A cross-sectional study on quality of life among the elderly in non-governmental organizations' elderly homes in Kuala Lumpur

The Relationship Between Quality of Life and Depressive Symptoms Among Jordanian Community-Dwelling Older Adults

OBJECTIVE

The current study aimed to examine the relationship between depressive symptoms and quality of life among Jordanian community-dwelling older adults.

METHODS

A cross-sectional, descriptive correlational design was used. A convenience sample (N = 602) was selected to recruit the participants in the Amman governorate during the period from August to November 2021.

RESULTS

Findings demonstrated that the mean (SD) age of older adults was 67.5 (7.0) years and 51.5% of participants were females. Also, 54.1% of the participants experienced moderate to severe depressive symptoms with a total mean (SD) score was 8.57 on a scale of 0 to 15, while the mean (SD) for the quality of life scale was 12.12 (3.85) on a scale of 4 to 20. Significant differences existed in quality of life and depressive symptoms based on marital status (p < .001), educational level (p < .001), working status (p < .01), income (p < .001), and chronic disease (p < .01). Quality of life and its domains were negatively associated with depressive symptoms (B= - 0.596, p < .001). Also, marital status, working, educational level, income, and chronic disease were associated with depressive symptoms.

CONCLUSION

Strategies to improve quality of life should be promoted to minimize depressive symptoms among older adults and consider significant demographic factors.

Comparative analysis of mental workload and performance between young and elderly drivers: Implications for road safety and age-related driving challenges

BACKGROUND

Driving represents a multifaceted cognitive endeavor, demanding heightened vigilance and swift responses. Considering the high statistics of driving accidents and heavy loads, as well as the effect of the driver's age on the occurrence of accidents, it is important to investigate these factors to reduce accidents.

OBJECTIVE

This study investigates the impact of mental workload on the performance of young and older drivers in a dynamic driving scenario to compare cognitive performance, workload perception, and driving outcomes between the two age groups.

METHODS

Cognitive tests including the Stroop test, Continuous Performance test, and Focused Attention test were conducted, alongside the use of the DALI questionnaire to measure workload levels. Participants encompassed twenty male drivers, divided into two age groups: 20 to 35 years and 55 to 70 years, with varying years of driving experience. The study entailed a dynamic driving scenario involving a designated route in Tehran, Iran.

RESULTS

Results exhibited differences in workload scores between the age groups, particularly in dimensions such as visual demand, auditory demand, attention, and interference. Older drivers demonstrated heightened cognitive and physical demands during driving, implying a greater need for attention and cognitive effort.

CONCLUSION

The findings of this study indicated that navigating through congested roads and dense urban traffic significantly elevates the mental workload for drivers, consequently impacting their cognitive functioning. Given the critical need for attention in driving, this heightened workload can manifest as increased fatigue, increasing stress levels, and diminished concentration, all of which substantially raise the risk of vehicular accidents. Furthermore, the study highlighted a particular concern for older drivers, whose diminished cognitive capacities further raise their vulnerability to accidents under such demanding driving conditions.

Quality of Life and Its Biopsychosocial Determinants: A Study Among the Yadav Community From Delhi, India

Introduction The COVID-19 pandemic has not only affected the physical and mental health of people but has also had a detrimental impact on their quality of life (QoL). Therefore, ways to improve the QoL must be promoted for the overall well-being of individuals and society. The present study aims to assess the status of QoL and understand its association with physical and mental variables among the Yadav community of Delhi. Methods A cross-sectional study was conducted among 600 participants aged 18 to 55 years. Participants were recruited based on inclusion criteria, that is, individuals aged between 18 and 55 years, residing in Delhi, belonging to the Yadav community, and exclusion criteria, that is, pregnant females, lactating mothers, and individuals with any chronic illness or suffering from COVID-19. Data were analyzed in IBM SPSS Statistics for Windows, Version 22 (Released 2013; IBM Corp., Armonk, New York) using various descriptive and inferential statistics. Results Mental disorders were found to have a negative impact on QoL. The participants detected with higher levels of stress and depression reported a significant decrease in their scores (p ≤ 0.001) across all the domains of QoL. Hypertensive individuals have significantly lower mean scores than normal individuals across all domains. The regression analysis revealed that all these predictors have a negative impact on QoL. The present study indicated that women have a lower QoL than men. Among the four domains of QoL, the participants in the social domain had the highest proportion of good QoL, followed by the environmental domain. Conclusion This study reveals that the predictors of physical and mental health adversities have a negative association with QoL, and the results were significant across all the domains. It affects an individual's overall well-being, leading to decreased productivity, work-life balance, and happiness. The status of QoL among the participants was poor in the psychological domain and good in the social domain. Intervention programs based on diverse sociocultural practices should be targeted toward improving QoL by understanding the health needs and risks of different communities in Delhi.

The effects of walking on frailty, cognitive function and quality of life among inactive older adults in Saudi Arabia: a study protocol of randomized control trial by comparing supervised group-based intervention and non-supervised individual-based intervention

BACKGROUND

Kingdom of Saudi Arabia (KSA) demographics are also changing with the increase in life expectancy in the country and the rise in the number of older Saudi Arabians. Saudi Arabia has a higher rate of physically inactive people, and most of them are between the ages of 55-64. Walking is one of the most prevalent forms of physical activity in Saudi Arabia and the study showed that most people prefer walking for recreational and health benefits. Therefore, the purpose of the proposed study is to compare the effects of supervised group-based walking and non-supervised individual-based walking interventions on frailty, cognitive function and quality of life among inactive older adults in Saudi Arabia.

METHOD

This study will apply a three-group (2 intervention groups and 1 control group), double-blinded, randomized controlled trial (RCT) to examine the effect of different forms of walking interventions on Saudi Arabia older adults' frailty, cognitive function and quality of life immediately after a 16-week intervention, as well as the residual effects 12 weeks after completion of the interventions.

DISCUSSION

This study aims to determine whether supervised group walking and non-supervised individual walking lead to different effects. Given the limited evidence in the literature regarding Saudi Arabia older adults' physical fitness and health, it is worthwhile to explore the effect of walking, as well as the forms of walking on improving the overall physical fitness and psychological status of older adults in Saudi Arabia. The findings of the current study could also create awareness of the government and the general public in Saudi Arabia of the ageing problems and the effective ways of achieving better intervention results.

