Perceived neighborhood social cohesion and functional disability among older adults: The moderating roles of sex, physical activity, and multi-morbidity

Kofi Awuviry-Newton; Dinah Amoah; Daniel Doh; Williams Agyemang-Duah; Kwadwo Ofori-Dua; Paul Kowal; Seth Christopher Yaw Appiah

doi:10.1371/journal.pone.0293016

Perceived neighborhood social cohesion and functional disability among older adults: The moderating roles of sex, physical activity, and multi-morbidity

PLoS One. 2024 Jan 31;19(1):e0293016. doi: 10.1371/journal.pone.0293016. eCollection 2024.

Authors

Kofi Awuviry-Newton^{1

2}, Dinah Amoah^{1

3}, Daniel Doh^{1

4}, Williams Agyemang-Duah^{1

5}, Kwadwo Ofori-Dua^{1

6}, Paul Kowal⁷, Seth Christopher Yaw Appiah⁶

Affiliations

¹ African Health and Ageing Research Centre (AHaARC), Australia.
² College of Science, Health and Engineering, Victoria University, Melbourne, Victoria, Australia.
³ School of Health Sciences, University of Tasmania, Australia.
⁴ School of Allied Health, University of Western Australia, Perth, Australia.
⁵ Department of Geography and Planning, Queen's University, Kingston, Ontario, Canada.
⁶ Department of Sociology and Social Work, Faculty of Social Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
⁷ International Health Transitions, Canberra, Australia.

Abstract

Though the Ghanaian social structure is largely communal in several of its social life and social spaces, the extent to which cohesive neighbourhood affects functional ability of older persons and the moderating factors of the relationship, are unknown in Ghana. This study examines the moderating roles of sex, multimorbidity, and physical activity on the association between neighbourhood social cohesion and functional disability among older people in Ghana. A cross-sectional study of 4,446 people-50 years and older-from WHO's Study on global AGEing and adult health Ghana Wave 2 was employed. Functional disability-WHO Disability Assessment Schedule 2.0-and neighbourhood social cohesion measured with community-level participation, perceived trust and safety were studied. Generalised Logistic regressions with interactional tests were used to examine the associations. A more socially cohesive neighbourhood was significantly associated with a lower functional disability among older people (OR = 0.94, 95%CI: 0.93, 0.94; P<0.001). A similar relationship was found for community-level participation (aOR = 0.94, 95%CI: 0.94, 0.95; P<0.001) and perceived trust (aOR = 1.00, 95%CI: 0.99, 1.00; P<0.001). Community-level participation is associated with a lower functional disability among older people who were physically active (aOR = 0.98, 95%CI: 0.96, 0.99; P<0.001). Among the three individual-level measures of neighbourhood social cohesion, only physical activity (OR = 0.98, 95%CI: 0.98, 0.99; P<0.01) moderated the association between community-level participation and functional disability. Community-level participation, along with physical activity, may be relevant in improving functional ability among older people. The results highlight the usefulness of policy to ensure a more socially cohesive neighbourhood for older people in Ghana to improve their quality of life.

Copyright: © 2024 Awuviry-Newton et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

MeSH terms

Aged
Aged, 80 and over
Cross-Sectional Studies
Ghana
Humans
Multimorbidity*
Quality of Life*
Residence Characteristics
Social Cohesion

Grants and funding

The author(s) received no specific funding for this work. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.