to morbidities than their counterparts of higher socioeconomic status, consequently leading to early death (Allen et al., 2014; Cornwell & Waite, 2009; Ma et al., 2018; Yamada & Arai, 2018). While socioeconomic inequalities exist among all age groups, some researchers argue it is more amplified among older adults mainly due to their vulnerabilities to frailty and the pathway of life-course determinants that become exacer bated in late life (Benzeval et al., 2011; van Kippersluis et al., 2010). Older persons are thus said to be more vulnerable to social frailty than younger adults. Social frailty refers to the absence of crucial social and economic resources as well as self -management abilities vital for achieving one’s social needs and invariably negatively impact physical and psychosocial wellbeing (Bunt et al., 2017; Ma et al., 2018). Studies show that older adults living with greater social support and social assistance, including formal financial sup port from governments, have better mental health than their counterparts with less social support (Kobayashi & Steptoe, 2018; Min et al., 2016; O’Hara et al., 2016). In this context, social frailty among older adults is significantly associated with depre