Psychological distress among recently retired individuals in a resource-limited setting: the role of overall functioning and the moderating effect of perceived social support

Abstract

Background

Retirement marks a significant life transition that can bring about a myriad of changes, challenges, and opportunities for individuals. Retired individuals may encounter various psychological stressors that can affect their mental wellbeing. There is a paucity of published data regarding the psychological profile of recently retired individuals in developing countries such as Ethiopia.

Methods

A cross-sectional study was conducted. Data were collected using interviewer-administered, structured questionnaire. Psychological distress was assessed using the Kessler Psychological Distress Scale (K10), functioning was measured with the 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS-12), and social support was evaluated using the three-item Oslo Social Support Scale (OSSS-3). Data were entered into Microsoft Excel 2016 and analyzed using SPSS version 26. Descriptive analysis was used to summarize the general characteristics and the magnitude of psychological distress. To examine the factors associated with mental health parameters, hierarchical multiple regression analysis was performed. The interactions were visualized using a simple slope analysis.

Results

In this study, 396 recently retired individuals were included, yielding a response rate of 95.9%. The study population was predominantly male (56.6%). The mean Kessler Psychological Distress Scale (K10) score for the studied retirees was 5.55 ± 4.24, with 44.2% (n = 175) having psychological distress. The association between the level of functional impairment and psychological distress differed between the low social support group (1 SD below the mean, β = 0.297, p < 0.001) and the high social support (1 SD above the mean, β = 0.022, p = 0.676).

Conclusions

Recently retired individuals experienced high levels of psychological distress. Furthermore, social support moderates the relationship between level of functional impairment and psychological well-being. Therefore, pragmatic interventions targeting level of functional impairment and social support should be implemented to improve the psychological well-being of new retirees.

Introduction

Simply put, retirement is the withdrawal from a paid working life. It marks a significant life transition that can bring about a myriad of changes, challenges, and opportunities [1]. While often framed as a disruption, Continuity Theory suggests individuals maintain core identities and routines during such transitions [2], emphasizing stability over radical change. It is often associated with reaching a certain age, which can vary depending on the country and individual circumstances. In Ethiopia, retirement at age 60 (extendable to 70 for private sector employees) intersects with cultural expectations of elder roles, creating unique adaptation dynamics [3, 4].

Retirement and employment transitions can be fluid, with individuals sometimes re-entering the workforce or experiencing phased retirement. These varied pathways lead to heterogeneous psychological outcomes [5, 6]. The shift from structured work to retirement can generate psychological stressors; however, Adaptation Theory highlights how resilience mechanisms and social networks mediate these effects [7]. Although some retirees experience transient distress or denial, many adjust gradually through phased disengagement rather than abrupt withdrawal [8, 9].

Numerous psychosocial factors such as loss of identity, social connections, routine, and financial security can contribute to mental distress among retired individuals [10, 11]. The impact of identity or financial loss becomes particularly pronounced when institutional support for norm-based transitions is lacking, as emphasized by Institutional Theory [12].

Psychological distress (PD) in retirees often manifests as symptoms of stress and anxiety, which can exacerbate chronic conditions commonly seen in aging populations [13]. Transformative Change Theory, however, reframes retirement as an opportunity for personal growth through activities such as volunteerism or education, provided there is adequate institutional support [12]. Additionally, PD is associated with increased risks of adverse health outcomes, including poor glycemic control among individuals with diabetes mellitus and higher overall mortality rates [14]. This issue is particularly concerning for the aging population, who are disproportionately vulnerable to various chronic diseases [15, 16].

Pre-retirement counseling plays a critical role in enhancing the well-being and preparedness of individuals transitioning into retirement [17]. By offering comprehensive guidance and support, such counseling can facilitate a smoother transition, enabling retirees to engage in fulfilling activities like volunteering, education, and other meaningful pursuits beyond traditional employment. Despite its significance, the availability of pre-retirement counseling remains limited, potentially impeding retirees from leveraging their accumulated expertise and skills in productive roles that could help address growing demands for social and health services [18, 19].