TRIAL REGISTRATION

The trial is registered at the ClinicalTrials.gov PRS (Trial ID: NCT05151575; Date of first posted: 12/07/2021).

Determinants of active aging and quality of life among older adults: systematic review

Introduction

Population demography across the globe shows an increasing trend in the aging population due to better healthcare, improved nutrition, advanced health-related technology, and decreased fertility rate. Despite these advancements, there remains a knowledge gap in understanding the association between active aging determinants and quality of life (QoL) among older adults, particularly within diverse cultural contexts, which has not been adequately explored in previous research. Therefore, understanding the association between active aging determinants and QoL can help policymakers plan early interventions or programs to assist future older adults in both aging actively and optimizing their quality of life (QoL), as these two factors have a bidirectional relationship.

Objective

This study aimed to review evidence regarding the association between active aging and quality of life (QoL) among older adults and to determine the most widely used study designs and measurement instruments in studies conducted between 2000 and 2020.

Methods

Relevant studies were identified by a systematic search of four electronic databases and cross-reference lists. Original studies examining the association between active aging and QoL in individuals aged 60 years or older were considered. The quality of the included studies and the direction and consistency of the association between active aging and QoL were assessed.

Results

A total of 26 studies met the inclusion criteria and were included in this systematic review. Most studies reported a positive association between active aging and QoL among older adults. Active aging had a consistent association with various QoL domains including physical environment, health and social services, social environment, economic, personal, and behavioral determinants.

Conclusion

Active aging had a positive and consistent association with several QoL domains among older adults, backing the notion that the better the active aging determinants, the better the QoL among older adults. Considering the broader literature, it is necessary to facilitate and encourage the active participation of older adults in physical, social, and economic activities for the maintenance and/or improvement of QoL. Identifying other possible determinants and enhancing the methods to improve those determinants may help improve the QoL among older adults.

Quality of life among geriatric population residing in Bhavnagar city, Gujarat, Western India

Background

All of the health status, lifestyle, satisfaction, mental state, or well-being, all facets of health status together reflect the multidimensional nature of quality of life (QOL) in an individual. Our objective is to assess quality of life and factors affecting quality of life.

Methods

We conducted a community-based cross-sectional study among 260 subjects (aged ≥ 60 years) residing in 13 wards of Bhavnagar city during September 2019-2020 after taking permission from ethics committee (no. 892) using the World Health Organization Quality of Life BREF-25 (WHO QOL BREF-25) scale. We assessed psychiatric morbidity using General Health Questionnaire-12 scale. Independent t-test was performed to find out factors associated with quality of life.

Result

Among 260 subjects, 36% were males. Study found highest score in psychological domain and lowest score in physical domain of WHO QOL BREF-25 scale. Physical health was better among Muslims, geriatrics <75 year of age, not addicted abusive substance and no co-morbid condition, whereas geriatrics belonged to upper socio-economic status and normal as per General Health Questionnaire-12 scale had better social relationship. Environmental domain score was significantly better among males and geriatric without co-morbidity.

Conclusion

These findings highlight the importance of active ageing interventions in order to improve the quality of life.

Quality of life and its associated factors among home-dwelling older people residing in the District of Colombo, Sri Lanka: a community-based cross-sectional study

INTRODUCTION

This community-based cross-sectional study explored the factors affecting overall and domain-specific (physical health, psychological health, social relationships and environmental) quality of life (QOL) of home-dwelling older residents of the District of Colombo, Sri Lanka.

METHODS

A representative sample (n=723) of older adults aged >65 years was obtained by the multistage cluster sampling technique. QOL was assessed using the validated Sinhala version of WHOQOL BREF Questionnaire. Data analysis was done using SPSS V.20.

RESULTS

The mean±SD age was 72.23±6.3 years with the overall QOL score being (mean±SD) 56.73±12.57/100. The mean±SD QOL score of physical health, psychological health, social relationships and environmental domains were 55.81±15.80, 59.25±14.68, 46.36±20.08 and 64.61±11.96, respectively. The overall QOL in the adjusted model showed a significant positive association with the educational status, living conditions (with spouse, with spouse and children), participation in religious activities, being visited by friends or relatives and financial independence. The overall QOL was negatively associated with limitations in activities of daily living and instrumental activities of daily living, chronic arthritis and heart disease in the adjusted model. Living with the spouse was positively associated with the psychological domain of QOL. Osteoporosis and chronic arthritis affected the physical health domain, while cancer and disabling stroke affected the psychological domain of QOL negatively. All statistical significances were considered at p<0.05.

CONCLUSION

The overall QOL of home-dwelling elders of the Colombo District is moderate, with the lowest score being in social relationships and the highest in the environmental domain. Educational status, engaging in religious activities and financial independence are key factors associated with a better QOL. Limitations in physical activity and chronic diseases are associated with a reduced QOL. Living with the spouse is a key factor associated with the psychological health domain.

Social and Health Determinants of Quality of Life of Community-Dwelling Older Adults in Malaysia

Quality of life (QOL) of older adults is a complex issue that requires an understanding of the intersection between socioeconomic and health factors. A poor quality of life (QOL) is frequently reported as sub-optimal among older adults whereby concerted and collective actions are required through an evidence-based approach. Hence, this cross-sectional study aims to determine the social and health predictors of the QOL of a community-dwelling older adult Malaysian population through a quantitative household survey using multi-stage sampling. A total of 698 respondents aged 60 years old and older were recruited and the majority of them had a good quality of life. Risk of depression, disability, living with stroke, low household income, and lack of social network were identified as the predictors of a poor QOL among the community-dwelling older Malaysians. The identified predictors for QOL provided a list of priorities for the development of policies, strategies, programmes, and interventions to enhance the QOL of the community-dwelling older Malaysians. Multisectoral approaches, especially collective efforts from both social and health sectors, are required to address the complexities of the ageing issues.

