Social isolation and loneliness have been linked to adverse health outcomes such as depression in old age. However, limited data exist on the association of loneliness and social isolation with probable depression (PD) in low- and middle-income countries (LMICs), while psychosocial mediators are largely unknown. This study investigates the individual and joint associations of social isolation and loneliness with PD among older adults in Ghana. It quantifies the extent to which psychosocial factors mediate the associations. Cross-sectional data from the Aging, Health, Well-being, and Health-seeking Behaviour Study were analyzed. PD was defined as moderate to severe depressive symptoms with the Center for Epidemiologic Studies Depression (CES-D-9) scale. Loneliness and social isolation were assessed with the University of California, Los Angeles 3-item loneliness scale and the Berkman-Syme Social Network Index, respectively. Multivariable logistic models and PROCESS macro bootstrapping mediation analyses were performed. Among the 1,201 adults aged ≥50 years (Mage = 66.1 ± 11.9 years, 63.3% women), 29.5% PD cases were found. The prevalence of social isolation and loneliness was 27.3% and 17.7%, respectively. Loneliness (OR = 3.15, 95% CI = 3.26–5.28) and social isolation (OR = 1.24, 95% CI = 1.10–1.41) were independently associated with higher odds of PD. The loneliness and PD association was modified by spatial location (Pinteraction = 0.021); thus, the association was more pronounced in rural areas (OR = 7.06) than in urban areas (OR = 3.43). Psychosocial factors (e.g. sleep problems) mediated the loneliness/social isolation and PD association. Loneliness and social isolation were independently associated with a higher likelihood of PD, and psychosocial factors mediated the associations. Interventions to reduce PD in later life should also consider addressing loneliness and social isolation, as well as sleep problems.

Studies point to the role of sociocultural and household power dynamics in women’s risk of mental illnesses. Using the context of Mozambique, we examined the association between women’s household decision-making autonomy with probable depression and reporting symptoms of anxiety. We used the 2022–2023 Mozambique Demographic and Health Survey and applied logistic regression analysis. Our findings indicate high prevalence rates of depression (10%) and anxiety (11%) among married women. We also find that married women with the highest forms of household autonomy who take decisions alone on their health care (OR = 0.43, 95% CI = 0.32, 0.59; OR = 0.52, 95% CI = 0.38, 0.70), on making large household purchases (OR = 0.43, 95% CI = 0.28, 0.64; OR = 0.52, 95% CI = 0.35, 0.76) and visiting family members or relatives (OR = 0.36, 95% CI = 0.25, 0.51; OR = 0.64, 95% CI = 0.46, 0.89) were all less likely to report propable depression and symptoms of anxiety, respectively. Additionally, higher household wealth and employment acted as protective assets against both depression and anxiety. We recommend working to remove the sociocultural barriers to women’s autonomy while improving their socioeconomic status, such as income and employment opportunities, which will lead to a better mental health outcome and serve as an important pathway to increasing their autonomy.