Loneliness and physical function impairment: Perceived health status as an effect modifier in community-dwelling older adults in Ghana

Background: Although loneliness and physical function impairment (PFI) are common geriatric syndromes and public health issues, little is known about how their associations vary via self-perception of health. We examine how loneliness is associated with PFI, and whether the association is modified by perceived health status. Methods: We conducted a cross-sectional analysis of 1201 adults aged >= 50 years from the Aging, Health, Psychological Well-being and Health Seeking Behavior Study (AgeHeaPsyWel-HeaSeeB) in Ghana. We assessed loneliness using the three-item short-form of the UCLA Loneliness Scale, and PFI was measured with a seven-item scale on mobility-related deficiencies. Adjusted logistic regressions and moderation analysis evaluated the hypothesized associations. Results: The prevalence of moderate, severe loneliness, and PFI were 37.5%, 17.7%, and 36.1%, respectively. Regressions showed that loneliness was associated with a 23% increased risk of PFI after adjusting for several potential confounders (OR = 1.23; 95%CI = 1.03-2.81). PFI sub-types revealed similar risks. The loneliness-PFI association was significantly moderated by perceived health status such that a positive health perception attenuated the effect of loneliness on PFI (OR = 0.46, 95%CI = 0.23-0.90). Conclusions: Individuals who were lonely had significantly higher odds for PFI but the effect was tempered by perceived health status. Social policy and public health practices for healthy aging should address loneliness and negative health perception among older people.