The Effect of Social Relationships on the Well-Being and Happiness of Older Adults Living Alone or with Relatives

The aim of this study is to analyze the effect of the type of habitation of older adults-with relatives or alone-on their health and well-being. The participants were 352 people over 65 years of age who collaborated with the research on a voluntary basis. The data indicated that those who live with family members have better social integration, well-being and happiness than those who live alone. A multiple regression analysis showed the positive effect of living with relatives on well-being and happiness. However, participation in social activities mitigates the effect of the type of cohabitation explaining better well-being and happiness in the older population. These findings support the idea of designing and implementing intervention policies focused on activities that promote social participation and social interactions to improve well-being and happiness in the older adults.

Person-Centered Climate, Garden Greenery and Well-Being among Nursing Home Residents: A Cross-Sectional Study

Nursing home residents' well-being is often proxy-rated in studies, and few studies have explored the association between resident-rated person-centered climate, garden greenery, and resident-rated well-being. A cross-sectional study was conducted. Questionnaire data from a convenient sample of 470 nursing home residents in a city in Southeast China in 2021 were analyzed using multiple linear regressions, with block-wise models. The instruments used were the Person-centered Climate Questionnaire-Patient version, the Nursing Home Greenery Index, and, for well-being, the EuroQol-Visual Analogue Scale, the Life Satisfaction Questionnaire, and the 9-item Patient Health Questionnaire (depression symptoms). In the unadjusted models, the person-centered climate was positively associated with general health (β 0.29, p < 0.001), person-centered climate and greenery with life satisfaction (β 0.39, and 0.18; both p < 0.001), and negatively with depression (β -0.28, and β -0.23, both p < 0.001). After adjusting for personal and nursing home characteristics, the associations between person-centered climate, greenery, and well-being remained statistically significant. The three models explained 36%, 35%, and 21% of the variance in general health, life satisfaction, and depression, respectively. This study provides knowledge on person-centered climate in long-term care and the access to greenery.

Why Men Fare Worse: A Mixed-Methods Study Examining Gender Differences in Nursing Home Resident Quality of Life

BACKGROUND AND OBJECTIVES

Despite research documenting gender differences in numerous outcomes in later life, we know little about gender differences in quality of life (QoL) for nursing home (NH) residents. This study examines the relationship between gender and residents' QoL, including possible reasons for differences observed.

RESEARCH DESIGN AND METHODS

We used a mixed-methods design including surveys with a random sample of Minnesota NH residents using a multidimensional measure of QoL (n = 9,852), resident clinical data, facility-level characteristics (n = 364), interviews with residents (n = 64), and participant observations. We used linear mixed models and thematic analysis of resident interviews and observations to examine possible gender-related differences in residents' QoL.

RESULTS

After controlling for individual and facility characteristics, men reported lower overall QoL than women, including significantly lower ratings in several QoL domains. In interviews, men noted being less satisfied with activities than women, having fewer friends, and being less able to rely on family for support. Some women described the NH as a place of respite, but men more often described being dissatisfied with life in the NH and undesirable for long-term living. Our observations were consistent with interview findings but provide additional nuances, such as that some men organized their own social groups.

DISCUSSION AND IMPLICATIONS

Our findings suggest that men and women experience QoL differently in NHs, with men reporting lower QoL in several domains. Tailoring more activities for men and finding ways to strengthen relationships for men in NHs could help reduce the gender differences in QoL we observed.

Family functions, social support and quality of life among elderly during pandemic COVID-19

This study aims to determine the relationship between family function, social support, and the quality of life of the elderly in Kebumen District. Commonly elderly face weakness, limitation, and disability issues so that their quality of life decreases. Families have an important role to improve the quality of life of the elderly. This study used a cross-sectional design involving 468 elderly determined by a simple random sampling technique. Data analysis used univariate, bivariate, and multivariate analysis. The bivariate analysis used simple logistic regression analysis and if the value of the bivariate analysis was < 0.25, then it would be continued with the multivariate analysis. The multivariate analysis used multiple logistic regression with Adjusted OR and 95% CI with a significant level of 0.05. : there is a significant relationship between family function and social support and the quality of life of the elderly with a p-value of 0.001 with 95% CI (2.35-4.19) and a p-value of 0.001 with 95% CI (3.33 – 6.02) respectively. Family function and social support are factors reducing the morbidity and mortality rates which finally can improve the quality of life of the elderly.

Quality of life of older people in nursing homes in China–evaluation and application of the Chinese version of the life satisfaction questionnaire

Background

Chinese and global populations are aging, and more older people are living in nursing homes in China. However, there is a lack of research measuring nursing home residents’ quality of life (QOL), and especially associations with nursing home types (publicly versus privately run). Therefore, this study aimed to determine the construct validity and internal consistency of the Chinese version of the life satisfaction questionnaire (LSQ-Chinese) and determine the associations between nursing home types (publicly versus privately run), residents’ sociodemographic characteristics, and their QOL.

Methods

A cross-sectional survey measuring QOL among older people living in nursing homes was conducted (n = 419). Confirmatory factor analysis and Cronbach’s alpha were used to assess the construct validity and reliability of the LSQ-Chinese. In addition, multivariate regression analysis was used to examine these associations.

Results

Confirmatory factor analysis indicated acceptable goodness-of-fit statistics for the seven-factor LSQ solution. All factors and the total scale had good internal consistency, with Cronbach’s alpha values > 0.70. The two factors with the highest QOL scores (higher scores indicate a more desirable state) were “physical symptoms” and “socioeconomic situation,” and those with the lowest QOL scores were “quality of close-friend relationships” and “quality of daily activities fun”. Residents living in privately run nursing homes had higher LSQ scores overall and for all factors except “physical symptoms” and “sickness impact” compared with publicly run nursing homes. Multivariate analyses indicated that marital status, number of chronic diseases, education level, main source of income, and nursing home type significantly contributed to the variance in the total LSQ scores. The associated sociodemographic variables differed between the factors, and the variable publicly versus privately run was significant for five of the seven factors.

Conclusions

The LSQ is a suitable instrument for measuring the QOL of Chinese nursing home residents. The total LSQ score was higher among residents in privately run nursing homes than in publicly run ones. According to residents’ needs, staff should work for person-centered activities, and facilitate residents’ social interactions with friends, as both these aspects were scored relatively low.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-022-03040-4.

