Aging, Gender and Quality of Life (AGEQOL) study: factors associated with good quality of life in older Brazilian community-dwelling adults

A Post-Implanto-Prosthetic Rehabilitation Study Regarding the Degree of Improvement in Patients' Quality of Life: A Before-After Study

BACKGROUND

Implant-prosthetic rehabilitation has the ability to improve the quality of life of patients, because, in addition to the role of restoring masticatory function, they also have many other benefits, such as restoring aesthetics or improving speech. This study aimed to analyze whether patients' quality of life was improved by implanto-prosthetic rehabilitation and which were the most important aspects.

MATERIALS AND METHODS

In this before-after study, we applied the Oral Health Impact Profile (OHIP-14) questionnaire to analyze the degree to which complex implanto-prosthetic rehabilitation led or not to an increase in patients' quality of life. The present study was carried out at the level of a private medical center in a city in the central region of Romania and included patients who visited this medical center between January and June 2022 and who benefited from a complex implanto-prosthetic rehabilitation, with the total number of patients eligible for inclusion in the study being 116.

RESULTS

Overall, an improvement in quality of life after implant-prosthetic rehabilitation was found. Patients' gender, age, or educational level did not significantly influence their responses. The network analysis offered an overview (intuitive visual representation) of the similarities but also the differences in the OHIP-14 item relationships in both situations: before and after oral rehabilitation.

CONCLUSIONS

A better understanding of how patients perceive implanto-prosthetic rehabilitation and the aspects that influence this perception can lead to an improvement in their quality of life, increasing the addressability of this type of medical procedure.

Ultra-processed food consumption and quality of life: a cross-sectional study in Iranian women

Background

Ultra-processed foods (UPFs) have been associated with a higher intake of added sugars, sodium, and unhealthy fats; however, the relationship between UPFs and quality of life (QoL) is not well understood.

Methods

The present cross-sectional study included 193 Iranian women aged 18-48 years with a body mass index (BMI) of ≥25 kg/m2. UPFs were identified using the NOVA classification. QoL was evaluated using the SF-36 questionnaire. Anthropometric measurements and body composition were assessed using an appropriate method.

Results

The mean BMI and fat-free mass (FFM) of the subjects were 30.90 kg/m2 and 46.69 kg, respectively. At first, a significant difference was observed in the height of women across tertiles of UPF consumption. The mean score of the total QoL scale was 66.90. Women who were in the tertile 3 of UPFs intake had 23.59 units lower the scale of limitation in physical capabilities and activity (score of role-physical) (β = -23.59, 95% CI: -37.77-9.40, p = 0.001). Among those with the highest adherence to UPF intake, there was an 8.76 unit reduction in addressing feelings of energy and fatigue (vitality domain) in model 2 (β = -8.76, 95% CI: -16.42-1.11, p = 0.02). Finally, a reduction of 15.78 units was observed in the mental health scale, specifically in the mental states of anxiety and depression, among participants in the third tertile of UPF intake (β = -15.78, 95% CI: -24.11-7.45, p < 0.001).

Conclusion

Increased UPF consumption was associated with lower QoL in Iranian women. Further studies are needed to confirm these findings and develop effective strategies to promote healthy food choices.

A Moderated Mediation Model of Age-Related Decline in Selective Executive Functions and Quality of Life in Men with Substance Use Disorder

Objective

It is known from earlier literature that substance use is associated with diminished executive functioning and decreased quality of life (QoL). The study extended this knowledge by assessing whether selective executive function components would mediate the association between age and QoL domains in young men with substance use disorder and whether family history of substance use would moderate these mediated associations.

Method

A sample of 212 young inpatient men with substance use disorder (105 positive family history and 107 negative family history of substance use disorder) was selected from drug units/wards of government sector hospitals.

