Sense of coherence mediates the relationship between digital health literacy and anxiety about the future in aging population during the COVID-19 pandemic: a path analysis

Angela Yee Man Leung, Laurence Lloyd Parial, Ma. Carmen Tolabing Tolabing, Timothy Sim, Phoenix Kit-Han Mo, Orkan Okan, Kevin Dadaczynski

Research output: Journal article publicationJournal articleAcademic researchpeer-review


Objectives: During the COVID-19 pandemic, older adults experience various challenges, including information uncertainties, financial pressure, and visit restrictions, which may lead to anxiety about the future. As a protective factor, sense of coherence (SOC) may play a role to reduce some psychological discomfort. This study aimed to analyze the relationships of SOC with anxiety, digital health literacy (DHL), information, and financial satisfaction among older adults during the outbreak.

Methods: This is part of a large-scale DHL study with a cross-sectional survey across 41 countries. This study extracted data from three Asian countries (China, the Philippines, and Singapore) and included people aged ≥60. Structural equation modeling with path analysis was utilized to examine the relationships of SOC with anxiety about the future and other variables.

Results: A total of 266 older adults were included, with 43.2% expressed anxiety about the future. DHL (β=–0.13, p < 0.05) and SOC (β=–0.26, p = 0.01) were negatively associated with anxiety, while financial and information satisfaction were not. However, financial satisfaction (β = 0.34, p < 0.01) and DHL (β = 0.32, p = 0.01) were positively associated with SOC. Higher SOC further mediated the negative relationships of DHL (β= −0.11, p = 0.004) and financial satisfaction (β= −0.12, p = 0.004) on anxiety of older adults.

Conclusions: SOC had direct negative effect on anxiety and mediated the relationships between anxiety and DHL/financial satisfaction. Strategies should be developed to enhance SOC and DHL among older adults, as these capacities may help to manage anxiety during the pandemic.
Original languageEnglish
JournalAging and Mental Health
Publication statusPublished - 13 Jan 2021


  • Anxiety
  • COVID-19 pandemic
  • digital health literacy
  • sense of coherence

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