Social support, physical health and spiritual engagement help older adults truly flourish

Older Canadians who are socially connected, physically healthy, and spiritually engaged are significantly more likely to experience complete mental health, according to a new nationally representative study examining adults aged 65 and older.

Using data from 2,024 respondents in Statistics Canada's 2022 Mental Health and Access to Care Survey (MHACS), researchers examined factors associated with both the absence of psychiatric disorder (APD) and complete mental health (CMH), a broader measure that combines freedom from mental illness with high emotional, psychological, and social well-being.

Our findings shift the conversation away from mental illness alone and toward understanding what helps older adults truly flourish. Complete mental health reflects not just the absence of disorders, but the presence of meaning, satisfaction, and strong social connections."

Daniyal Rahim, first author, PhD Candidate, Ontario Institute for Studies in Education, University of Toronto

The study found that older adults were more likely to experience APD and CMH if they were married or in a common-law relationship, had strong social support, rated their physical health as fair or better, and reported no chronic pain, sleep problems, or limitations in daily activities. Social support emerged as one of the strongest predictors, more than doubling the odds of achieving complete mental health.

"Social relationships appear to be a cornerstone of mental well-being in later life," said coauthor Shannon Halls, Research Coordinator, Institute for Life Course & Aging, University of Toronto. "Having people to rely on during stressful times may buffer against psychological distress and promote resilience, happiness, and a sense of purpose."

Spirituality was also strongly associated with mental well-being. Older adults who reported that religion or spirituality was important in their daily lives had significantly higher odds of both APD and CMH.

"Spiritual beliefs may help older adults cope with adversity by providing meaning, hope, and a sense of community," said co-author Ying Jiang, a senior epidemiologist in the Applied Research Division, Centre for Surveillance and Applied Research, Public Health Agency of Canada. "These factors can be particularly relevant during periods of declining health or life transitions."

Physical health factors played a critical role. Freedom from chronic pain, sleep problems, and limitations in instrumental activities of daily living was consistently associated with better mental health outcomes. Conversely, living in a large urban center was linked to lower odds of complete mental health compared to rural living.

"These findings underscore that mental health in aging is shaped by a complex interplay of social, physical, and environmental factors," said senior author Esme Fuller-Thomson, Director, Institute for Life Course & Aging, University of Toronto, Factor-Inwentash Faculty of Social Work, University of Toronto. "Public health strategies that strengthen social support, address pain and sleep problems, and promote meaningful engagement could substantially improve well-being among older adults."

The authors emphasize that many of the identified factors are modifiable, suggesting opportunities for targeted interventions, including social programming, pain management, sleep treatment, and community-based supports to help more older Canadians achieve complete mental health.