Cross-cultural adaptation and validation of the 15-item Geriatric Depression Scale (GDS-15) into Igbo language: a validation study

Background

Late-life experiences such as protracted and indisposing medical disorders can negatively impact older adults’ psychological and mental health, making them vulnerable to depression. Majority of the assessment tools for depression were developed for use in western countries. There is therefore the need for availability of culture- and environment-specific tools for assessment of depression in low-and-middle-income countries. This study was designed to cross-culturally adapt and validate the Geriatric Depression Scale-15 (GDS-15) into Igbo language and culture.

Methods

The English version of the GDS-15 was translated into Igbo language; synthesized, back-translated, and underwent expert panel review, pretesting and cognitive debriefing interview, according to the American Academy of Orthopedic Surgeons’ guidelines. The Igbo version of the GDS-15 was tested for concurrent and structural validities, and internal consistency among consecutively recruited 140 consenting older adults (62.9% females) in Enugu North Senatorial District at 0.05 level of significance.

Results

The English version of the GDS-15 was successfully cross-culturally adapted to Igbo with all the 15 items still retained on the Igbo version of the GDS-15. The Igbo version of the GDS-15 exhibited the same structure as the English version, and displayed a Cronbach’s alpha value of 0.53 with no significant ceiling (0%) and floor (0%) effects. The correlation between the participants’ total scores on the Igbo and the English versions of the GDS-15 (ρ = 0.86) was adequate. There was no significant difference between corresponding scores in the English and Igbo versions of the GDS-15 (p = 0.89).

Conclusions

The Igbo version of the GDS-15 is a valid and culturally specific instrument, and can be used for assessing depression among Igbo older adults in Nigeria.

Impacts of age and marital status on the elderly's quality of life in an elderly social institution

Background: Living a life of good quality is important for everyone. This research aimed to get an overview of the quality of life (QOL) of the elderly in an elderly social institution in Jakarta, Indonesia.

Design and Methods: This descriptive study with a cross-sectional design included 107 participants using simple random sampling technique. Data were collected using an abbreviated World Health Organization Quality of Life (WHOQOL-BREF) and analyzed using statistical software, Mann Whitney and Kruskal Wallis test.

Results: The mean quality of life of the elderly’s was 66.09 (scale: 0–100), with a mean QOL of 67.58 in the physical domain, 66.26 in the psychological domain, 64.64 in the social relationships domain, and 65.88 in the environment domain. Regarding age and marital status, there was a significant difference in the mean QOL of the elderly living in the elderly social institution (p=0.017 and 0.001). In contrast, there was no significant difference in their mean QOL in terms of gender, level of education, and length of stay (p=0.323, 0.164, and 0.697).

Conclusions: The low quality of life of the elderly is our concern. The staff in the elderly social institution could develop some activities for the elderly to increase the elderly’s QOL, such as making daily activities plans and the evaluation of those activities.

An epidemiological study on quality of life among elderly in an urban area of Thirumazhisai, Tamilnadu

Introduction:

One of the most important indicators of health and well being of the elderly is the quality of life they live in. Owing to the rise in elderly population due to the demographic transition, there is growing need to address the health concerns of this population.

Aims:

The study was undertaken to find out the Quality of Life among the elderly and the associated factors.

Methodology:

This is a descriptive cross sectional study done in urban area of Thiruvallur district Tamil Nadu. To arrive at the required sample of 199, elderly people above 60 years were selected by probability proportionate to size sampling. Semi-structured pre-tested questionnaire was used for data collection regarding sociodemographic details and related factors. Katz scale was used to assess activities of daily living and Quality of life (QOL) was assessed using WHO quality of life BREF (WHOQOL BREF) questionnaire.

Results:

Moderate score in QOL was obtained in all the 4 domains with highest in Psychological and environmental domains. Nearly 99% of had full activity in Katz scale. All the three QOL domains were found to have statistical significant association with age and education. Gender and marital status were found to be associated with psychological domain, and employment/pensioner status with physical domain.

Conclusion:

Measures like Health education have to be targeted for the elderly in ways to improve their physical and psychological wellbeing which can imporove the quality of life they live in. Primary care and family physicians have to be made aware and empowered to identify the various domains of QOL in elderly and to identify in which domain the person needs to take care the most.

Impact of sense of coherence, resilience and loneliness on quality of life amongst older adults in long-term care: A correlational study using the salutogenic model

AIMS

This study aimed to identify the predicting factors of quality of life (QoL) from a set of psychosocial, sociodemographic and clinical variables amongst older adults in a long-term care setting.

DESIGN

A cross-sectional, descriptive correlational study.

METHOD

The study was conducted in a nursing home and a day care centre from July to December 2019. Two hundred older adults were recruited. Guided by the salutogenic model, the sense of coherence (SOC) scale, Connor-Davidson resilience scale, de Jong Gierveld loneliness scale and World Health Organization quality of life instrument-older adults (WHOQOL-OLD) were used. The sociodemographic and clinical profiles of participants were collected. Descriptive statistics, Pearson product-moment correlation coefficient, independent-samples t test, one-way analysis of variance and stepwise regression were utilised in the analysis.

RESULTS

The mean score for WHOQOL-OLD was 94.42 ± 19.55. The highest mean score was observed in the "Death and Dying" facet, while the lowest mean scores were reflected in the "Autonomy" and "Intimacy" facets of QoL. Regardless of resident type, most QoL scores were similar across different variables. Based on the stepwise regression, higher manageability and meaningfulness in SOC, higher resilience, lower social loneliness, lower emotional loneliness and hearing impairments are significantly associated with higher QoL.

CONCLUSION

Manageability, meaningfulness and resilience should be enhanced while ameliorating feelings of loneliness to improve the QoL amongst older adults receiving long-term care. Age, marital status, educational level, care arrangement, body mass index, performance in activities of daily living, comorbidities and hearing and mobility impairments could influence QoL and thus warrant more attention.

IMPACT

Future interventions can be conducted in group sessions to facilitate social interaction and alleviate loneliness. More resources should be allocated to enhance older adults' care arrangements and coping mechanisms to provide them with the support, as they face challenges in daily life due to mobility impairment and other restrictions.

