2.1. Variables

2.2. Confounders

The confounders selected for the study were sex, marital status and perceived general health of respondents. The confounders for the study were also selected based on the literature [48, 49].

2.3. Theoretical Framework of the Study

In this study, it was conceptualised that social wellbeing (i.e., social integration, social contribution, social acceptance, social coherence and social actualization) is dependent on the emotional wellbeing (i.e., not being depressed, not worried, not feel neglected and isolated), physical wellbeing (i.e., engaging in moderate to vigorous exercise, ability to eat and cut up food, bath and walk without aid), psychological wellbeing (i.e., ability to remember things, concentrate, cope in difficult times and have control over things in life) and spiritual wellbeing (i.e., belong to a religion, participate in religious services, believe in or harmonious relationship with a supreme being and personal satisfaction).

This implies that older persons who are not depressed, worried and do not feel isolated can engage in exercises, eat and cut up food, bath and walk without aid, can concentrate and cope with difficulties in life, could also participate in religious services, have personal satisfaction which influences how they integrate into society, contribute to their communities, feel accepted by people in society, feel safe in society and have satisfaction with their overall quality of life in society.

In furtherance, it was conceptualised that socioeconomic factors (sex, age, marital status, education, religious affiliation, ethnicity, place of residence, ecological zones, general health, work status and level of income) have a direct relationship with the social wellbeing of older persons. Lastly, the study conceptualised that these confounders have a direct impact on social wellbeing as well as an indirect influence on social wellbeing through the domains of wellbeing such as emotional, physical, psychological and spiritual wellbeing.

In addition, it was conceptualised that social wellbeing (i.e., social integration, social contribution, social acceptance, social coherence and social actualisation) influences the level at which older persons withdraw from society (Disengagement theory) [50] or maintain the activities of middle age for high life satisfaction (Activity theory) [51]. Lastly, the study conceived that improvement in the holistic wellbeing quadrant (emotional, physical, psychological and spiritual) determines whether older persons would withdraw from society (Disengagement theory) or can replace the role losses for higher life satisfaction and overall quality of life (Activity theory). Details are shown in Figure 1.

2.4. Theoretical Framework

Conceptual Framework.

2.5. Hypotheses of the Study

2.6. Analysis

The theoretical framework in Figure 1 was tested using the SEM technique. The analysis was done using SPSS Version 26.0 and AMOS Version 23.0 for Windows. The analysis was conducted in two phases. The first phase constituted the measurement models with confirmatory factor analysis (CFA). The structural equation modelling with latent variables was conducted in phase two. The data used was a good fit for the study. The data analyses were restricted to older persons 60 years and above.

The theoretical framework (Figure 1) included exogenous latent factors of emotional, physical, psychological and spiritual wellbeing. These exogenous variables were hypothesised to influence each other and directly and indirectly affect the endogenous factor of social wellbeing. Sex, marital status and perceived general health of respondents were also hypothesised to mediate the effects of the holistic wellbeing quadrant on the outcome variable. The maximum likelihood estimation with missing values (MLMVs) was applied in the SEM to handle missing data [31] and obtain adequate information from observations with missing values from the data used.

The models were fitted using the maximum likelihood estimation (MLE) approach. Since the chi-square value (χ²) of the likelihood ratio is usually significant with a large sample (n = 1927), four fit indices were used to determine the model fit. These included the Non-normed Fit Index (NFI), Tucker–Lewis Index (TLI), Comparative Fit Index (CFI) and the Root Mean Square Error of Approximation (RMSEA) [52]. The NFI, TLI, and CFI values larger than 0.90 and the RMSEA value smaller than 0.08 denote acceptable model fit. Values larger than 0.90 for NFI, TLI and CFI and 0.08 or lower for RMSEA indicate acceptable model fit [52]. All three relative fit indices (NFI, TLI and CFI) exceeded the 0.90 criterion 0.94, 0.92 and 0.95, respectively [52]. The value of RMSEA (0.06) was also lower than 0.08 [52]. Therefore, an acceptable model fit was achieved. The final model is presented in the results.