In developing countries such as Ethiopia, pre-retirement counseling is especially crucial due to challenges including financial constraints, limited mental health resources, and difficulties associated with managing lower social status during the transition to post-retirement life [20]. Yet, retirees in these regions rarely receive adequate pre-retirement counseling. The lack of comprehensive retirement preparation programs and training in retirement counseling presents significant challenges for retirees in developing contexts [21].

In settings like Ethiopia, the psychosocial impacts of retirement are intensified by resource limitations. Research indicates elevated rates of depression among unemployed retirees [22], which can be particularly problematic during the critical six-month adaptation period following retirement [13, 23]. Punctuated Equilibrium Theory describes this phase as a period of destabilization preceding the establishment of new stability patterns [24], underscoring the importance of culturally grounded support during this transition.

However, there is paucity of comprehensive studies addressing the psychological challenges faced by newly retired individuals in Ethiopia. These evidences point towards the need to document the actual magnitude of PD among this specific demographic group while also comprehending contextual factors contributing to it. Thus, this study was designed with the following primary objectives: (1) to determine the magnitude of PD among recently retired individuals in Ethiopia; (2) to examine factors associated with PD in this population; and (3) to investigate the moderating effect of social support on the relationship between functional impairment and PD.

Methods and materials

Study setting, design and period

This cross-sectional study was conducted from May 1 to June 30, 2024, in Addis Ababa, the capital of Ethiopia, which comprises eleven sub-cities and 117 woredas. As of November 2024, the city has a high population density with approximately 5,703,630 residents [25]. The population aged over 60 in Ethiopia is estimated at around 6.1 million, constituting 5.3% of the total population [26]. There are over 750,000 retirees in the country, with women making up about 38%. Annually, around 50,000 individuals retire, including approximately 4,800 in the capital.

The Public Servants’ Social Security Administration Bureau operates seven branches in Addis Ababa: Addis Ababa Region, Bole, Yeka, Akaki, Nifas Silk Lafto, Kolfe, and Addis Ketema. Among these, the Addis Ababa Regional Office, where this study was carried out, serves the highest number of retirees.

Source population and study population

The study included all retired individuals aged over 55 years who had left their jobs and ceased working completely in the preceding six months as its source population. The study population, on the other hand, encompassed all retired individuals aged over 55 years visiting the Public Servants’ Social Security Administration bureau during the study period. The inclusion criteria consisted of individuals aged over 55 years who retired in the preceding six months. The exclusion criteria involved individuals with serious communication disorders, such as hearing disabilities.

Sample size determination and sampling technique

The sample size for this study was calculated using a single population proportion formula. The population proportion of retired individuals experiencing PD was taken to be 57.9%, based on a previous report from Ethiopia [27]. The formula used is , where n = the required sample size, p = the proportion of retired individuals with psychological distress = 0.579, Z_α\2 = the critical value at 95% confidence level = 1.96, and e = precision (margin of error) = 5%. Plugging in these values, the minimum required sample size was calculated to be 375, which was then increased to 413 to account for a 10% contingency. Consequently, consecutive eligible retirees visiting the Public Servants’ Social Security Administration Bureau of the Addis Ababa Region branch during the study period were approached for interview.

Study variables

The dependent variable was the presence of psychological distress, which was dichotomized as “yes” or “no.” The independent variables included background characteristics such as age, sex, pre-retirement monthly salary, collateral sources of income, marital status, family size, type of family structure, and comorbidity. Psychosocial factors included the level of social support, history of substance use, history of previous psychiatric disorders, and level of functional impairment.

Data collection tools and procedures

The required data were collected via face-to-face interview using a structured Amharic version questionnaire. The tool contained closed-ended items including Likert-type ones specifically designed for the study, and it was prepared from previous similar studies [15, 28–30]. The data collection format comprised items divided into a set of background variables, social support and psychological distress. Additionally, it included the level of functioning, which was set to be measured by means of the 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS-12) questionnaire.

