ArticleBMC geriatrics2026
Social and community determinants of living arrangements among older adults: the role of social support and mental health promotion.
Article in BMC geriatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundLiving arrangements are a key social determinant of health among older adults, influencing well-being, access to care, and social participation. Beyond sociodemographic characteristics, social and community factors—particularly social support and mental health promotion—may play important roles in shaping living arrangements. However, evidence on the associations between these multidimensional factors and living arrangements remains limited. This study examined the relationships between social and community determinants and living arrangements among older adults.
methodsA cross-sectional study was conducted among adults aged 60 years and older (n = 468). Living arrangements were categorized as living alone or living with a spouse and/or children. Binary logistic regression analyses were conducted using three hierarchical models. Model 1 included sociodemographic characteristics; Model 2 added overall social support and overall mental health promotion; and Model 3 examined specific components of social support and mental health promotion. Odds ratios (ORs) with 95% confidence intervals (CIs) were reported.
resultsGender and age were consistently associated with living arrangements across models. After adjustment for sociodemographic factors, several social and community determinants were significantly associated with living arrangements. In the fully adjusted model, stronger interpersonal relationships and higher financial support were associated with higher odds of living with a spouse and/or children. In contrast, greater accessibility to technology and higher levels of emotional and instrumental support were independently associated with lower odds of co-residence. Regarding mental health promotion, higher levels of community-based mental health promotion were inversely associated with living with a spouse and/or children, while personal- and family-level mental health promotion showed no significant associations in the final model. The final model demonstrated good explanatory power (Nagelkerke R² = 0.682).
conclusionsLiving arrangements among older adults are shaped by a complex interplay of sociodemographic, social, and community factors. Different dimensions of social support and mental health promotion show distinct and sometimes contrasting associations with co-residence. These findings highlight the importance of adopting a nuanced, multidimensional approach when designing social and community-based interventions to support appropriate and sustainable living arrangements among older adults.
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