3.1. Background Characteristics of Respondents

Of the 3, 575 older persons who participated in the study, 1927 fulfilled the inclusion criteria and were included in the present analysis (mean ± SD: 14.1 ± 62.6 years; 43.2% male and 56.8% female). About 4 in every 10 of them were young olds (60–69) and 58% were married. Forty-five percent of the aged, representing the highest, had no formal education. Approximately 73% were Christians and 46% of them were Akans. Also, 47.4% worked full-time and 49.6% lived in the forest zone. Also, about 61% lived in rural areas. Most of the aged had a high level of income and 68.2% had perceived good general health status. Details are shown in Table 1

3.2. Interdependence of the Measures of Social Wellbeing of the Older Persons

The measures of social wellbeing, as analysed in this study, comprised five subdomains made of 16 indicators. The factor loadings for all the indicators of social wellbeing were positive, indicating that a higher score reflects high social wellbeing among older persons. Social integration and social contribution were observed to be positive. However, social integration and coherence are negatively correlated, indicating that increasing social integration is associated with declining social coherence. There was a positive covariance between social contribution and social acceptance; thus, improvement in social contribution also improves social acceptance, and vice versa. Social acceptance positively covary with social coherence but negatively covary with social actualisation. This implies that social acceptance of older persons improves their social coherence but lowers their social actualisation and vice versa.

3.3. Direct Effects of the Holistic Wellbeing Quadrant on Social Wellbeing

Figure 2 shows the direct of the other domains’ wellbeing (emotional wellbeing (β = 0.17, p < 0.001)), physical wellbeing (β = 0.57, p < 0.001), psychological wellbeing (β = 0.17, p < 0.001) and spiritual wellbeing (β = 0.25, p < 0.001) on social wellbeing of older persons. A unit increase in emotional and psychological wellbeing was both, on average, associated with 0.17 units increase in social wellbeing. Also, on average, a unit increase in physical wellbeing was associated with a 0.57 unit increase in social wellbeing. Finally, an increase of one unit in spiritual wellbeing increased social wellbeing by 0.25 units on average.

Regarding the confounders, the results show that sex (β = 0.10, p < 0.001), perceived general health status (moderate (β = 0.86, p < 0.001) and good (β = 0.94, p < 0.001)) and marital status (married (β = 0.07, p < 0.001), separated/divorced (β = 0.13, p < 0.001) and widowed (β = 0.08, p < 0.001)) had a statistically significant (p < 0.01) and direct effects on social wellbeing. Females, on average, had a higher social wellbeing by 0.10 units when compared with males. Also, older persons who rated their general health status as moderate, on average, had improved social wellbeing by 0.86 units while those who reported good general health status had higher social wellbeing by 0.94 units when compared with those who reported poor general health status. For marital status, the results show that respondents who were married, separated/divorced and widowed, on average, had higher social wellbeing by 0.07, 0.13 and 0.08 units, respectively, when compared to those who never married.

3.4. Indirect Effects of the Holistic Wellbeing Quadrant on Social Wellbeing

The indirect associations also show that the effects of emotional, physical, psychological and spiritual wellbeing on the social wellbeing of older persons were mediated by their marital status. Older persons who were ever married (currently married (β = 0.10, p < 0.001), separated/divorced (β = 0.09, p < 0.001) and widowed (β = 0.13, p < 0.001)) had higher emotional wellbeing, which influenced their social wellbeing. So, for older persons who were ever married, a unit increase in their emotional wellbeing was associated with an increase of 0.10, 0.09 and 0.13, respectively, in their social wellbeing, on average, when compared with those who never married. Also, of older persons who were ever married, a unit increase in physical wellbeing, on average, was associated with an increase of 0.28 (p < 0.001), 0.17 (p < 0.001) and 0.21 (p < 0.001), respectively, in their social wellbeing compared with those never married. The results also show that respondents who were ever married had improved psychological and spiritual wellbeing, which further enhanced their social wellbeing when compared with those who never married, as detailed in Figure 2.

Furthermore, results in Figure 2 show that the sex of the respondent operates through physical (β = 0.10, p < 0.001), psychological (β = 0.41, p < 0.001) and spiritual (β = 0.31, p < 0.001) wellbeing to influence the social wellbeing of older persons. For females, on average, a unit increase in their physical, psychological and spiritual wellbeing increased their social wellbeing by 0.10, 0.41 and 0.31 units, respectively, when compared with males. Also, the effects of physical, psychological and spiritual wellbeing on the social wellbeing of older persons were mediated by their perceived general health status.

