Assessment of quality of life among elderly in urban and peri-urban areas, Yangon Region, Myanmar

The impact of community older adult care services on the quality of life of older adults in China: the mediating role of social adaptation

Background

With the deepening trend of aging in China, community older adult care services occupy an important position in China's older adult care system. This paper aims to explore the impact of different types of community older adult care services on the quality of life of older adults and to analyze its underlying influencing mechanism.

Methods

The research data are obtained from the 2020 China Longitudinal Aging Social Survey data. The Structural Equation Model is used to examine the relationship between of three types of community older adult care services on older adults'quality of life.

Results

(1) Three types of community older adult care services are positively associated with quality of life of older adults. Compared to basic older adult care services, extended older adult care services have a more significant impact on older people's quality of life. (2) It is found that the impacts of three types of community older adult care services on the quality of life of older adults are heterogeneous in terms of age, registered residence, and disablement status. (3) Social adaptation mediated the relationship between three types of community older adult care services and older adults' quality of life.

Discussion

The results of this study show that three types of community older adult care services could improve the quality of life of older adults, and social adaptation plays a mediating role between three types of community older adult care services and quality of life. Therefore, it is necessary to strengthen the supply of community older adult care services, especially extended older adult care services. By accurately identifying the needs of the older adults and optimizing service supply, giving the older adults more useful services, improving their attitudes towards society and helping them better adapt to society, thereby improving the quality of life of older adults. This study provides a basis for optimizing community older adult care services and improving the quality of life of the older adults, and emphasizes the key role of social adaptation, which has important practical guiding significance for promoting the sustainable development of the older adult care service system.

Effect of Elderly School Policy on Quality of Life among Thailand's Senior Citizens: A Propensity Score Matching Approach

Background

As Thailand's population ages, promoting senior citizens' quality of life (QoL) is crucial. In 2017, the Ministry of Social Development and Human Security launched the "elderly school" initiative to foster lifelong learning and enhance the QoL among senior citizens. However, comprehensive evaluations of its impact on QoL remain limited.

Methods

This cross-sectional survey aimed to assess the policy's effect on QoL in Phetchabun province, Thailand. Using quota and systematic sampling, 1,374 senior citizens aged 60-80 participated. Propensity score matching (PSM) with a 1:1 match was employed to estimate the average treatment effect (ATE) of attending the elderly school on QoL. Additionally, multiple linear regression was analyzed to assess the association between QoL and its associated factors.

Results

PSM were matched successfully, the standardized difference was less than 10 percent, and the baseline after matching indicated balances with 687 elderly people in each group. The mean QoL score of the non-attending group was 44.40 (SD = 7.11), and that of the attending group was 57.50 (SD = 7.53). The ATE for elderly people attending school was 10.67 scores (95% CI: 9.67 - 11.67 scores) higher than those unattended. Being female, having monthly income higher than 20,000, having employment, having a caregiver, and attendance at elderly school were positively associated with QoL, and the standardized beta coefficients were 0.078, 0.059, 0.094, 0.066, and 0.550, respectively. Additionally, higher education was positively associated with higher QoL.

Conclusion

The elderly school policy significantly enhanced the QoL of the attending senior citizens. Findings suggest continued collaboration among stakeholders to sustain and optimize this policy for improved seniors' QoL, which has the potential to utilize lifelong learning to create an inclusive framework for healthy aging among senior citizens.

Association between social capital and mortality among community-dwelling older adults in Myanmar 2018-2022: a prospective cohort study

BACKGROUND

Healthy aging is crucial in Asia given its rapidly aging society. Social capital, which refers to the resources derived from social networks, norms, and trust that facilitate cooperation and collective action within a community or society, has demonstrated health benefits for older adults. However, its impact varies by country. Most research focuses on high-income countries, with little attention on low- and middle-income countries.

METHODS

This prospective cohort study examined the effects of social capital on all-cause mortality among older adults in Myanmar from 2018 to 2022, using structured questionnaires based on the Japan Gerontological Evaluation Study. Multistage random sampling and face-to-face interviews were conducted with community-dwelling older adults aged 60 and above in Yangon and Bago in 2018. Subsequently, three waves of follow-up telephone surveys were conducted in 2020, 2021, and 2022. The questionnaires evaluated three components of social capital: civic participation, social cohesion, and social support, alongside baseline demographic information. Their impact on all-cause mortality was assessed using the Cox proportional hazards model with multiple imputations, adjusting for potential confounders including age, gender, body mass index, self-rated health, socioeconomic status, lifestyle, illness, and residential area.

