Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Serdang, Malaysia.
Department of Human Development and Family Studies, Faculty of Human Ecology, Universiti Putra Malaysia, Serdang, Malaysia.
Front Public Health. 2021 May 5;9:624394. doi: 10.3389/fpubh.2021.624394. eCollection 2021.
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.
居住安排已被报道对老年人的几种心理健康状况有重大影响，但他们的社交网络可能会混淆这种关联。本研究旨在检验居住安排和社交网络对马来西亚老年人心理健康状况的交互影响。共有 2188 名居住在全国范围内的马来西亚老年人参与了这项横断面研究。参与者根据其居住安排（独自居住或不独自居住）和社交网络规模（使用 Lubben 的社交网络规模-6 进行评估）分为四组。社交网络较差被定义为得分的最低四分位数（第四四分位数）。心理健康状况包括生活充实、生活满意度、认知功能、孤独感、抑郁和感知压力。调整年龄、性别、教育和合并症后，多线性回归模型显示，无论居住安排如何，良好的社交网络与充实量表评分的增加显著相关。不独自居住和拥有良好的社交网络与蒙特利尔认知评估分数的增加和孤独感分数的降低显著相关。本研究发现，居住安排并不总是老年人心理健康状况的危险因素。然而，它可能会受到社交网络水平的干扰。研究结果表明，社交网络的影响可能超过居住安排的影响。建议卫生专业人员更加关注马来西亚老年人的社交网络，以利用其改善心理健康状况的益处。