The effects of physical wellbeing on social wellbeing were mediated by moderate (β = 0.16, p < 0.001) and good (β = 0.27, p < 0.001) general health status. Thus, a unit increase in their physical wellbeing was associated with 0.16 and 0.27 units increase in their social wellbeing. The effect of psychological wellbeing on social wellbeing was influenced by perceived general health status (moderate (β = 0.39, p < 0.001) and good (β = 0.19, p < 0.001)). For respondents with moderate and good perceived general health, an increase in psychological wellbeing by 0.39 and 0.19 units was associated with an increase in social wellbeing when compared with those who reported poor perceived general health. Furthermore, for respondents who reported moderate (β = 0.22, p < 0.001) and good (β = 0.45, p < 0.001) perceived general health status, improvement in spiritual wellbeing was associated with improved social wellbeing.

3.5. Covariances Among the Holistic Wellbeing Quadrant and Their Effects on Social Wellbeing

The results further show interdependence among the holistic wellbeing quadrant, which further influences the social wellbeing of older persons (Figure 2). Emotional wellbeing positively covary with physical and psychological wellbeing to impact the social wellbeing of older persons. This indicates that healthy emotional wellbeing positively impacts physical and psychological wellbeing to influence the social wellbeing of older persons and vice versa. Furthermore, the results show that psychological wellbeing is highly correlated with physical and spiritual wellbeing, while spiritual wellbeing also positively covary with the emotional wellbeing of older persons. The positive covariance observed between the psychological wellbeing of older persons and their physical and spiritual wellbeing implies that high psychological wellbeing improves the physical and spiritual wellbeing of older persons to positively impact their social wellbeing. Therefore, older persons with high psychological wellbeing also had high physical and spiritual wellbeing and, thus, high social wellbeing. Also, older persons with high spiritual wellbeing had high emotional wellbeing and, therefore, high social wellbeing.

4.1. Emotional Wellbeing and Social Wellbeing (H₁)

The study hypothesised (H₁) that emotional wellbeing positively influences social wellbeing, with higher emotional stability and lower levels of depression fostering greater social integration, contribution and acceptance. It was observed that emotional wellbeing is rooted in the ability to maintain positive feelings, cope with stress and avoid isolation. Keyes [28] found that older persons with higher emotional stability and life satisfaction are more likely to engage in social activities, maintain robust social networks and experience a sense of belonging in their communities. Conversely, emotional distress, such as loneliness or depression, can lead to social isolation and reduced participation in community activities [42]. This is particularly relevant in Ghana, where older persons often face emotional challenges due to the loss of loved ones, reduced independence and shifting family dynamics, which can negatively impact their social integration and overall wellbeing [23]. Gyasi et al. [1] highlighted that older Ghanaians who maintain emotional wellbeing are more likely to participate in community activities and sustain social connections, which are crucial for their quality of life. These findings align with Taylor et al. [22], who emphasised that emotional wellbeing is a key predictor of social engagement and life satisfaction, especially in developing countries where social support systems may be limited.

4.2. Physical Wellbeing and Social Wellbeing (H₂)

The study also hypothesised (H₂) that physical wellbeing enhances social wellbeing, as better physical health enables older persons to participate in social activities and maintain independence. It was found that physical wellbeing is a critical determinant of social wellbeing, as it facilitates social connections by allowing older persons to engage in communal activities. Research consistently shows that physical activity is a key factor in maintaining social connections. For example, Weinstein et al. [42] found that older persons who engage in regular physical activities, such as walking or gardening, report higher levels of social integration and satisfaction. These activities not only improve physical health but also provide opportunities for social interaction, which is essential for maintaining social wellbeing [42]. Similarly, Nicklett et al. [53] highlighted that access to physical activities, particularly in community settings, enhances social cohesion. Their study found that older persons who participated in group exercises or community gardening projects reported stronger social ties and a greater sense of belonging [53]. In the Ghanaian context, physical independence is a significant predictor of social participation and satisfaction. Older persons who are physically capable of performing daily activities without assistance are more likely to engage in social and communal activities, leading to higher levels of social wellbeing [25]. This aligns with Gyasi et al. [1], who noted that physical independence allows older persons to maintain their roles in the community, thereby enhancing their social integration and overall quality of life. Physical wellbeing also contributes to social cohesion by enabling older persons to participate in communal activities, such as attending community events, religious services or family gatherings, which are vital for maintaining social networks in Ghana [1].