The Kessler Psychological Distress Scale (K10) was used to gauge PD among the study participants. It is a 10-item scale designed to measure nonspecific psychological distress in epidemiologic surveys [31]. It is a popular screening instrument applicable across various cultures and settings, and easy to administer in clinical and population-based settings. In the general population, K10 scores have been demonstrated to correspond well with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnoses of anxiety and affective disorders and show a robust relationship with disability and mental health service use. Each item of the K10 has five response categories: ‘none of the time’ (0), ‘a little of the time’ (1), ‘some of the time’ (2), ‘most of the time’ (3) and ‘all of the time’ (4). The total score is the sum of all responses, and it ranges between 10 and 50 [32, 33].

The WHODAS-12 is a self-reported, short-version questionnaire developed by the WHO as a generic tool that integrates an individual’s level of overall functioning in major life dimensions, directly linked to the International Classification of Functioning (ICF), Disability and Health. The tool was developed based on an inclusive set of categories considered in the framework of ICF to measure disability during the preceding 30 days, and it tries to rate functioning from the respondent’s subjective perspective. It consists of 12 items, rated on five-point, Likert-type scales. It has shown adequate psychometric attributes in hospital and community mental health settings [34, 35].

Social support was assessed with the 14-point Oslo Social Support Scale (OSSS-3). The OSSS-3 is a brief and economic instrument designed to assess the level of social support. It consists of only three items that ask for the number of close confidants, the sense of concern from other people, and the relationship with neighbors with a focus on the accessibility of practical help [36–38].

Two experienced general practitioners were recruited and briefly trained on the data collection procedure. For data collectors and supervisors, a relevant one-day training was provided by the principal investigator to familiarize them with the data collection tool, interview technique, eligibility criteria, sampling techniques and ethical concern.

Operational definitions

Social support refers to the resources provided by others to assist individuals in coping during times of need, as measured by the OSSS-3 [38]. Psychological distress denotes the psychological suffering experienced by an individual, as measured by the K10, where a total score of ≥ 7 indicates clinically significant PD from a score a total score that ranges from 0 to 40 [39].

Data quality control and assurance

Brief training on the data collection process was provided to data collectors prior to the commencement of actual data collection. Throughout the data collection period, close supervision was maintained, and completed questionnaires were reviewed daily for consistency and completeness by both the data collectors and the principal investigator. Distress-related data were gathered using the pre-validated Amharic version of the K10, which has demonstrated adequate psychometric properties within the Ethiopian context [39].

Previous Ethiopian studies have shown that the Amharic version of the WHODAS-12 exhibits good cross-cultural adaptation and internal consistency (Cronbach’s α = 0.88), along with excellent validity, reliability, and factor structure [40]. Similarly, the Amharic version of the OSSS-3 has been utilized in community and facility-based studies in Ethiopia, demonstrating good applicability [41].

Data processing and analysis

Collected data were entered and coded with Excel spreadsheet version 2016, and statistical analysis was carried out using Statistical Package for Social Science (SPSS) version 26. At the end of data entry, data cleaning was done using frequencies, cross tabulations, sorting and listing to check missed values and outliers. The missing data were handled using the listwise deletion approach, and only fully completed questionnaires were considered for analysis. The general characteristics and the magnitude of PD of participants was summarized using descriptive statistics such as mean ± standard deviation and median + interquartile range for continuous variables while percentage and frequencies for categorical ones.

Demographic variables (including age, sex, pre-retirement monthly salary, collateral source of income, marital status, family size, type of family structure, comorbidity, history of substance use, history of previous psychiatric disorder), then physical functional impairment and social support, and finally the interaction terms between physical functional impairment and perceived social support were entered into hierarchical blocks sequentially. To account for multicollinearity, the variance inflation factor (VIF) was used, with VIF < 10 indicating no significant multicollinearity.

Results

General characteristics of respondents

In this study, 396 recently retired individuals were included, yielding a response rate of 95.9%. The study population was predominantly male (56.6%), with a male-to-female ratio of 1.3:1. Participants’ age distribution was skewed, and the median age was 60 years, with an interquartile range of 58–60.

