Cross-sectional association of food insecurity with loneliness in older adults: The role of sex, age, and psychosomatic factors - 03/08/24

Doi : 10.1016/j.jnha.2024.100328 
Razak M. Gyasi a, b, , Emelia Aikins c, André Hajek d, Jones Opoku-Ware e, Benjamin Appiah Osei f, Joana Kwabena-Adade g, Louis Jacob h, i, j, Masoud Rahmati k, l, m, George Dakurah c, Karl Peltzer n, o, p
a African Population and Health Research Center, Nairobi, Kenya 
b National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW, Australia 
c Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana 
d Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany 
e Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana 
f Department of Hospitality and Tourism Studies, School of Business, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana 
g Department of General and Liberal Studies, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, Ho, Ghana 
h Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, 42, 08830 Sant Boi de Llobregat, Spain 
i AP-HP, Université Paris Cité, Lariboisière-Fernand Widal Hospital, Department of Physical Medicine and Rehabilitation, 75010 Paris, France 
j Université Paris Cité, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases (EpiAgeing), 75010 Paris, France 
k CEReSS-Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France 
l Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran 
m Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran 
n Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand 
o Department of Psychology, University of the Free State, Bloemfontein, South Africa 
p Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan 

Corresponding author.

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Abstract

Objective

Food insecurity (FI) is a critical social determinant of poor psychosocial health. While data on the specific roles of sex and age in the FI-loneliness link among older adults are limited, the underlying mechanisms are largely unknown. This study examines the age-sex-specific associations of FI with loneliness among older adults in Ghana and quantifies the extent to which psychosomatic factors mediate the association.

Methods

We analyzed cross-sectional data from the Aging, Health, Psychological, and Health-seeking Behavior Study in Ghana. The past 30-day FI was assessed using items on hunger and breakfast skipping frequency due to a lack of resources. We assessed loneliness severity with the University of California, Los Angeles 3-item Loneliness Scale. Multivariable OLS regressions and bootstrapping mediation analysis using the Hayes PROCESS macro plug-in were used to evaluate the associations.

Results

We included 1,201 individuals aged ≥50 years (mean = 62.9 [SD = 11.9]; women = 63.3%). The prevalence of loneliness was 17.7%. The prevalence of moderate and severe FI was 44.0% and 8.5%, respectively. In the adjusted model, greater FI was significantly associated with loneliness severity (B = .22, SE = .029, p < .001). We found significant interactive effects of FI × age (B = −.17, SE = .023, p < .01) and FI × sex (B = −.28, SE = .036, p < .001) on loneliness. Thus, the FI-loneliness link was respectively more marked among women (B = .25, SE = .035, p < .001) and ≥65 age groups (B = .34, SE = .041, p < .001) than men (B = .16, SE = .051, p < .01) and those aged 50−64 (B = .22; SE = .040, p < .001). Finally, comorbid depression/anxiety (41.07%), hopelessness (48.6%), worthlessness (42.1%), functional limitations (8.2%), and pain severity (6.4%) mediated the FI-loneliness association.

Conclusions

Age- and sex-specific associations between FI and loneliness exist among older Ghanaians. Addressing FI in concert with psychosomatic problems in older adults may contribute meaningfully to reducing loneliness in later life.

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Keywords : Food insecurity, Hunger, Perceived isolation, Social determinant of health, Older adults


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Vol 28 - N° 9

Article 100328- septembre 2024 Retour au numéro
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