4.3. Psychological Wellbeing and Social Wellbeing (H₃)

Psychological wellbeing, which encompasses cognitive function, coping mechanisms and a sense of control over daily activities, positively influence social wellbeing. This supports H₃, which posits that psychological wellbeing fosters social coherence and actualisation through cognitive functioning, resilience and autonomy. Research shows that older persons with higher psychological wellbeing are more resilient, better able to handle life’s challenges and more likely to actively participate in their communities [27]. Psychological resilience—the ability to adapt to stress—plays a key role in maintaining social connections and community engagement. Older persons with strong psychological wellbeing are more likely to contribute to their communities and experience social acceptance and coherence [41]. Cognitive functioning, a component of psychological wellbeing, is essential for social interactions. It enables older persons to process social cues, engage in conversations and participate in community activities, all of which are critical for social integration. Studies, such as those by Yu et al. [29], show that better cognitive function is linked to stronger social networks and higher social wellbeing. This is particularly relevant in Ghana, where older persons often face psychological challenges due to economic hardships, loss of social roles and limited access to mental health services [1]. These challenges can hinder social connections, highlighting the importance of psychological wellbeing in promoting social integration. In addition, psychological wellbeing fosters a sense of autonomy and control, which is crucial for social actualisation. Older persons who feel in control of their lives are more likely to engage in community activities and derive satisfaction from their social roles. This aligns with Ryff’s [27] findings that autonomy and purpose in life are key to social wellbeing. In Ghana, where older persons often experience shifting family dynamics and reduced independence, maintaining psychological wellbeing can help reduce social isolation and enhance their ability to contribute meaningfully to their communities.

4.4. Spiritual Wellbeing and Social Wellbeing (H₄)

The study’s findings highlight the impact of spiritual wellbeing on social wellbeing, as engagement in religious practices fosters a sense of belonging and community. This finding supports Hypothesis 4 (H₄), which posits that spiritual wellbeing promotes social well-being by fostering community, belonging and resilience, particularly in Ghana’s culturally rich spiritual context. This aligns with previous research showing that religious practices strengthen social ties and provide emotional and psychological support [31, 38]. In Ghana, where spirituality is central to daily life, religious communities offer social support, identity and networks that enhance social integration and acceptance [14]. Spiritual practices such as prayer and communal worship also reduce stress and promote resilience [31]. The study further highlights the interdependence between spiritual wellbeing and emotional wellbeing, with higher spiritual wellbeing linked to greater emotional stability and resilience [31]. This is particularly significant in Ghana, where religious communities provide crucial support for older persons facing challenges like loneliness or declining health [1]. The findings align with the biopsychosocial–spiritual model [16], emphasising spirituality’s role in enhancing psychological resilience and social integration. Older persons engaged in spiritual practices are more likely to maintain a positive outlook, cope with challenges and feel a sense of purpose, fostering meaningful community engagement [10].

4.5. The Interconnectedness of Emotional and Psychological Wellbeing (H₅)

The study findings support the hypothesis (H₅) that emotional wellbeing and psychological wellbeing are interconnected and significantly influence social wellbeing among older persons. Specifically, emotional wellbeing was found to positively correlate with both physical and psychological wellbeing. This interdependence suggests that higher emotional stability can mitigate depression and anxiety, thereby supporting both physical and mental health in older persons [35]. This reciprocal relationship indicates that positive emotional wellbeing enhances an individual’s capacity to cope with physical ailments and stressors, enabling older persons to maintain their social roles and interactions throughout the ageing process. This, in turn, leads to greater life satisfaction and social wellbeing, as informed by the Activity Theory [51]. The relationship between emotional wellbeing and physical health is well documented. Keyes and Ryff [28] found that older persons with higher emotional stability and life satisfaction are more likely to engage in social activities and maintain strong social networks, which support physical health. Conversely, emotional distress, such as loneliness or depression, is linked to physical health decline, including cardiovascular risks and weakened immune function [34].

In Ghana, emotional wellbeing enables older persons to participate in community activities and maintain social connections, enhancing their quality of life [1]. Psychological wellbeing, closely tied to emotional wellbeing, is crucial for maintaining social connections and community engagement. Older persons with higher psychological wellbeing are more resilient, better able to handle life’s challenges and more likely to participate in their communities [29]. Cognitive functioning, a key component of psychological wellbeing, facilitates social interactions by enabling older persons to process social cues, engage in conversations and participate in community activities, all of which are vital for social integration [27]. The study emphasises the interconnectedness of emotional, physical and psychological wellbeing, where improvements in one domain positively influence others. For example, emotional wellbeing enhances psychological resilience, which supports physical health by reducing stress and improving immune function [10]. This interconnectedness is especially relevant in Ghana, where older persons face psychological challenges due to economic hardships, loss of social roles and limited mental health access [1]. Maintaining emotional and psychological wellbeing helps reduce social isolation and enables older persons to contribute meaningfully to their communities.