The majority (n = 305, 77%) of the study population were either married or remarried. Nearly three-fourths (n = 290, 73.2%) of the studied retirees stated to have some sort of collateral source of income. In relation to the type of family structure, well more than half (n = 217, 54.8%) belonged to a nuclear family, whereas eighty-three (21%) were living in an extended family.

Half (n = 196, 49.5%) claimed to have at least one chronic medical condition. Only eighty-seven (22%) retirees reported using substances such as alcohol, cigarettes, and khat. Only twelve (3%) out of all retirees stated that they had been diagnosed with a psychiatric disorder earlier than the time of the interview. Apart from this, most (n = 345, 87.1%) of the studied participants were optimistic about the benefit of pre-retirement counseling while fifty-one (12.9%) were unsure of its possible benefits, as presented in Table 1.

Table 1.

Distribution by background characteristics of recently retired individuals at Addis Ababa, Ethiopia, 2024 (n = 396)

Variable	Frequency	Percent (%)
Sex
Male	224	56.6
Female	172	43.4
Age category
< 60 years	142	35.9
≥ 60 years	254	64.1
Current marital status
Married or remarried	305	77.0
Unmarried/Divorced/Widowed	91	23.0
Collateral source of income
No	106	26.8
Yes	290	73.2
Type of family structure
Nuclear family	217	54.8
Extended family	83	21.0
Single parent family	45	11.4
Grandparent family	26	6.6
Empty nest family	14	3.5
Childless family	11	2.8
Pre-retirement salary (median + interquartile range	6097 + 3500
Presence of comorbidity
No	200	50.5
Yes	196	49.5
Substance use*
No	309	78.0
Yes	87	22.0
Psychiatric illness
No	384	97.0
Yes	12	3.0
Perceived benefit of pre-retirement counseling
Yes	345	87.1
Unsure	51	12.9

*Substances considered were alcohol, cigarette and khat

Correlations between continuous variables

The mean WHODAS-12 (functional impairment) and OSS-3 scores were 21.37 ± 6.81 and 8.83 ± 2.25, respectively. Pre-retirement salary and OSS-3 score demonstrated negative correlation with KS score (r = − 0.13 and r = − 0.65, respectively; p < 0.05). Additionally, a significant positive correlation WHODAS-12 score and KS score (r = 0.50; p < 0.01) (Table 2).

Table 2.

Pearson’s correlation coefficient of age, pre-retirement salary, WHODAS-12 score and social support with psychological distress

		Mean (SD)	1	2	3	4	5	6
1	Age	59.44(2.38)	1
2	Pre-retirement salary	6325.53(2414.70)	0.07	1
3	Family size	5.05(1.61)	0.10	0.10	1
4	WHODAS score	21.37(6.81)	0.01	−0.12*	−0.18**	1
5	OSSS score	8.83(2.25)	−0.04	0.09	0.15**	−0.45**	1
6	KS score	6.85(4.78)	0.02	−0.13*	−0.03	0.50**	−0.65*	1

*P value < 0.05; 

**P value < 0.01

Magnitude of psychological distress

Using Kessler’s tool as an evaluation instrument, the magnitude of PD was found to be 46.2% (95% CI: 41.3–51.1%) (Fig. 1).

Fig. 1.

Magnitude of psychological distress among recently retired individuals in Addis Ababa, Ethiopia, 2024

The moderating role of perceived social support

Cronbach’s alpha reliability analysis indicated satisfactory internal consistency for all scales: social support (α = 0.77), WHODAS level of functional impairment (α = 0.92), and Kessler’s PD (α = 0.71). The analysis also met the assumptions of multicollinearity given that the tolerance ranges from 0.442 to 0.910 while the value inflation factor (VIF) ranges from 1.117 to 2.264, indicating that multicollinearity is not a problem in this study.

