Social support, physical activity and psychological distress among community-dwelling older Ghanaians

Objective: Physical activity (PA) has often been linked with improved mental health outcomes among older people but the subject has received limited attention in sub-Saharan African context. This paper examines the moderating effect of social support (SS) on the association between PA and psychological distress (PD) among community-dwelling older persons in Ghana. Methods: Individuals 50 years or older (N = 1200) who participated in a 2016/2017 Aging, Health, Psychological Wellbeing and Health-seeking Behavior Study (AHPWHB) were included. PD outcome, measured by the Kessler Psychological Distress Scale (KPDS-K10) was regressed on PA levels, SS and the interaction term. Results: Findings suggest that regular PA (OR = 0.824; 95%CI: 0.610-0.913) and higher levels of SS (OR = 0.475; 95%CI: 0.360-0.626) were associated with reduced PD outcomes after adjusting for theoretically relevant confounding variables. More importantly, the inclusion of the interaction term (PA x SS) showed a significant negative relationship of regular PA with the PD outcome as SS levels increased (OR = 0.651; 95%CI: 0.376-0.727). Conclusions: Although regular PA potentially contributes to reducing PD among older persons, the relationship is even stronger for those embedded in a higher constellation of SS. Policy and practical interventions seeking to improve regular PA engagement such as old-age friendly environment and psychological resources for socially isolated older persons are warranted.