4.6. The Interconnectedness of Psychological, Physical and Spiritual Wellbeing (H₆)

The study results support the hypothesis (H₆) that psychological, physical and spiritual wellbeing interrelate and significantly impact social wellbeing. Psychological wellbeing, the ability to maintain mental focus, cope with life’s challenges and feel a sense of control, is closely linked to greater physical autonomy. Research shows that individuals with higher psychological wellbeing manage physical health challenges more effectively, enhancing their ability to engage in social activities and maintain independence [1, 29]. For instance, older persons with strong psychological resilience are more likely to participate in community activities, maintain social networks and experience a sense of belonging, all of which boost social wellbeing [27]. In Ghana, psychological wellbeing is crucial for fostering social integration and reducing isolation among older persons [1]. Spiritual wellbeing, characterized by a sense of meaning, purpose and connection to something greater than oneself, is especially significant in the Ghanaian context. Spiritual practices such as prayer and communal worship provide emotional and psychological support, enhancing strength and reducing stress [10, 28]. Given the deep-rooted role of spirituality and religion in daily life in Ghana, spiritual wellbeing fosters a sense of community and belonging, directly boosting social wellbeing [1]. Older persons who engage in spiritual practices are more likely to maintain positive social relationships, participate in community activities and experience a sense of purpose [38]. Physical wellbeing, which involves maintaining functional health and managing chronic conditions, is also closely tied to spiritual wellbeing. Studies show that physically active and healthy older persons are more likely to participate in spiritual and religious activities, further enhancing their social wellbeing [22, 53]. In Ghana, where communal activities and social support networks are vital, physical wellbeing enables older persons to engage in religious and social activities, fostering a strong sense of belonging and community [1].

The study shows that physical and spiritual wellbeing contributes to sustained social involvement, counteracting withdrawal tendencies by the disengagement theory, suggesting that some individuals may naturally withdraw from social roles in old age [14]. Hence, maintaining high spiritual wellbeing through religious participation and emotional wellbeing through positive social interactions facilitates ongoing social wellbeing. This corroborates findings on how spiritual engagement provides psychological and social support, reinforcing wellbeing through community belonging and emotional connection [19, 39].

The findings in this study emphasise that sex, marital status and general health status significantly mediate the relationship between wellbeing domains (emotional, physical, psychological and spiritual wellbeing) and social wellbeing. Older females reported higher social wellbeing than males [49]. This is attributed partly to increased social engagement in activities such as family care, church involvement, and community interactions. In Ghana, women, due to their traditional caregiving roles and communal interactions, often exhibit higher levels of social engagement and support networks than men [49]. These gender-based social networks support the Activity Theory, which posits that staying active in meaningful roles fosters life satisfaction and wellbeing in older persons [51].

The findings show that older persons who are married, separated or widowed have higher social wellbeing than those who were never married. This trend can be explained by the companionship, support and social connections often derived from marital relationships, which extend beyond marriage through widowhood or separation [47]. Marriage has been found to act as a protective factor that offers social and emotional support, facilitating positive social wellbeing outcomes [48, 49].

The study revealed that older persons with perceived moderate or good health reported higher social wellbeing, as better health enables more participation in community activities and social interactions. This aligns with disengagement theory, which suggests that poor health can drive social withdrawal in older persons [50]. However, healthy individuals, particularly those who can maintain physical independence, are more likely to sustain social connections, as informed by the Activity theory [24].

The study highlights healthier older persons in Ghana, through better general health and physical independence, can fully engage in social and community activities, which positively impact their social wellbeing [24]. This echoes the activity theory of ageing, which proposes that maintaining social roles, physical activity and engagement in later life enhances life satisfaction. By contrast, the Disengagement theory posits a gradual withdrawal from societal roles as an adaptive ageing process [50]. However, findings suggest that better physical health and independence challenge this view, enabling older persons to continue meaningful participation in their communities, which fosters social wellbeing [24].

Studies by Taylor et al. [22] and Nicklett et al. [53] support the assertion that physical activity is essential for social wellbeing, showing that older persons who engage in physical activities like walking or gardening are more socially integrated and satisfied. Physical independence enhances social wellbeing by enabling participation in social and communal activities, fostering a sense of belonging and security within communities [47].