Development of the Active Ageing Awareness Questionnaire in Malaysia

The world's ageing population is associated with increased morbidity, disability, and social and financial insecurity, which may affect quality of life (QoL). Therefore, the World Health Organization (WHO) endorsed the Active Ageing Framework (AAF) in 2002 to enhance QoL as people age. However, little is known about the status of awareness of active ageing among the population, and there is no appropriate tool for assessment. Hence, the Awareness of Active Ageing Questionnaire (AAAQ) was developed. The content, linguistic and face validations together with test-retest reliability were conducted. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to test the structural validity of the AAAQ. A total of 110 participants (mean ± SD = 50.19 ± 5.52) were selected for the pilot, 81 participants (mean ± SD = 49.40 ± 5.70) for the test-retest, and 404 participants (mean ± SD = 49.90 ± 5.80) for CFA and EFA tests. The 16-item AAAQ Malay version showed satisfactory reliability and validity. The Cronbach's alpha was more than 0.7 and showed good fit: Cmin/df = 2.771, GFI = 0.903, TLI = 0.951, RMSEA = 0.08. The AAAQ is suitable for measuring the awareness of active ageing among the middle-aged population in Malaysia.

Efficacy of the self-mutual-group model targeting quality of life improvement among empty-nest older adults in Taiyuan, China: an intervention study

Background

In China, more and more older people have encountered a situation called “empty nest.” Meanwhile, the health status of empty-nest older adults is an increasing public health concern. This research aims to examine the effectiveness of Self-Mutual-Group (SMG) model in improving quality of life of the empty-nest older adults to provide a scientific evidence for improving their health.

Methods

A prospective intervention study was conducted among empty-nest older adults in Taiyuan, Shanxi. Multi-stage stratified random cluster sampling was employed to selected participants. A total of 396 empty nesters were enrolled as participants, of which 204 and 192 were in the intervention and control group, respectively. The intervention group received a seven-month SMG-based intervention. A participant’s quality of life was measured at the baseline and seven months after using the Short Form 36-Item Health Survey (SF-36).

Results

No significant difference was found between the intervention and control groups in terms of participant characteristics at baseline (P > 0.05). After the intervention, participants’ scores on Mental Component Summary (MCS), Physical Component Summary (PCS), role emotional (RE), vitality (VT), social function (SF), mental health (MH) and general health (GH) increased significantly in the intervention group. Additionally, these scores differed significantly from those in the control group (P < 0.05).

Conclusion

This study showed that the SMG-based health management is effective in improving quality of life among empty-nest older adults after seven months.

Trial registration

Study on the ‘SMG’ Health Management Model Based on Community Organization Theory among empty-nest older adults (ChiCTR1800015884). Registration date: 26-04-2018. Retrospectively registered.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-021-02155-4.

Factors Influencing the Quality of Life of Empty Nesters: Empirical Evidence from Southwest China

Quality of life is a widely accepted concept based on the notion that people’s lives have been subject to rapid development and industrialization. This study aims to explore the impact of different factors on the quality of life of empty nesters in Southwest China. The main factors explored are resilience and social supports (SS), highlighted here from different perspectives. Moreover, the correlations between other variables and quality of life are shown here. This study experimented with a hierarchical multiple regression model from survey data with 3583 valid responses. It argued that both resilience and social supports, including family members and friends, are significantly correlated with the Chinese empty nesters’ quality of life. Family support and friend support play a significant mediating role in the association between resilience and quality of life. However, neither government nor nongovernmental support significantly influences the quality of life. Therefore, the hypothetical recommendations of this study have been partially confirmed. The findings of this study provide a more comprehensive understanding of the overall mental and physical health of Chinese empty nesters.

Exploring the determinants of synergetic development of social organizations participating in home-based elderly care service: An SEM method

The current aging service industry has problems in meeting the ever-increasing demand for the home-based elderly care service (HECS). Social organizations participating in HECS seems to be a promising way to address these problems but also raises new challenges, like uncoordinated cooperation among stakeholders, which could lead to low management efficiency and low service quality. However, Synergetic development can be promising to enhance the participation of social organizations and to improve social welfare. This study introduces a conceptual model to explore relationships between five determinants and synergetic development of social organizations participating in HECS. A structural equation model (SEM) based on questionnaire survey is used as a test methodology. The results indicated that stakeholder engagement plays a critical role in synergetic development in HECS, resource allocation can only be improved by institutional climate, and supervision capacity cannot facilitate information sharing. This study provides effective strategies and directions for the improvement of home-based elderly care services.

Biosocial and disease conditions are associated with good quality of life among older adults in rural eastern Nepal: Findings from a cross-sectional study

Background

The ageing population in most low-and middle-income countries is accompanied by an increased risk of non-communicable diseases culminating in a poor quality of life (QOL). However, the factors accelerating this poor QOL have not been fully examined in Nepal. Therefore, this study examined the factors associated with the QOL of older adults residing in the rural setting of Nepal.

Methods

Data from a previous cross-sectional study conducted among older adults between January and April 2018 in in rural Nepal was used in this study. The analytical sample included 794 older adults aged ≥60 years, selected by a multi-stage cluster sampling approach. QOL was measured using the Older People’s Quality of Life tool; dichotomized as poor and good QOL. Other measures used included age, gender, ethnicity, religion, marital status, physical activity, and chronic diseases such as osteoarthritis, cardiovascular disease, diabetes, chronic obstructive pulmonary disease (COPD), and depression. The factors associated with QOL were examined using mixed-effects logistic regression.

Results

Seven in ten respondents (70.4%) reported a poor QOL. At the bivariate level, increasing age, unemployment, intake of alcohol, lack of physical activity as well as osteoarthritis, COPD and depression were significantly associated with a lower likelihood of a good QOL. The adjusted model showed that older age (AOR = 0.50, 95% CI: 0.28–0.90), the Christian religion (AOR = 0.38, 95% CI: 0.20–0.70), and of an Indigenous (AOR: 0.25; 95% CI: 0.14–0.47), Dalit (AOR: 0.23; 95% CI: 0.10–0.56), and Madheshi (AOR: 0.29; 95% CI: 0.14–0.60) ethnic background were associated with lower odds of good QOL. However, higher income of >NRs 10,000 (AOR = 3.34, 95% CI: 1.43–3.99), daily physical activity (AOR: 3.33; 95% CI: 2.55–4.34), and the absence of osteoarthritis (AOR: 1.9; 95% CI: 1.09–3.49) and depression (AOR: 3.34; 95% CI: 2.14–5.22) were associated with higher odds of good QOL.