RESULTS

A total of 1200 individuals were followed for an average of 2.6 years (3123 person-years), with 143 all-cause deaths observed among 1031 participants. Bivariate analyses showed that participants who died were more likely to be older, underweight, have shorter daily walking times, live in Bago, and have less social support. Higher social support was significantly associated with lower mortality after adjusting for all covariates (HR = 0.80, 95% CI 0.69-0.94). Specifically, instrumental support, defined as the exchange of practical assistance, such as receiving or providing care during illness, was found to be protectively associated with mortality. When stratified by residential area, significant associations were found only in Bago, a rural area. Among older adults in Myanmar, instrumental support was a more prominent protector against all-cause mortality than emotional support, especially in rural areas.

CONCLUSIONS

Our findings indicate that social support networks play an important role in the survival of older adults in Myanmar, even under unstable social conditions.

Gender differences in the association between transitions in depressive symptoms and oral health among older adults with chronic conditions

BACKGROUND

Oral health influences the quality of life of older adults. Further, depression is negatively associated with oral health. However, little is known about this relationship among older adults with chronic health conditions. Additionally, since oral health and depression differ between genders, this study aimed to investigate the effect of transitions in depressive symptoms on oral health among older adults with chronic health conditions by gender.

METHODS

We used data from the Korean Longitudinal Study of Aging (2020-2022). The study sample comprised 2836 older adults (1104 men; 1732 women). We adopted multiple linear regression to examine the association between depressive symptom transitions and oral health by gender.

RESULTS

The new onset depression symptoms were significantly associated with the deterioration of oral health in men (β = -5.4308) and women (β = -4.8328). Our study showed a gender-specific association between new onset depressive symptoms and particular domains of oral health. For men, the association was slightly more negative in psychosocial function (β = -2.1177) while women presented lower GOHAI scores in both the physical function domain (β = -1.8800) and the psychosocial function domain (β = -1.8801).

LIMITATIONS

The data used in this study were self-reported via a survey; thus, self-report bias may be a relevant concern.

CONCLUSION

To prevent deterioration in oral health, depressive symptoms must be detected and addressed early among older adults with chronic conditions. This study underscores the importance of interventions that consider gender differences in the association between depressive symptoms and psychosocial and physical functioning.

Efficacy of rehabilitation after provision of ICRC lower limb prostheses in low-income and middle-income countries: A quantitative assessment from Myanmar

BACKGROUND

Low-income and middle-income countries (LMICs) have poorly resourced health services. Lack of access to assistive devices, such as prosthetics, may limit the functional outcomes of persons with amputation and affect quality of life (QoL).

OBJECTIVE

The objective of this study was to assess the functional level and QoL of prosthetic users in LMICs when prescribed a prosthesis made from International Committee for Red Cross (ICRC) components.

STUDY DESIGN

The study design included a quantitative descriptive methodology assessing functional outcomes and QoL after prosthetic provision.

METHODS

Participants were identified from the prosthetic service in Mandalay, Myanmar. Included participants were those with unilateral, traumatic, lower limb amputations, with ICRC devices delivered at least 6 months earlier. Participants attended the prosthetic service and were assessed using the Amputee Mobility Predictor with Prosthesis tool and the World Health Organization Quality of Life Brief and Disability modules.

RESULTS

Thirty-five participants completed the study; of them, 63% were persons with transtibial level amputation and 37% were with transfemoral level amputation. Approximately 83% achieved a score of more than 37 using the Amputee Mobility Predictor with Prosthesis. There is a strong positive correlation between QoL and physical health (r = 0.55; p < 0.001), social relationships (r = 0.66; p < 0.001), and inclusion (r = 0.53; p < 0.001). Participants had a better QoL and overall health when they had better psychological health.

CONCLUSION

The patient-based results presented within this study could be considered as a contribution to the evidence base and importance of provision of prosthetic services in LMICs. It was observed that participants with an amputation were able to achieve a high level of physical function with the ICRC prostheses while also reporting a high QoL.

A Study on Quality of Life among the Elderly at Urban Health Center in North Delhi

Background

Elderly population in India is growing around 3% annually and is supposed to triple by 2050 than that at the time of 2011 census, according to a country report published by the UN Population Fund (UNFPA, 2017). A better quality of life (QOL) of the elderly has become a major public health challenges of the 21st century, so timely emphasis on maintenance of physical health and psychological issues is crucial. Therefore, the aim of the present study is to measure QOL among the elderly population and to find out the association with sociodemographic factors.

Materials and Methods

This is a cross-sectional study done among the elderly population of an urban health training center. The study includes the World Health Organization Quality of Life Questionnaire-Brief version and a questionnaire for sociodemographic variables. Univariate and multivariate analyses were used to determine associations and P value.

