Associations between economic distress, social support, and subjective well-being among older adults in Greece. A cross-sectional study

Well-being is a complex and multifaceted construct with no universally accepted definition. It is commonly conceptualised as encompassing physical, psychological and social dimensions of health, including individuals’ perceptions of happiness and life satisfaction (Bautista et al., 2023). According to the World Health Organization, well-being represents a positive state that can be experienced individually or collectively, encompassing both quality of life and the capacity to derive meaning and purpose (WHO, 2024).

Wistoft (2021) highlights that well-being enables individuals to manage daily stressors, maintain functional productivity and contribute meaningfully to society. Bradburn (1969, as cited in Librán, 2006) defined subjective well-being as the predominance of positive experiences over negative ones, while Costa and McCrae (1980, as cited in Librán, 2006) emphasised the importance of a balance between the two.

In recent years, the well-being of older adults has garnered increasing research attention, reflecting demographic shifts and population ageing (Paralikas et al., 2021). Social support has been consistently identified as an important correlate of well-being in later life. Studies have demonstrated that older adults living with family and receiving emotional and practical support report higher well-being compared to those living alone or in institutional settings (Paralikas et al., 2025; Mali and Lavania, 2023). Similarly, findings from a large European sample demonstrated that greater social support was associated with better psychosocial well-being among older adults (Lu et al., 2023). These findings suggest that social integration and connectedness may contribute to lower loneliness and improved life satisfaction among older adults.

Moreover, economic distress has been shown to negatively affect subjective well-being in this population. Large-scale research has found that financial insecurity among older adults is associated with lower levels of self-reported well-being (Singh and Suvidha, 2024; Huang et al., 2020; Dumontet et al., 2024). Income stability and financial stability have been positively linked to higher well-being, possibly by reducing stress and enabling better access to health care, nutrition and social participation (Liu et al., 2024).

While prior studies have examined the individual association of social support and financial status on well-being in older adults, fewer have examined their associations simultaneously within the same sample. The present study addresses this gap by examining how perceived social support and personal economic distress were associated with subjective well-being among community-dwelling older adults.

The sample consisted of 181 community-dwelling adults aged 65 years and older. Exclusion criteria included inadequate proficiency in Greek and any known diagnosis of a neurological condition impairing cognitive function, based on self-report or medical records. A non-probability convenience sampling method was used, based on accessibility and willingness to participate.

Data were collected through a structured questionnaire consisting of four components.

The first component recorded demographic information, including sex, age, marital status, number of children, educational attainment and monthly personal income.

The second component used the Index of Personal Economic Distress (IPED), an eight-item scale designed to assess financial strain in meeting basic needs. Respondents rated each item on a three-point Likert scale (1 = rarely, 2 = sometimes and 3 = often). Total scores range from 8 to 24, with higher scores indicating greater economic distress. The scale, developed for use in the Greek population (Madianos et al., 2010), has demonstrated acceptable internal consistency (Cronbach’s α ranging from 0.5 to 0.8).

The third component assessed subjective well-being using the WHO-5 Well-Being Index, a validated five-item scale measuring the frequency of positive emotional states over the preceding two weeks (e.g. feeling cheerful, calm, energetic, refreshed and interested in life). Responses were recorded on a six-point Likert scale (0 = at no time to 5 = all of the time). Raw scores (0–25) are multiplied by four to yield a total score ranging from 0 to 100, with higher scores indicating greater well-being. The WHO-5 has demonstrated good psychometric properties across diverse populations and settings (Topp et al., 2015). In a large multi-country European sample that included Greece, the instrument showed high internal consistency across countries, ranging from α = 0.83 to 0.93 (Sischka et al., 2020). The officially translated Greek version of the instrument was used in the present study.

The final component was the Short Form of the Social Support Questionnaire (SSQ-Short), which comprises six double items assessing perceived social support. For each item, respondents indicated the number of individuals they could rely on for support, and then rated their satisfaction with that support on a six-point Likert scale (1 = very dissatisfied to 6 = very satisfied). The first dimension (number of supportive persons) yields a score from 0 to 9; the second (satisfaction) ranges from 6 to 36. Higher scores indicate higher levels of perceived support. The SSQ-Short was originally developed by Sarason et al. (1987) and later adapted and validated for the Greek population by Kafetsios (2006), demonstrating excellent internal consistency (Cronbach’s α ≈ 0.90).