Conclusion

The findings of this study reinforce the need of improving QOL of older adults through implementing programs aimed at addressing the identified biosocial and disease conditions that catalyse poor QOL in this older population residing in rural parts of Nepal.

Association of smoking status and health-related quality of life: difference among young, middle-aged, and older adults in Shandong, China

PURPOSE

Few studies explored the relationship between smoking status and health-related quality of life (HRQOL) among adults in China. This study aims to explore the relationship between smoking status and HRQOL among adults (18 +) and examine whether there is a difference in this relationship among young, middle-aged, and older adults in China.

METHODS

A total of 23,021 respondents were included in this study. The HRQOL is measured by EQ-5D-3L. The smoking status is divided into never smokers, current smokers, and former smokers. Tobit regression and Logistic regression are employed to explore the association between smoking status and HRQOL. The interaction term is included to explore the difference among young, middle-aged, and older adults.

RESULTS

This study finds smoking status is significantly associated with HRQOL. An interaction analysis shows that the association between smoking status and HRQOL is significantly different among young, middle-aged, and older adults (P < 0.05). The smoking status is only significantly associated with HRQOL in middle-aged and older adults, but not for young adults. Compared with never smokers, former smokers report significantly lower EQ-5D-3L utility value in middle-aged adults (coefficient =  - 0.089; 95%CI - 0.128 to - 0.050), current smokers report significantly higher EQ-5D-3L utility value in older adults (coefficient = 0.041; 95%CI 0.005 to 0.076).

CONCLUSIONS

This study demonstrates a significant association between smoking status and HRQOL among adults in China, and there is a difference in this relationship among young, middle-aged, and older adults. The government should take efforts to formulate a variety of measures to control tobacco use among adults.

Quality of life and its predictors among aging people in urban and rural Nepal

PURPOSE

We studied the quality of life (QoL) of the elderly in Nepal and their special needs. Nepal is a low- and middle-income country where the elderly population is growing significantly.

METHODS

A random selection of informants from the Kavre district was carried out in this cross-sectional, population-based, door-to-door survey. The district has a mixture of urban and rural communities. In Nepal, families generally take care of their elderly. Hardly any placement is made in institutions. A validated Nepali version of World Health Organization Quality of Life 8-question scale (WHOQoL-8) estimated QoL among the elderly (≥ 60 years; N = 439). Other variables of interest were socio-demographics, substance use, physical and psychological health, and family support. Depression was measured by Geriatric Depression Scale short form [GDS-15]. Due to a high illiteracy rate, a structured and culturally adapted questionnaire was presented in an interview format. The relationships between the variables and QoL were analyzed using independent sample t tests, linear regression and Pearson's correlations.

RESULTS

The mean QoL score was 25.7 (± 4.2); 49.2% rated their QoL as good. Positive predictors of QoL were: urban residence (p = 0.03); employment (p = 0.02); absence of chronic physical health problems (p = 0.02); absence of depression (p < 0.001); adequate time given by family (p = 0.001), and reports of non-abusive family relationships (p < 0.001). A negative correlation was found between geriatric depression and the QoL score (r = - 0.697; p < 0.001).

CONCLUSION

QoL of the elderly in Nepal may potentially improve by care directed towards their physical and psychological health, by strengthening family relations, and by financial independence.

Gender Differences in Function, Physical Activity, Falls, Medication Use, and Life Satisfaction Among Residents in Assisted Living Settings

The purpose of the current study was to test for gender differences among residents living in assisted living settings. This was a secondary data analysis using data from the first 64 facilities participating in the ongoing Function Focused Care for Assisted Living study using the Evidence Integration Triangle (FFC-AL-EIT). A total of 593 residents were recruited. Differences by gender with regard to function, physical activity, falls, total number of medications, and satisfaction with assisted living were tested using multivariate analysis of variance. There were 166 (28%) men and 427 (72%) women with a mean age of 88 (SD = 7.5 years). Participants had five (SD = 2) comorbidities and took on average 6.88 medications (SD = 3.47). Participants had moderate functional impairment with a mean of 64.13 (SD = 19.09) on the Barthel Index and engaged in 43.8 (SD = 76.12) minutes daily of moderate level physical activity. Women reported higher satisfaction with activities (4.32 [SD = 1.14]) than men (3.85 [SD = 1.51]), and women received more medications than men (7.09 [SD = 3.51] vs. 6.34 [SD = 3.31]). Current study findings suggest that deprescribing may be particularly important for women versus men and focusing on expanding activity options to include those preferred by men should be considered in assisted living settings. [Research in Gerontological Nursing, 13(1), 31-40.].

The Impact of Cohousing on Older Adults' Quality of Life

The global population including Canada's is aging, which demands planning for housing that will support older adults' quality of life. This mixed-method study is the first Canadian study to examine the impact of cohousing on older adults' quality of life and involved 23 participants. The older adults rated their quality of life very high, especially in the environmental, physical, and psychological domains of the World Health Organization Quality of Life (WHOQOL_BREF) survey; quality of life in the social domain was rated low, which was surprising in light of the focus group data findings. Four themes of "belonging in a community", "life in the community", "changes associated with aging," and "aging in place" emerged from the qualitative data to explain factors that influence older adults' quality of life. This research provides foundational, strong evidence that seniors' cohousing is an innovative housing solution that can support older adults' quality of life.

Loneliness in the Context of Quality of Life of Nursing Home Residents

Background

Numbers of the elderly have been on a steady increase both in Poland and other countries of the world. As they age, their health declines and they need help with their housekeeping. This, coupled with the transformation of intergenerational into single-generation or nuclear family structures, causes a markedly rising demand for institutional care. Holistic care of an elderly nursing home resident requires a comprehensive approach and consideration for their feelings. Loneliness and solitude are increasingly common among these feelings, undoubtedly affecting quality of life.

Method

250 elderly residents of seven nursing home situated in Mazovia, Poland, have been examined using: De Jong Gierveld Loneliness Scale, WHOQOL-BREF Questionnaire, Basic Hope Scale (BHI-12), Satisfaction with Life Scale (SWLS), Acceptance of Illness Scale (AIS).

