Psychosocial mechanisms largely mediate the path between food insecurity and depressive symptoms in later life

Razak M Gyasi; Nana Araba Abokoma Egyir; Joana Kwabena-Adade; Barnabas Addai Amanfo; Simon Boateng; Mark Gyapong; Victoria Mensah Nyamadi; Mary Sefa Boampong; Louis Jacob; David R Phillips; André Hajek

doi:10.1016/j.gerinurse.2026.103802

Psychosocial mechanisms largely mediate the path between food insecurity and depressive symptoms in later life

Geriatr Nurs. 2026 Jan 22:68:103802. doi: 10.1016/j.gerinurse.2026.103802. Online ahead of print.

Authors

Affiliations

¹ African Population and Health Research Center, Nairobi, Kenya; National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW, Australia; Department of Educational Leadership, Akenten Appiah-Menka University of Skills Training and Entrepreneurial Development, Kumasi, Ghana. Electronic address: RGyasi.Research@gmail.com.
² Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. Electronic address: egyirnanaarabaabokoma@gmail.com.
³ Department of General and Liberal Studies, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, Ho, Ghana. Electronic address: jkwabena-adade@uhas.edu.gh.
⁴ Department of Educational Leadership, Akenten Appiah-Menka University of Skills Training and Entrepreneurial Development, Kumasi, Ghana. Electronic address: baamanfo@aamusted.edu.gh.
⁵ Department of Interdisciplinary Studies, Akenten Appiah-Menka University of Skills Training and Entrepreneurial Development, Kumasi, Ghana. Electronic address: simonboateng@aamusted.edu.gh.
⁶ Department of Interdisciplinary Studies, Akenten Appiah-Menka University of Skills Training and Entrepreneurial Development, Kumasi, Ghana. Electronic address: mgyapong@aamusted.edu.gh.
⁷ Department of Management Studies Education, Akenten Appiah-Menka University of Skills Training and Entrepreneurial Development, Kumasi, Ghana. Electronic address: vmnyamadi@aamusted.edu.gh.
⁸ Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. Electronic address: marysefaboampong@gmail.com.
⁹ Université Paris Cité, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases (EpiAgeing), Paris, France; AP-HP, Université Paris Cité, Lariboisière-Fernand Widal Hospital, Department of Physical Medicine and Rehabilitation, Paris, France; Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, Spain. Electronic address: louis.jacob.contacts@gmail.com.
¹⁰ Department of Sociology and Social Policy, Lingnan University, Hong Kong. Electronic address: rosserphillips@gmail.com.
¹¹ Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany.

PMID: 41576575
DOI: 10.1016/j.gerinurse.2026.103802

Abstract

Food insecurity (FI) is highly prevalent and can lead to depression. This study 1) examines the association of FI with depression symptoms (DS) among older adults in Ghana, 2) explores the degree to which psychosocial factors mediate the FI-DS link, and 3) investigates the effect modification of the association by age and sex differences. Data from adults aged ≥50 years in the AgeHeaPsyWel-HeaSeeB Study were analyzed. DS (cutoff of ≥9) was assessed using the CES-D-10 scale. Continuous score and categorical FI were measured with hunger and skipped breakfast items due to insufficient food or resources. Multivariable regression and bootstrapping analyses were used to evaluate the hypothesized associations. The sample included 1201 individuals (M_age=66.1[11.9]; F = 63.3%). Moderate (OR=1.75, 95%CI=1.22-2.51) and severe FI (OR=4.69, 95%CI=2.58-8.55) (vs no FI) were associated with DS, while a unit increase in FI was associated with 1.67 (95%CI=1.39-2.01) times higher odds for DS. The association was much stronger in males than in females and in those aged 50-69 years than in those aged ≥70. Anxiety (mediated percetage 41%), loneliness (30%), hopelessness (8%), and social isolation (4%) mediated the FI-DS association. Higher FI levels are positively associated with DS. Addressing FI and the identified psychosocial mediators may reduce DS in food-insecure older adults in low-income countries, pending future longitudinal conclusions.

Keywords: Depression; Food insecurity; Loneliness; Mental health; Older adults.