Data collection occurred at a local health centre in Greece, between October and December 2024. Participants were approached in the waiting area and invited to take part in the study. After providing informed consent, they completed the paper-based questionnaire independently. Assistance was offered in reading or interpreting questions when needed, without influencing responses. Completed questionnaires were checked for completeness before being entered into the database.

Formal ethics committee approval was not required for this study, in accordance with institutional procedures for minimal-risk, anonymous survey-based research involving adult participants; the research protocol was reviewed and approved by the academic supervisor. The study was conducted in accordance with the ethical principles of the 1964 Declaration of Helsinki and its later amendments (available at Link to wmaLink to the cited website of wma). Informed consent was obtained from all participants, and no identifying personal data were collected. No identifying personal data were collected, and all responses were anonymised to ensure confidentiality.

Statistical analyses were performed using IBM SPSS Statistics software. Descriptive statistics were calculated to summarise participant characteristics and the main study variables. The internal consistency of the measurement instruments was evaluated using Cronbach’s alpha coefficients. Pearson correlation analyses were conducted to examine the associations between economic distress, subjective well-being and the two dimensions of perceived social support: number of supportive persons and satisfaction with social support. Analyses were performed using available cases. Statistical significance was set at p < 0.05 (two-tailed).

An artificial intelligence (AI) language model was used to assist with formatting and language editing during manuscript preparation; it was not used to generate research content, data or analysis.

In Table 1, a total of 181 older adults participated in the study, comprising 79 men (43.6%) and 102 women (56.4%). Participants were categorised into four age groups: 65–74 years (46.4%, n = 84), 75–84 years (29.3%, n = 53), 85–94 years (20.4%, n = 37) and ≥95 years (3.9%, n = 7). The majority of participants were married (64.1%, n = 116), while 28.2% (n = 51) were widowed. Most participants had children (87.3%, n = 158).

In terms of educational attainment, 39.2% (n = 71) had completed primary school, 26.0% (n = 47) junior high school and 12.7% (n = 23) high school. A total of 9.9% (n = 18) held a university degree and 3.9% (n = 7) held a technical institute qualification. With respect to income, 26.5% (n = 48) reported a monthly individual income of less than €500, 48.6% (n = 88) earned between €500 and €1,000 and 24.9% (n = 45) earned more than €1,000.

The internal consistency of the psychometric instruments used in the study was assessed using Cronbach’s alpha (α) coefficient. As shown in Table 2, all measures demonstrated acceptable internal consistency, with Cronbach’s alpha coefficients ranging from 0.809 to 0.843. Notably, both subscales of the SSQ, number of supportive persons and satisfaction with support, showed strong internal consistency, with values above 0.80, indicating satisfactory measurement properties.

Descriptive statistics for the study’s main variables are presented in Table 3. The IPED had a mean score of 10.8 (SD = 3.6), with values ranging from 8.0 to 24.0, indicating relatively low levels of reported economic distress within the sample. The WHO-5 Well-Being Index yielded a mean of 60.4 (SD = 21.6), with scores spanning from 8.0 to 100.0, reflecting a moderate to high level of subjective well-being.

The number of supportive persons reported by participants had a mean of 2.5 (SD = 1.4), with a minimum of 0.0 and a maximum of 8.5. Satisfaction with this support was relatively high, as indicated by a mean score of 5.2 (SD = 0.8), on a six-point Likert scale ranging from 1.0 to 6.0.

Pearson correlation coefficients were computed to explore the relationships between economic distress, subjective well-being and the two dimensions of perceived social support (i.e. number of supportive persons and satisfaction with support). As shown in Table 4, economic distress was negatively correlated with subjective well-being (r = −0.182, p = 0.015), suggesting that greater financial hardship is associated with lower psychological well-being.