Results

The overall QOL scores ranged between 52 and 110, with a mean score of 78.59 ± 12.6. Good QOL was observed among 64.9%of the elderly, excellent was observed among 19.8%; and the rest 15.3% had fair/average, while none of the elderly had poor QOL. Determinants significantly associated with QOL with P < 0.05 are age, educational status, professional status, marital status, and behavior of children with them and the elderly with comorbidities.

Conclusion

This study shows the association of multiple factors with QOL among the elderly. Factors such as age, educational status, professional status, marital status, and behavior of children with them and the elderly with comorbidities significantly affect the QOL of the elderly. Hence, strengthening the health-care system, increase in level of education, encouraging social interaction, social security systems, and better environmental infrastructure could potentially increase QOL of the elderly population.

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.

Correlation between functional disability and quality of life among rural elderly in Anhui province, China: a cross-sectional study

Objective

We aimed to explore the correlation between functional disability and quality of life (QoL). And exploring the interaction of functional disability, basic demographic characteristics and health-related information on QoL among the rural elderly in Anhui Province.

Methods

This study used multi-stage stratified cluster sampling in rural Anhui Province from January to July 2018 to conduct a cross-sectional survey of older adults who met the inclusion criteria. The Five-Dimensional European Quality Of Health Scale (EQ-5D) and the WHO Disability Assessment Schedule (WHODAS2.0) scale were used to evaluate the QoL and functional disability, and the basic demographic characteristics of the survey subjects were also collected. Using binary logistic and Classification and regression tree model (CART) models to analyze the data, explore the relationship between functional disability and QoL in the elderly.

Results

A total of 3491 older adults were included in the survey, and 3336 completed the entire survey, with an effective response rate of 95.56%. After adjusting for covariables, those who had limited in dimension of mobility (AOR=2.243, 95%CI: 1.743-2.885), getting along (AOR=1.615, 95%CI: 1.173-2.226), life activities (AOR=2.494, 95%CI:1.928-3.226), and social participation (AOR=2.218, 95%CI: 1.656-2.971) had a lower QoL. However, the dimension of cognition (AOR=0.477, 95%CI: 0.372-0.613) is a protective factor for QoL. Additionally, we also observe that 96.3% of those who were unemployed and limited in both mobility and life activities dimensions had a lower QoL, but among those who were robust in both mobility and social participation dimensions and not suffer from chronic diseases, 56.3% had a higher QoL.

Conclusions

Our findings indicate that special attention should be paid to the elderly who are unemployed, have limited in cognition, getting along, social participation, mobility, life activities and cognition robust to improve their QoL. This research is of great significance for formulating targeted strategies and measures to improve the QoL for rural elderly.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-12363-7.

Association between Frequency of Going Out and Psychological Condition among Community-Dwelling Older Adults after the COVID-19 Pandemic in Japan

Background: The psychological condition and frequency of going out (FGO) of community-dwelling older adults after the spread of COVID-19 will provide insights for supporting the daily lives of community-dwelling older adults. Going out is defined as moving from one’s own home to a place or region beyond one’s own home and is considered to reflect the daily and social life of community-dwelling older adults. This study investigates the relationship between the FGO and current psychological condition after the second wave of COVID-19 in community-dwelling older adults in Japan. Methods: This study adopted a self-administered questionnaire by mail. A total of 493 members of CO-OP Kagoshima were included in the analysis and divided into two groups according to the change in FGO. Multiple logistic regression analysis was conducted after a bivariate analysis to investigate the relationship between the FGO and psychological condition. Results: Significant differences were noted between the groups with decreased FGO and those with increased/unchanged FGO in general and pandemic-related psychological condition. Multiple logistic regression analysis showed a significant relationship between FGO and psychological condition, such as mental fatigue, not smiling as much as before, and anxiousness to go outside. Conclusion: Community-dwelling older adults may have experienced a decrease in the frequency of going out and a detrimental effect on their psychological condition after the COVID-19 pandemic. This finding may inform strategies to identify priorities for psychological approaches altered by COVID-19 to prevent confinement and stress in older adults.

Predictors of quality of life among geriatric population in a tribal dominant state of India: A community based analytical study

Background:

Improving the quality of life of the geriatric population along with maintaining their health and promoting social participation still poses a major public health challenge in the twenty-first century. Hence, we planned to measure the quality of life (QOL) in each domain namely physical, psychological, social, and environmental using the world health organization quality of life brief version (WHO QOL-BREF) questionnaire and to assess the predictors of QOL among the elderly population.

