Food insecurity and mobility difficulty in middle-aged and older adults: The importance of bio-psychosocial factors.

OBJECTIVE: Food insecurity has been associated with mobility difficulty (MD) in old age. However, there is a scarcity of research on this topic from low- and middle-income countries, while the bio-psychological factors underlying this association are largely unknown. We investigated the food insecurity-MD link in Ghana and explored how sleep, anxiety, loneliness, and physical activity (PA) mediate the association. METHODS: Community-based, representative cross-sectional data from the Aging, Health, Well-being, and Health-seeking Behavior Study were analyzed (N = 1201; Mage = 66.5; women = 63%). MD was assessed with items from the SF-36 of the Medical Outcomes Study. We assessed food insecurity with items on hunger and breakfast-skipping frequency due to lack of food and resources. Adjusted OLS and mediation models via bootstrapping technique evaluated the associations. RESULTS: Results revealed the expected association between food insecurity and MD, such that greater food insecurity was significantly and positively associated with MD across paths (from ß = 0.33 to ß = 0.42, p < .001). Analyses of indirect effects showed that sleep problems (27.8%), anxiety (15.5%), loneliness (17.5%), and PA (18.0%) mediated the association between food insecurity and MD. Cross-level interactions revealed that food insecurity significantly modified the link between each mediator and MD. CONCLUSIONS: Our data provide novel evidence that bio-psychological mechanisms may underlie the food insecurity-MD link and should, therefore, be considered relevant targets for interventions to prevent/manage MD in later life.

Associations of financial inclusion with physical activity participation in later life.

Background: Physical activity (PA) is a vital modifiable psychosocial intervention for promoting healthy longevity but problematically decreases with age. Innovative community-based strategies are recommended by the World Health Organization (WHO) to improve PA but prior research has seldom considered the interactive effect of financial inclusion, social networks, and sex differences on PA. In this study, we examine the role of sex differences and resourceful social networks in relation to the association of financial inclusion with PA among older Ghanaian people. Methods: The sample included 1201 adults aged ≥50 years who participated in the 2016-17 AgeHeaPsyWel-HeaSeeB study. We assessed financial inclusion with an eight-item Financial Instrument Questionnaire Scale and PA with the International Physical Activity Questionnaire Short Form (IPAQ-SF). Linear regressions and moderation analysis were used to test the hypothesized associations. Results: The mean financial inclusion and PA scores were 1.9(±1.8) and 9.0(±4.4) respectively. After full adjustment for potential confounders, a unit increase in financial inclusion was significantly and positively associated with increases in PA participation (ß = .308, p < .005) and also notable among those aged ≥65 years (ß = .413, p = .023). Crucially, the positive association between financial inclusion and PA was significantly modified by social networks (ß = .151, p < .001). However, the role of sex in this association was not robust. Conclusions: Findings emphasize the effect of financial inclusion on PA in old age, particularly when considering social networks. Programs to improve financial inclusion and social integration may benefit the acceptance and participation of PA among older adults.