Furthermore, the study shows that psychological and spiritual wellbeing are crucial for both physical and social wellbeing. Older persons who maintain cognitive abilities, manage daily challenges and engage in social activities report higher social coherence and integration [39]. This interdependence across physical, psychological, emotional and spiritual domains supports a holistic view of wellbeing, where improvements in one domain of wellbeing enhance other domains of wellbeing, cumulatively boosting social wellbeing. This interconnectedness highlights the need for multidimensional support in ageing, encouraging interventions that consider physical, emotional and spiritual needs to improve social inclusion and life satisfaction.

Lastly, the study’s findings highlight that spiritual wellbeing positively interacts with emotional and psychological wellbeing to enhance social cohesion. Religious participation often correlates with improved mental resilience, which bolsters one’s capacity to engage with others and foster a fulfilling social life [20]. Spiritual practices and beliefs offer coping mechanisms that are instrumental in psychological resilience and stress reduction, as found in studies on the psychological impact of religious engagement among older populations [14].

5.1. Strengths and Limitations of the Study

The study employs a comprehensive multidimensional analysis that explores the interplay between emotional, physical, psychological and spiritual wellbeing and its impact on social wellbeing among older persons in Ghana. This holistic approach provides valuable insights into the various factors influencing wellbeing within this demographic. The use of SEM further enhances the analysis, allowing for a robust examination of both direct and indirect relationships among different domains of wellbeing. This method effectively accounts for the complexity and interdependence of these factors, leading to a deeper understanding of their collective influence on social wellbeing. In addition, the research benefits from a large, nationally representative sample drawn from Wave 2 of the WHO’s Study on Global Ageing and Adult Health (SAGE), which includes 1927 individuals aged 60 and above. This substantial dataset enhances the generalizability of the findings and emphasizes the cultural and contextual relevance of the study in addressing the needs of older persons in Ghana.

Despite its strengths, the study is limited by its use of cross-sectional data, which restricts the ability to infer causation among the observed relationships between wellbeing domains. As a result, the findings reflect associative patterns rather than definitive causal pathways, highlighting the need for longitudinal studies to validate these relationships further. In addition, the reliance on self-reported measures for assessing wellbeing introduces potential bias, as participants’ perceptions may be shaped by subjective factors, impacting the accuracy of the reported outcomes. The study also addresses some socioeconomic variables but could have considered additional external influences, such as community or environmental factors, to achieve a more nuanced understanding of social wellbeing in older persons. Standardized scales may not fully capture culturally specific aspects of wellbeing in Ghana, such as traditional healing or communal support, limiting contextual relevance. Finally, while the study is culturally relevant to Ghana, its findings may not fully apply to older populations in different socioeconomic or cultural contexts, necessitating further cross-cultural validation to enhance its applicability in diverse settings.

5.2. Implications and Future Research

Given the study’s finding that physical, emotional, psychological and spiritual wellbeing collectively enhance social wellbeing, policies should adopt a holistic approach to elderly care. Integrate health programs that address physical health alongside emotional support and spiritual engagement can foster overall wellbeing. Prioritise accessible, affordable and high-quality healthcare for older persons, focusing on preventive care, chronic condition management and rehabilitation services, given physical wellbeing’s strong link to social wellbeing. Engage faith-based and community organisations to promote social inclusion and emotional resilience through religious and cultural activities, strengthening social ties and improving quality of life. Develop targeted programs for older men, who may face higher social isolation risks, while leveraging the higher social wellbeing reported by older women. Foster social connections for older persons, particularly widowed or unmarried individuals, through community programs that encourage social interaction. For practical implications, holistic care models should be adopted for multidimensional care approaches addressing emotional, physical, cognitive and spiritual wellbeing to enhance social wellbeing. Community engagement is needed to organise group exercises, social events and spiritual gatherings to maintain social connections and prevent isolation. Training for health professionals is crucial to recognise interconnected wellbeing dimensions, emphasising cultural context and spirituality’s role in older persons’ lives.

Concerning implications for future research, future research should explore the causal relationships between wellbeing dimensions over time, given the cross-sectional nature of this study. Further studies should investigate how cultural practices and beliefs influence the interconnections between wellbeing domains and social wellbeing. Research on the effectiveness of integrated wellbeing interventions in enhancing social wellbeing among older persons in Ghana can provide evidence-based strategies for policy and practice.