Associations among housing accessibility, housing-related control beliefs and independence in activities of daily living: a cross-sectional study among younger old in Sweden

There is some evidence that housing accessibility, external housing-related control beliefs (HCB) and activities of daily living (ADL) are associated in complex ways; however, these pathways have not been explored in younger old. The aim was to assess the role of external HCB in the relationship between housing accessibility and ADL by applying moderation and mediation models. This was a cross-sectional study involving 366 community-living 67–70 years old participants from the Skåne part of the Swedish National Study of Aging and Care. We assessed moderation by including an interaction term in a logistic regression analysis (significant if p value < 0.05). We assessed mediation with a series of regression analyses with effect size measures expressed as proportion mediated and its 95% confidence interval (CI). In the absence of statistically significant interaction there was no support for external HCB as a moderator. There was evidence for partial mediation as external HCB was associated with ADL when controlled for housing accessibility, while housing accessibility remained associated with independence in ADL when adjusted for external HCB. The proportion mediated was 6% (95% CI 1; 14). While the results did not support external HCB as a moderator, external HCB mediated the association between housing accessibility and ADL. These results were different from previous findings suggesting that external HCB plays a marginally significant moderating and mediating role among very old. Such differences call for further studies that would allow further exploration and validation of the findings at different stages of the ageing process, preferably utilizing longitudinal study designs.