As shown in Table 3, control variables such as age, sex, pre-retirement monthly salary, collateral source of income, marital status, family size, type of family structure, comorbidity, history of substance use, and history of previous psychiatric disorder significantly explained the level of PD in the first step of regression analysis (adjusted R² = 0.124, p < 0.001). Following the exclusion of the effects of the control variables in the second step, level of functional impairment exhibited significant positive associations with PD (β = 0.329, p < 0.001) while social support exhibited significant negative associations with PD (β = −0.515, p < 0.001). In the third step, the interaction term (level of functional impairment × social support) was significantly negatively correlated with PD (β = −0.188, p < 0.001), and its inclusion accounted for additional 3% variance in predicting retirees’ PD (ΔR² = 0.030, F (1,382) = 25.53, p value < 0.001).

Table 3.

Results of the hierarchical regression analysis on psychological distress

	Step 1	Step 2	Step 3
Step 1
Age	−0.007	−0.059	−0.055
Sex	−0.003	0.116	0.115
Pre-retirement salary	−0.152**	−0.052	−0.046
Collateral source of income	−0.216***	−0.158***	−0.151
Marital status	−0.031	−0.014	−0.011
Family size	−0.012	0.123**	0.112**
Type of family structure	0.046	0.042	0.047
Comorbidity	0.252***	−0.083	−0.029
History of substance use	0.023	0.016	0.021
History of psychiatric illness	0.133**	0.082	0.092**
Step 2
Level of functional impairment		0.329***	0.227***
Social support		−0.515***	−0.575***
Step 3
Interaction			−0.191***
F value	6.587***	150.377***	25.530***
Adjusted R2	0.124	0.507	0.536
ΔR2	0.146***	0.376***	0.030***

**<0.01, ***p value < 0.001

Additionally, the simple slope analysis is presented to better illustrate the nature of the moderating effect. By probing the interaction term, the slope analysis showed that the strength of the relationship between level of functional impairment and PD decreased with increasing social support. However, the level of functional impairment exhibited differential effects on PD at low social support (1 SD below the mean, β = 0.297, p < 0.001) and high social support (1 SD above the mean, β = 0.022, p = 0.676).

In other words, for individuals with low level of social support, the effect of level of functional impairment on PD is statistically significant and stronger; unstandardized regression weight increased from 0.160 in the original (at average-level) test to 0.297 in low levels of the moderator. On the other hand, the effect of level of functional impairment on PD is not significant among individuals with high level of social support, with a relatively straight line (Fig. 2).

Fig. 2.

Simple slope plot of the interaction between level of functional impairment and social support on psychological distress among recently retired individuals

Discussion

The high prevalence of PD among recently retired individuals in Addis Ababa underscores the compounded challenges faced by retirees in resource-limited settings. Limited access to mental health care, inadequate pension systems, and the scarcity of structured pre-retirement counseling exacerbate the psychological vulnerability of this population. These findings highlight the urgent need for contextually appropriate interventions—such as strengthening informal social support networks and integrating mental health screening into routine retirement services—that are both scalable and sustainable within the constraints of Ethiopia’s healthcare infrastructure. Moreover, the moderating effect of social support observed in this study suggests that even in the absence of extensive formal resources, community and family-based support systems can play a critical protective role.

This study showed that nearly half of the studied retirees had PD. The results demonstrated a positive correlation between the level of functional impairment and PD among retirees. Additionally, it revealed that social support is a significant moderator, considerably reducing the effect of level of functional impairment on PD.

Crucially, nearly half (46.2%) of the retirees studied exhibited PD, a rate comparable to the 45% prevalence of depression observed among elderly populations in other parts of Ethiopia [42]. This proportion is notably higher than the 35.1% mental distress prevalence reported in the general Ethiopian population [43], as well as the 17.7% prevalence among the working Ethiopian population and 9.9% documented in high-resource settings like Finland [30, 44]. Similarly, it exceeds the 28% prevalence of depression reported among retirees in other international studies [45]. Conversely, the current finding is slightly lower than the 57.9% mental distress reported among older adults in Northwest Ethiopia [27] and the 68.1% depression rate found in institutionalized elders in central Ethiopia [46].