Conversely, satisfaction with social support was positively correlated with subjective well-being (r = 0.274, p = 0.001), indicating that greater satisfaction with received support was associated with higher levels of subjective well-being. No statistically significant correlations were observed between economic distress and number of supportive persons (r = −0.032, p = 0.677) or between economic distress and satisfaction with support (r = −0.151, p = 0.061), although the latter approached significance.

Similarly, the number of supportive persons did not correlate significantly with subjective well-being (r = 0.141, p = 0.065), nor with satisfaction with support (r = 0.068, p = 0.410). These findings suggest that the perceived quality of social support may be more closely associated with subjective well-being than the quantity of available support (Table 4).

The present study examined the associations between personal economic distress, perceived social support and subjective well-being among community-dwelling older adults. The findings indicate that greater economic distress was associated with lower subjective well-being, whereas greater satisfaction with social support was associated with higher well-being.

One of the key findings was that the participants exhibited relatively low levels of economic distress, as indicated by their scores on the IPED. This finding is relevant within the context of Greece’s recent history of economic challenges, during which many individuals, particularly older adults, experienced substantial financial constraints associated with adverse physical and mental health outcomes (Karanikola et al., 2018).

Another salient result relates to social support. Although participants reported having a relatively small number of supportive persons in their social network, their satisfaction with the quality of this support was notably high. These findings suggest that the perceived quality of social support may be more closely related to subjective well-being than the number of supportive persons available. This interpretation is supported by previous findings showing that social support has been associated with lower levels of loneliness and psychological distress in later life (Gautam et al., 2024). Moreover, the sample exhibited moderate to high levels of subjective well-being, a finding consistent with the notion that well-being helps individuals navigate daily challenges while maintaining productivity and social engagement (Paralikas et al., 2025; Wistoft, 2021).

In line with previous studies, the current results showed a statistically significant negative correlation between economic distress and subjective well-being (Triyuliarari et al., 2024; Liu et al., 2024; Dumontet et al., 2024). This finding suggests that greater financial strain is associated with poorer psychological well-being and quality of life among older adults. These findings highlight the potential relevance of policies and supportive measures aimed at reducing financial strain and supporting well-being among older adults.

Furthermore, perceived social support particularly satisfaction with that support was found to be positively associated with subjective well-being. This result supports prior research indicating that social isolation and limited social opportunities are important factors associated with reduced well-being in older adults (Singh and Suvidha, 2024; Mali and Lavania, 2023; Mishra et al., 2023). These findings highlight the importance of family and community-based social networks that promote social integration and emotional support in later life.

This study has several limitations that should be considered when interpreting the findings. First, the use of convenience sampling may limit the generalisability of the results beyond the study sample. Second, the recruitment of participants from a single geographic area may limit the applicability of the findings to other populations of older adults with different demographic and socioeconomic characteristics. Third, the cross-sectional design prevents conclusions regarding causal relationships or temporal associations between economic distress, social support and subjective well-being.

Future research should examine these associations using larger and more diverse samples across different cultural and socioeconomic contexts. Longitudinal studies and multivariable analyses may further contribute to understanding the factors underlying the relationship between financial strain, social support and well-being in later life.

Theodora Plataniti is based at the Department of Nursing, University of Thessaly, Larissa, Thessaly, Greece.

Theodosios Paralikas is based at the Department of Nursing, University of Thessaly, Larissa, Thessaly, Greece.

Georgios Tsioumanis is based at the Department of Nursing, University of Thessaly, Larissa, Thessaly, Greece.

Evangelos Fradelos is based at the Department of Nursing, University of Thessaly, Larissa, Thessaly, Greece.

Ioanna Dimitriadou is based at the Department of Nursing, University of Thessaly, Larissa, Thessaly, Greece.

Pavlos Sarafis is based at the Department of Nursing, University of Thessaly, Larissa, Thessaly, Greece.

Maria Saridi is based at the Department of Nursing, University of Thessaly, Larissa, Thessaly, Greece.

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

An AI language model (Claude and Anthropic) was used to assist with formatting references according to journal style, restructuring the abstract into the required format and language editing. The AI was not used to generate research content, data, analysis or conclusions, which are entirely the authors’ own work.