Functional limitations and mental well-being among frail older adults: the mediating effect of social relationships

Objectives: Physical functional limitations come with aging that impact social relationships and participation (SRP). This study aimed to investigate whether SRP mediates the association between functional limitations and MWB in frail older adults. Method: We used survey data collected from 338 frail older adults in Norway between 2017 and 2019. Older adult’s functional limitation was measured by activities of daily living (ADL). Linear regressions were used to estimate the effect of ADL and SRP on MWB, and the effect of ADL on SRP. A structural equation model (SEM) was used to decompose the total effect of ADL on MWB into direct and indirect (via SRP) effects. Results: We found that both ADL and SRP significantly predicted MWB. The effect of ADL on SRP was also statistically significant (β = 0.265; p < 0.01). The direct effect of ADL was higher (β = 0.763; p < 0.01) than its indirect effect (β = 0.383; p < 0.01). The proportion of the total effect that is mediated was about 34%. Analyses from the longitudinal framework showed similar results. Conclusion: Healthy aging can improve MWB directly or indirectly through better SRP. Our findings may have important implications for the design of health policies for older adults by further focusing on maintaining and investing in SRP.