Results

The participants with positive family history compared to those with negative family history scored significantly lower on all QoL domains except physical QoL. Mediation analyses revealed that only inhibition but not flexibility mediated the negative association of age with psychological, social, and environmental QoL. Furthermore, family history of substance use moderated all the significant mediated associations with stronger indirect negative associations in participants having a family history of substance use disorder compared to those with no such history.

Conclusions

It is concluded that inhibitory control, which is vulnerable to aging, substance use, and family history of substance use, is an important factor related to QoL in young substance abuser men.

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.

Cluster-Based Multinomial Logistic Regression Model for Health-Related Quality of Life Among People Living with HIV in Brazil

Improvement in treatment options has increased the survival of people living with HIV (PLHIV). Thus, we evaluated the factors associated with better health-related quality of life (HRQoL) among PLHIV in Brazil. This was a cross-sectional study carried out among 349 PLHIV. Data were collected using an interview-based questionnaire, and HRQoL was assessed by the Brazilian version of the WHOQOL HIV BREF instrument. We used non-hierarchical cluster analysis (K-means) to compile the WHOQOL HIV BREF's overall and domain scores into a unique more multidimensional measure for HRQoL consisting of three clusters: poor, fair and good; associations with clusters of better HRQoL were assessed using multinomial logistic regression models. The mean and median overall HRQoL scores were 15.13 (SD = 3.39) and 16, respectively. The reliability and validity of the Brazilian version of the WHOQOL HIV BREF instrument was confirmed among PLHIV in a non-metropolitan, medium-sized municipality of Brazil, which reaffirmed the cross-cultural validity of this instrument. The factors male sex; heterosexual and asexual orientations; higher individual income; undetectable viral load; absence of any comorbidity and presence of an infectious or a chronic comorbidity, with mental illness as the reference; and never having consumed illegal substances were independently associated with good HRQoL. Thus, the compilation of the WHOQOL HIV BREF's overall and domain scores into a unique multidimensional measure for HRQoL, which this study proposed for the first time, may facilitate more robust interpretations and models of predictors. These differentials could simplify HRQoL as an indicator of health and wellbeing to be routinely used as a key outcome in the clinical management of patients and in the global monitoring of health system responses to HIV.

Relationship between intrinsic capacity and health-related quality of life among community-dwelling older adults: the moderating role of social support

PURPOSE

To examine how social support might moderate the relationship between intrinsic capacity and health-related quality of life (HRQoL) based on the buffering model of social support.

METHODS

This was a cross-sectional study with a sample of 1181 Chinese community-dwelling older adults aged ≥ 60 years in 2016. Social support was assessed using the Social Support Rating Scale. Intrinsic capacity was assessed using the revised integrated care for older people screening tool. HRQoL was measured by the 12-item Short Form Health Survey. Hierarchical linear regression analysis was implemented to test the moderating effect of social support.

RESULTS

Support utilization attenuated the relationship between lower intrinsic capacity and poor physical HRQoL while subjective support attenuated the relationship between lower intrinsic capacity and poor mental HRQoL. However, objective support had no significant moderating effect on the relationship between intrinsic capacity and specific domains of HRQoL.

CONCLUSION

The moderating effects of social support on the association between intrinsic capacity and HRQoL vary by support types. Effective interventions should target the perception and utilization of available support among older adults with lower intrinsic capacity to maintain their physical and mental HRQoL.

Predictors for quality of life in older adults: network analysis on cognitive and neuropsychiatric symptoms

BACKGROUND

Quality of life (QoL) of older adults has become a pivotal concern of the public and health system. Previous studies found that both cognitive decline and neuropsychiatric symptoms (NPS) can affect QoL in older adults. However, it remains unclear how these symptoms are related to each other and impact on QoL. Our aim is to investigate the complex network relationship between cognitive and NPS symptoms in older adults, and to further explore their association with QoL.