Results

Loneliness affects nearly 40% residents of the homes surveyed. Quality of their residents’ lives is reduced. Relations with their families and levels of motor efficiency imply a sense of loneliness. Degrees of illness acceptance, ability to adjust to change, and life satisfaction influence the level of loneliness felt.

Conclusion

40% of nursing home residents exhibit a sense of loneliness, while the greater loneliness and solitude, the lower the quality of life.

Health-related quality of life and related factors among elderly persons under different aged care models in Guangzhou, China: a cross-sectional study

PURPOSE

To analyze health-related quality of life (HRQoL) and related factors among elderly persons receiving community-based home care and institutional care in Guangzhou, a large city of mainland China.

METHODS

A representative sample of 1600 subjects aged 60 years and over residing in communities and nursing homes was randomly selected through stratified sampling. The 12-item Short Form Health Survey version 2 (SF-12v2) was used to assess HRQoL.

RESULTS

In total, 1014 elderly persons under different aged care models responded to the survey (response rate 63.4%) and 1000 were eligible for data analyses. Compared with the elderly receiving community-based home care or private institutional care, those in public institutional care had the lowest scores on the physical component summary (PCS, 36.89 ± 10.44) and the mental component summary (MCS, 47.16 ± 11.14). Number of chronic diseases, loneliness, and age were the most common significant factors (P < 0.05) affecting PCS and MCS. The interaction term between aged care model and number of chronic diseases significantly affected PCS (β = - 0.165, P < 0.05), indicating a stronger association between these factors for participants receiving community-based home care than institutional care. The interaction term between aged care model and loneliness had a significant effect on MCS (β = 0.189, P < 0.05), indicating a weaker association between loneliness and MCS for participants receiving community-based home care.

CONCLUSIONS

This study found poor HRQoL among the elderly in Guangzhou. The main factors associated with the physical and mental HRQoL of elderly persons included number of chronic diseases, loneliness, age, and education level. It also revealed the moderating effects of aged care model on HRQoL, suggesting specific health management strategies for elderly in community-based home care and institutional care, respectively.

Quality of life among elderly residents in the Gaza Strip: a community-based study

BACKGROUND

In Palestine, persons older than 60 years of age comprise 4.6% of the population in this decade and will remain relatively stable until the year 2020, when it is expected to begin to rise. The quality of life (QoL), which reflects well-being and health status, is under-reported in this vulnerable group in the Gaza Strip.

OBJECTIVE

Determine QoL and associated factors in persons aged older than 60 years.

DESIGN

A community-based cross-sectional study.

SETTING

Five Gaza Strip governorates.

SUBJECTS AND METHODS

Subjects were selected by convenience sampling. We used the validated Arabic WHOQOL-BREF to assess QoL and used descriptive, univariate and multivariate methods to analyze the data.

MAIN OUTCOME MEASURES

QoL, overall satisfaction with health and factors associated with good QoL.

SAMPLE SIZE

235 community-dwelling elderly.

RESULTS

The response rate was 85.5% (201/235). Mean age (SD) was 69 (7.95) years old and females accounted for 57.7% (116/201) of the sample. Almost half (44.2%, 90/201) of the elderly scored in the category of good QoL. The mean (SD) for overall QoL and perceived satisfaction with health was 3.3 (1.1) and 3.4 (1.0), respectively, on a 5-point Likert scale. The social relationship domain had the highest QoL score (65.4 [15.3]), whereas physical and environmental domains received equally lower scores (60.5 [15.2] and 60.5 [12.5] respectively). Multivariate analysis showed that factors associated with good QoL were higher education (OR: 3.1, CI 95%: 1.03-9.4) and perceived high satisfaction with health (OR: 3.6, CI 95%: 1.8-7.3).

CONCLUSION

More years of education and higher satisfaction with health were associated with a better perception of QoL. Interventions should be focused more on physical and environmental aspects in the life of elderly persons.

LIMITATIONS

Cross-sectional design, use of convenience sample and some possibly important factors not studied.

CONFLICT OF INTEREST

None.

Factors affecting the health-related quality of life in community-dwelling elderly people

OBJECTIVE

The purpose of this study was to investigate the determinants of the health-related quality of life of elderly people in Korea by applying the Andersen model.

DESIGN AND SAMPLE

This study was a descriptive survey. Participants were 240 elderly people over 65 years of age living in a community.

MEASURES

A hierarchical multiple regression was performed to analyze the factors related to the health-related quality of life, including predisposing, enabling, and need factors, and health behaviors.

RESULTS

Need factors, that is, self-reported health status, were the most significant in influencing the health-related quality of life of the elderly people; predisposing factors were age and education level, and enabling factors were income and activities of daily living.

CONCLUSION

The findings of this study can be used to develop a community-based intervention program and to establish a policy for improving the quality of life of elderly people.

Health related quality of life and its associated factors among community-dwelling older people in Sri Lanka: A cross-sectional study

BACKGROUND

Population ageing has become a public health issue as it is associated with increased morbidity, institutionalization and death. These may directly affect health-related quality of life (HRQOL) of older people.

PURPOSE

The aim of the study was to investigate HRQOL and its associated factors among community-dwelling older people in Kandy district, Sri Lanka.

METHOD

This cross-sectional survey involved 1300 older people. The Euro 5D-3L, International Physical Activity Questionnaire, body mass index, handgrip strength were used to measure HRQOL, physical activity and nutritional status of older people respectively. Factors associated with health-related quality of life were identified through complex sample logistic regression analysis.

RESULTS

Majority of older people (81.9%) reported poor health-related quality of life. Middle old (aOR: 12.06, 95% CI: 5.76, 25.23), very old (aOR: 174.74, 95% CI: 39.74, 768.38), vegetarian diets (aOR: 2.13, 95% CI: 1.14, 3.96), under-nutrition (aOR: 3.41, 95% CI: 1.65, 7.04) and over-nutrition (aOR: 1.85, 95% CI: 1.04, 3.28) were significantly associated with poor HRQOL. Using dentures (aOR: 0.05, 95% CI: 0.28, 0.90) was found as a protective factor for poor HRQOL.

