The nexus between living arrangements and health in older adults: behavioral and psychological pathways

Objectives Although the association between living arrangements and older adults’ health is well recognized, the underlying mechanisms driving this relationship remain largely unexplored. Therefore, this study aims to bridge that gap by examining how living arrangements influence health status in later life, with a particular focus on the mediating roles of health-risk behaviors and psychological well-being.Method Using data from the Longitudinal Ageing Study in India (LASI) Wave 1 (2017–18), we employed logistic regression to assess the association between living arrangements and self-rated health in older adults. The Karlson-Holm-Breen (KHB) method further explored the mechanisms underlying this association.Result Older adults in co-residence settings reported better self-rated health (76.4%; men 77.8%, women 74.9%) than those living alone (65%; men 68%, women 64.2%). The study found a notable reduction in the likelihood of poor self-rated health among older adults living with family. This protective association, quantified as a nearly 20% lower odds of poor SRH, was largely explained by the mediating roles of sleep problems and psychological well-being (PWB). Notably, PWB plays a stronger mediating role among men (28.2%) than women (26.3%).Conclusion In conclusion, our study underscores the significant protective health benefits of co-residential living for older adults, while highlighting the pivotal roles of sleep problems and PWB as key pathways linking living arrangements to health outcomes.