These variations may be explained by differences in study populations, timing, assessment tools, and methodologies. For example, this study employed the K10, whereas the Finnish study used the Mental Health Inventory-5 (MHI-5) [30]. Differences in availability of organized pre-retirement counseling, post-retirement psychosocial support, sociocultural contexts, and retirees’ lifestyles may also contribute to the observed discrepancies.

Although alarming, the high proportion of PD observed aligns with the recognition of retirement as one of life’s most stressful transitions [47, 48]. Resource limitations in developing countries like Ethiopia further amplify retirees’ vulnerability. With only 0.10 psychiatrists per 100,000 people and fragmented social safety nets [49], functional ability loses its buffering effect against PD when systemic supports such as pre-retirement counseling and accessible mental health services are absent [50]. This is consistent with Ecological Systems Theory, where macrosystemic deficits (limited pension coverage, < 10% formal sector retirement schemes) interact with exosystemic (healthcare access) and microsystemic (social support) factors to heighten PD [51].

Structural drivers further contextualize these findings. Ethiopia’s 25% pension coverage rate and cultural expectations of elderly financial responsibility create unique pressures absent in high-income comparators [52]. Retirees’ PD emerges not merely from individual functional decline but from intersecting social determinants: economic precarity (median pension: USD 27/month), limited rehabilitation services, and stigma against mental health help-seeking. These realities mirror patterns in Kenya and Nigeria, where retirement transitions disproportionately affect those without familial financial buffers [50].

In keeping with previous empirical findings [53], this study demonstrated that functional decline significantly contributes to PD among recently retired individuals. This relationship is well supported by established theories such as the stress and coping theory, which emphasizes that maladaptive coping strategies in the face of stressful life events—like functional impairment—can adversely affect mental health, leading to PD. The retirement transition, when compounded by functional decline, may intensify stress and deplete coping resources, thereby increasing vulnerability to PD [54]. Furthermore, our findings align with the learned helplessness theory, which postulates that functional decline can foster feelings of loss of control and helplessness, particularly in retirement when individuals lose the structure and purpose previously provided by work [55].

As anticipated, social support emerged as a significant moderator between functional status and psychological well-being, serving as both a protective factor and a buffer against distress. This observation aligns with several prior studies [56, 57] and resonates with the Stress-Buffering Model, which posits that social support mitigates the negative impact of life stressors on mental and physical health [58]. Social relationships may enhance psychological resilience by providing emotional support, reducing stress, improving coping mechanisms, fostering community solidarity, and creating positive feedback loops that nurture both individual well-being and collective strength, thereby cushioning the negative impacts of an event on an individual [59, 60]. Consequently, retirees with robust social support networks are less likely to experience PD in response to the challenges associated with retirement.

Notably, the moderating effect of social support identified in this study suggests that low-cost psychosocial interventions could help bridge systemic gaps in mental health care—a finding consistent with studies from Ghana and Bangladesh, where community mobilization effectively compensated for scarce formal mental health resources [61, 62].

This study’s primary strength lies in being the first original research to specifically examine the impact of functional status on the psychological well-being of newly retired individuals in a resource-limited setting—a demographic often underrepresented in the literature. Additionally, the use of a pre-validated assessment tools adapted for the local context enhances the reliability and validity of our findings.

However, several limitations warrant consideration. The cross-sectional design restricts our ability to infer causality or temporal relationships between functional decline, social support, and PD. It also limits the capacity to capture changes in these variables over time, thereby affecting the generalizability of the findings to other populations or periods. While operationalizing retirement as a discrete, one-time transition provided methodological clarity, it may oversimplify a complex, often gradual process.

Moreover, although dichotomizing PD using a validated cutoff facilitates clinical interpretation and identification of individuals with significant distress—our primary objective—this approach reduces analytic sensitivity by collapsing a spectrum of symptom severity into a binary outcome. This loss of granularity may obscure subtler associations within the data and should be considered when interpreting the results.