CONCLUSIONS

HRQOL was poor among community-dwelling older people in Kandy district. Nutrition-related factors need to be further investigated to improve HRQOL among older people.

Quality of life and associated factors in elderly people at a Reference Center

Studies have evaluated the quality of life (QOL) of many groups; however, such studies in relation to Reference Centers for the Elderly are scarce. This research identified factors associated with a good QOL of people using a Reference Center in the city of Belo Horizonte, MG, Brazil. Transversal study of 257 elderly people who used a Reference Center for the Elderly. The short version of the World Health Organization Quality of Life Assessment (WHOQOL-BREF) was used to evaluate the QOL of the elderly people. The analysis was rationalized by defining two groups in relation to perceptions of QOL and satisfaction regarding health. Logistic regression analysis was performed to assess the direction and magnitude of the association of each variable with QOL. The results showed that the majority (63.4%) of the elderly people considered that they had a good QOL and that they were satisfied with their health. The environmental domain received the lowest scores (average = 14.4). The factors of advanced age, being from the interior of the state of Minas Gerais, physical activity, diabetes, musculoskeletal diseases, hypertension and depression remained independently associated with QOL and satisfaction with health after the model was adjusted. The data that was obtained can be used to direct care strategies for the most vulnerable elderly people, with particular attention to issues that affect the environment.

Depression, functional disability and quality of life among Nigerian older adults: Prevalences and relationships

BACKGROUND

Ageing is associated with increased morbidity, depression and decline in function. These may consequently impair the quality of life (QoL) of older adults.

PURPOSE

This study was used to investigate the prevalence of functional disability, depression, and level of quality of life of older adults residing in Uyo metropolis and its environs, Nigeria.

METHOD

This cross sectional survey involved 206 (116 females and 90 males) older adults with mean age of 69.8±6.7. The World Health Organization Quality of Life-OLD, Functional status Questionnaire (FSQ) and Geriatric Depression Scale (GDS) were used to measure quality of life, functional disability and depression respectively. Data was analysed using frequency counts and percentages and Spearman rank-order correlation coefficient, at 0.05 alpha level.

RESULTS

45.5% of participants had depression, and at least 30% had functional disability in at least one domain, but their quality of life was fairly good (>60.0%) across all domains. Significant correlation existed between depression scores and individual quality of life and functional disability domains and between overall QoL and each functional disability domain (p<0.001).

CONCLUSIONS

Depression and functional disability were quite prevalent among sampled older adults but their QOL was not too severely affected. Since the constructs were interrelated, it seems interventions targeted at depression and functional status may invariably enhance the quality of life of the older adults.

The role of social relationships among elderly community-dwelling and nursing-home residents: findings from a quality of life study

AIM

In Western countries, older adults' needs are often managed through institutionalization. Based on the assumption that quality of life, particularly social relationships, may be perceived differently according to residential setting, the aims of this study were to compare World Health Organization Quality of Life brief version (WHOQOL-BREF) scores of elderly community-dwelling residents and nursing home residents.

METHODS

A sample of 207 older adults (135 community-dwelling residents, 72 nursing home residents) was evaluated with Mini-Mental State Examination (MMSE), WHOQOL-BREF, and Geriatric Depression Scale (GDS).

RESULTS

Nursing home residents achieved lower WHOQOL-BREF scores on the physical health scale only (P = 0.002). In a linear regression model, physical score correlated negatively with GDS score (P = 0.0001) and Mini-Mental State Examination score (P = 0.04), but positively with male gender (P = 0.02) and community-dwelling residence (P = 0.001); psychological score correlated negatively with GDS score (P = 0.0001) and being married (P = 0.03), but positively with male gender (P = 0.009) and being unmarried (P = 0.03). The social relationships score correlated negatively with the GDS score (P = 0.0001) and male gender (P = 0.02), but positively with high education level (P = 0.04). The environment score negatively correlated with GDS score (P = 0.0001). In a logistic regression model, living in a nursing home correlated with female gender (P = 0.001), age (P = 0.0001), a lower physical score (P = 0.0001), and a higher social relationships score (P = 0.02).

CONCLUSION

Depressive symptoms correlated with low scores in all WHOQOL-BREF domains. The variables that correlated with living conditions in a nursing home were older age, male gender, lower physical domain scores, and higher social relationship scores. Opportunities for socialization in nursing homes may thus improve perception of quality of life in this domain.

Determinants of Health-Related Quality of Life Among Elderly: Evidence From Chi Linh Town, Vietnam

As Vietnam confronts with the challenge of an aging population, the importance of quality of life for elderly people becomes apparent. This article aims to assess health-related quality of life (HRQoL) and its correlates for the elderly, using a cross-sectional study design. A total of 1599 adults, aged 60 years and older, were drawn from the 2016 baseline survey of Chi Linh Health and Demographic Surveillance System (CHILILAB HDSS), which incorporated the EQ-5D, to measure HRQoL. Data were analyzed using multivariate linear regression analyses. The EQ-5D index of the elderly was found to be 0.871 (95% confidence interval = 0.862-0.880). After controlling for covariates, there were statistically significant associations between lower HRQoL and older age (≥80 years), lower education, no pension, chronic disease(s), and health insurance schemes targeting poor/near poor/priority groups. Current and future policies for improving HRQoL in old age should be extended to cover the most vulnerable groups.

Social support network, mental health and quality of life: a cross-sectional study in primary care

The objective of this study was to identify the association between emotional distress and social support networks with quality of life in primary care patients. This was a cross-sectional study involving 1,466 patients in the cities of São Paulo and Rio de Janeiro, Brazil, in 2009/2010. The General Health Questionnaire, the Hospital Anxiety and Depression Scale and the brief version of the World Health Organization Quality of Life Instrument were used. The Social Support Network Index classified patients with the highest and lowest index as socially integrated or isolated. A bivariate analysis and four multiple linear regressions were conducted for each quality of life outcome. The means scores for the physical, psychological, social relations, and environment domains were, respectively, 64.7; 64.2; 68.5 and 49.1. In the multivariate analysis, the psychological domain was negatively associated with isolation, whereas the social relations and environment domains were positively associated with integration. Integration and isolation proved to be important factors for those in emotional distress as they minimize or maximize negative effects on quality of life.