Perceived safety and social inclusion are more strongly associated with quality of life in older age: repeated moderated mediation analyses

Person-environment (P-E) fit and ageing theories suggest that perceived safety and social inclusion are associated with health outcomes. However, no study has utilised time-separated unique samples to investigate whether age moderates the association of perceived safety with quality of life (QoL) through social inclusion. This study used three distinct, time-separated samples to ascertain whether the indirect association between perceived safety and QoL through social inclusion is moderated by age. This study employed a moderated mediation analysis repeated at three waves [wave 1 (2007/2008); wave 2 (2014/2015), and wave 3 (2018/2019)] from the World Health Organization’s Study on Global AGEing and adult health Ghana (WHO-SAGE Ghana). It included a weighted sample of 14,172 adults aged 50 to 112 years. The unique sample for each wave was 4724 nationally representative adults, and the Hayes’ Process Macros (Model 59) was utilised to assess moderated mediation. Perceived safety was not directly associated with QoL but was indirectly associated with QoL through social inclusion. The association of perceived safety with QoL was fully mediated by social inclusion, and the mediation was stronger in older age. There was a direct positive association of social inclusion with QoL, which was stronger in older age. The foregoing results were consistent across the three time points and samples. Social inclusion may be more strongly associated with QoL in older age. The results support positive ageing theories, including the Socioemotional Selectivity Theory, and reinforce the importance of enhancing neighbourhood safety and social inclusion.