Abstract
Background
Psychosocial experiences such as loneliness and humor are associated with health in later life, but less is known about their relationship with everyday self-care. This study examined whether self-care was associated with mental and physical health beyond emotional loneliness and self-enhancing humor and whether self-care statistically accounted for indirect associations between these psychosocial factors and health-related quality of life in older adults.
Method
A cross-sectional community-based sample of 675 adults aged 60–99 years completed measures of emotional loneliness, self-enhancing humor, self-care, and health-related quality of life. Meaning and Life Purpose was examined separately as an exploratory predictor. Hierarchical regression models adjusted for age and sex were followed by bootstrapped indirect-effect analyses with 5000 resamples. Sensitivity analyses used overlap-reduced self-care scores to address potential conceptual and item-level overlap among measures.
Results
The self-care composite was strongly positively associated with both mental (r = 0.692) and physical health (r = 0.700; both p < 0.001). In hierarchical models, self-care added 13.7% and 15.3% of explained variance in mental and physical health, respectively, yielding final R2 values of 0.529 and 0.526. In the final models, self-care remained positively associated with mental (β = 0.515, p < 0.001) and physical health (β = 0.545, p < 0.001), while emotional loneliness remained negatively associated with both outcomes. Bootstrapped analyses showed significant indirect associations through self-care for emotional loneliness and self-enhancing humor in relation to both health outcomes. These associations remained statistically supported in conservative overlap-reduced sensitivity analyses. Exploratory indirect associations involving Meaning and Life Purpose were not robust to sensitivity analyses.
Conclusion
Self-care was strongly associated with perceived mental and physical health and accounted for statistically supported indirect associations linking emotional loneliness and self-enhancing humor with health outcomes. The findings identify self-care as a potentially important behavioral intermediary in later life, while the cross-sectional design precludes conclusions about temporal or causal mechanisms. Longitudinal research is needed to determine the direction and developmental course of these relationships.
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Data Availability
The data supporting the findings of this study are not publicly available due to ethical and privacy restrictions. However, deidentified data may be made available by the corresponding author upon reasonable request.
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Conceptualization: M.G. Writing—original draft: M.G., E.B., N.Z. Writing—review and editing: A.P., E.D., A.N., C.T., S.M. Supervision: M.G. Project administration: M.G.
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Ethical approval was obtained from the Ethics Committee of the University of Ioannina (Approval No. 27944, dated July 24, 2024). The study was conducted in accordance with the Declaration of Helsinki and applicable data-protection requirements. All participants provided informed consent prior to participation.
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Bartzou, E., Dragioti, E., Paschou, A. et al. Self-Care as a Self-Regulatory Process Linking Loneliness and Humor to Mental and Physical Health in Older Adults. Int.J. Behav. Med. (2026). https://doi.org/10.1007/s12529-026-10497-9
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DOI: https://doi.org/10.1007/s12529-026-10497-9