Data collection relied on self-report questionnaires, which, while practical, may be subject to biases such as social desirability and recall bias, potentially influencing the accuracy of reported PD [63]. Additionally, the study did not capture important contextual factors such as work-family conflict history, levels of institutional support, or other occupational variables that could indirectly affect mental well-being.

Finally, the study was conducted exclusively in Addis Ababa, an urban setting with unique socioeconomic characteristics, access to services, and social support networks that may differ substantially from rural areas or other regions of Ethiopia. Cultural norms, family structures, and retirement systems in Ethiopia also differ markedly from those in other low- and middle-income countries or high-income settings, which limits the broader generalizability of our findings.

Conclusions

This study found that nearly half of recently retired individuals in Addis Ababa experience PD, with functional impairment emerging as a key contributing factor—particularly among those with limited social support. Importantly, social support was shown to moderate the relationship between functional impairment and psychological distress, highlighting its protective role during the retirement transition in resource-limited settings such as Ethiopia. These findings lend empirical support to the crisis model of retirement adaptation, which posits that retirement can be a period of significant psychological upheaval, especially when compounded by health or social vulnerabilities.

Recommendations

The findings of this study underscore the need for multidimensional programs tailored to the specific realities of resource-limited settings, aimed at enhancing well-being throughout the retirement transition. In particular, there is a clear imperative to develop and implement structured peri-retirement counseling programs that extend beyond financial planning to include psychological preparation, social engagement, and health maintenance.

Such interventions should prioritize improving functional autonomy, strengthening social support networks, and promoting healthy coping strategies among Ethiopian retirees. Establishing peer support groups and community-based organizations can foster social connections and mutual aid, while intergenerational activities and volunteer opportunities can help retirees remain engaged and valued within their communities. Additionally, integrating functional assessment and rehabilitation services into routine retirement and primary care is essential to maintain independence and alleviate disability-related distress.

Future research would benefit from longitudinal designs to clarify the directionality and causality between functional decline and psychological well-being, as well as to better understand the dynamics of social support moderation over time. Incorporating multidimensional models that encompass economic, cultural, and psychological factors will provide a more comprehensive understanding of retirement adaptation. While the self-report measures used in this study were validated, their inherent susceptibility to bias suggests that future studies should complement them with multiple methods, such as behavioral observations and in-depth interviews, to strengthen the robustness of findings. Finally, it is important to assess the applicability of the current model across diverse contexts, populations, and circumstances among recently retired individuals.

Overall, these results highlight the value of integrating social-ecological and life course perspectives in retirement research, emphasizing the need for frameworks that account for both individual and structural determinants in shaping psychological outcomes after retirement.

Abbreviations

ICF

International Classification of Func­tioning

K10

Kessler Psychological Distress Scale

OSSS

Oslo Social Support Scale

SPSS

Statistical Package for Social Science

WHODAS

World Health Organization Disability Assessment Schedule

Authors’ contributions

The author confirms sole responsibility for study conception and design, analysis and interpretation of results, draft manuscript preparation, and final approval of the version to be published.

Funding

The authors received no specific funding for this work.

Data availability

All the data that support the findings of this study are available from the corresponding author upon reasonable request.

Declarations

Ethics approval and consent to participate

This study was conducted in full accordance with the principles outlined in the Declaration of Helsinki. Ethical approval was granted by the Ethical Review Committee of the College of Health Sciences and Specialized Referral Hospital at Aksum University (Ref: 037/2024). Additionally, a support letter (Ref: 26/AA/Ad/8832) was obtained from the Public Servants’ Social Security Administration, Addis Ababa Region Office, to facilitate data collection.

Before data collection, data collectors were introduced to onsite healthcare practitioners. The study’s purpose was clearly explained to potential participants in the local language, and informed oral consent was obtained. To ensure confidentiality and minimize bias, interviews were conducted in private settings. Participants were assured that their information would remain anonymous and used solely for research purposes. Moreover, any participant exhibiting clinically significant distress was referred to a nearby health facility for further evaluation and care.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.