Methodology:

A community-based cross-sectional study was conducted in Ormanjhi, Ranchi, Jharkhand for a period of 6 months. The study was carried out among 206 geriatric populations fulfilling the eligibility criteria. The data collected were entered in MS Excel and analyzed using SPSS version 20. The QOL scores were expressed in terms of mean and standard deviation, and the difference between mean scores was tested by using student t-test/analysis of variance (ANOVA). The predictor associated with QOL was done by multiple linear regression analysis. P value less than 0.05 was considered statistically significant.

Results:

A total of 206 geriatric people fulfilling the study criteria were enrolled during the study. The majority of the people were of the age between 60 and69 years (71.8%). Most of them 202 (98.1%) resided in rural areas, 108 (52.4%) of them were illiterate by education, and nearly half 102 (49.5%) depended on pension for livelihood. Nontribal ethnicity, backward category, illiteracy, low socio-economic status, nuclear family, elderly person having no own source of income, currently living alone, person having more co-morbidity, and less activities of daily living (ADL) score were significantly associated with low QOL score.

Conclusion:

Overall QOL was good to excellent in Ranchi, Jharkhand. We concluded that QOL is affected by many different factors.

Reductions in the Frequency of Going Out Due to the COVID-19 Pandemic Negatively Affect Patients with Spinal Disorders

Introduction

The coronavirus disease 2019 (COVID-19) pandemic has greatly changed the lifestyles of individuals due to the need to prevent disease spread. Globally, governments have enforced various policies, including travel bans, quarantine, home confinement, and lockdowns, as safety measures. Consequently, the frequency of individuals going out has decreased. This survey aimed to assess how decreasing the frequency of going out due to the COVID-19 pandemic impacts patients with spinal disorders.

Methods

This multicenter cross-sectional questionnaire survey included patients who visited four private spine clinics for any symptoms. Participants completed questionnaires pre- and post-pandemic that assessed the following topics: frequency of leaving home, exercise habits, locomotive syndrome, and health-related quality of life (HRQOL). Patients were divided into decreased and non-decreased frequency of going out groups, according to observed changes in their frequencies of leaving home. Both groups were statistically compared using univariate and multivariate logistic regression analyses to identify factors associated with the frequency of going out.

Results

Among 855 patients, 160 (18.7%; the decreased group) reported that they went out less frequently, and 695 (81.3%; the non-decreased group) reported that they left home equally frequently post- versus pre-pandemic. Multivariate analyses showed that exercise habits significantly decreased (adjusted odds ratio (aOR) = 2.67, p = 0.004), the incidence of locomotive syndrome significantly increased (aOR = 2.86, p = 0.012), and HRQOL significantly deteriorated (aOR = 4.14, p < 0.001) in the decreased group compared to the non-decreased group.

Conclusions

Restrictions regarding leaving home due to the COVID-19 pandemic significantly decreased exercise frequency, increased the occurrence of locomotive syndrome, and were associated with deterioration of HRQOL in patients with spine disorders. It may be beneficial for spine surgeons to encourage patients with spinal disorders to leave home at a frequency similar to what they did pre-pandemic while avoiding crowded areas, despite the presence of the COVID-19 pandemic.

Quality of life in health Iranian elderly population approach in health promotion: A systematic review

BACKGROUND

The quality of life (QOL) is essential in all different stages of life; however, It is more important for older people as it can be effective in promoting their health. Therefore, the present study aimed to review the literature on the QOL in the Iranian elderly population.

MATERIALS AND METHODS

The study was carried out as a systematic review. For this purpose, all databases were searched in March 2021. The keywords used for the search were "quality of life, elderly, older adults, aging, seniors, and Iran" along with the Persian equivalents. PRISMA protocol was used to screen articles. After removing duplicate and irrelevant items, two evaluators appraised the articles separately based on a researcher-made checklist derived from the SBEM and STROBE Statement standard checklists.

RESULTS

The initial search yielded 3734 studies on the QOL in the Iranian elderly population. After screening and assessing the studies based on inclusion and exclusion criteria, 22 articles remained in the study. Most of the studies (cross-sectional) were conducted in Tehran using a 36-item Short-Form Health Survey to assess the QOL. The studies investigated sociodemographic determinants, physical and health-related behaviors, and spirituality and psychological determinants of the QOL. The sociodemographic determinants were the most common factors under study. The results showed that the role of gender and socioeconomic status was the strongest among the sociodemographic characteristics. A significant association was found between the QOL in the Iranian elderly population and factors such as depression and religious confrontation.

CONCLUSION

In addition to chronic diseases, diseases of the oral and dental, as well as an unhealthy diet, should be considered in the elderly. Therefore, attention should be paid to all social, physical, and psychological variables that affect the QOL of older people.