METHODS

A cross-sectional study was conducted in a sample of 389 older individuals with complaints of memory decline. The instruments included the Neuropsychiatric Inventory, the Mini Mental State Examination, and the 36-item Short Form Health Survey. Data was analyzed using network analysis and mediation analysis.

RESULTS

We found that attention and agitation were the variables with the highest centrality in cognitive and NPS symptoms, respectively. In an exploratory mediation analysis, agitation was significantly associated with poor attention (β = -0.214, P < 0.001) and reduced QoL (β = -0.137, P = 0.005). The indirect effect of agitation on the QoL through attention was significant (95% confidence interval (CI) [-0.119, -0.035]). Furthermore, attention served as a mediator between agitation and QoL, accounting for 35.09% of the total effect.

CONCLUSIONS

By elucidating the NPS-cognition-QoL relationship, the current study provides insights for developing rehabilitation programs among older adults to ensure their QoL.

Healthy eating habits and a prudent dietary pattern improve Nanjing international students' health-related quality of life

Purpose

Low-quality dietary practices, such as fast food consumption and skipping meals, deteriorate the quality of life. However, the available studies on diet and health-related quality of life (HRQoL) used matrices not specific to nutrition. Moreover, how diet affects the HRQoL of international students in China is unknown. Therefore, using a cross-sectional study, the effect of dietary patterns and habits on the HRQoL of international students in Nanjing, China, was examined.

Methods

The researchers collected dietary data using a food frequency questionnaire (FFQ) from February to March 2022. Then, the Food Benefit Assessment (FBA) was used to access HRQoL. Finally, the effect of eating habits and dietary patterns on HRQoL was explored using multilinear regression.

Results

Approximately 454 responses were obtained, with the responses mostly from male subjects (56.4%) and those aged 26 years and above (75.6%). The quality of life according to the food consumed was about average for all the constructs except for aesthetics and disease prevention, as 65.8% skipped meals, particularly breakfast (47.8%). Furthermore, three dietary patterns were identified: prudent, Western, and animal protein patterns. Consequently, by skipping breakfast, vitality (β = -2.362, p = 0.04), wellbeing (β = -3.592, p = 0.007), digestive comfort (β = -4.734, p = 0.008), and disease prevention (β = -5.071, p = 0.031) were all reduced. However, consuming at least three meals daily enhanced vitality (β = 2.254, p = 0.003) and disease prevention (β = 4.441, p = 0.019). Furthermore, aesthetics (β = 4.456, p = 0.05), physical appearance (β = 5.927, p = 0.003), and vitality (β = 3.323, p = 0.009) were also significantly increased by healthy dietary patterns. However, a more Westernized diet led to frequent snacking (β = -4.631, p = 0.032), a decline in wellbeing (β = -5.370, p < 0.001), and discomfort with digestion (β = -5.101, p = 0.01). Finally, increased frequency of snacking (β = -6.036, p = 0.012), a decrease in wellbeing (β = -4.494, p = 0.004), digestive comfort (β = -9.940, p < 0.001), physical appearance (β = -4.926, p = 0.027), and disease prevention (β = -5.835, p = 0.043) were all associated with an increase in animal protein patterns.

Conclusion

This research indicates that healthy eating habits and patterns positively impact international students' HRQoL. Therefore, the appropriate authorities should advise students to consume healthy foods regularly to improve their HRQoL.

Impact of a specialized oral nutritional supplement on quality of life in older adults following hospitalization: Post-hoc analysis of the NOURISH trial

BACKGROUND & AIMS

Both during and after hospitalization, nutritional care with daily intake of oral nutritional supplements (ONS) improves health outcomes and decreases risk of mortality in malnourished older adults. In a post-hoc analysis of data from hospitalized older adults with malnutrition risk, we sought to determine whether consuming a specialized ONS (S-ONS) containing high protein and beta-hydroxy-beta-methylbutyrate (HMB) can also improve Quality of Life (QoL).

METHODS

We analyzed data from the NOURISH trial-a randomized, placebo-controlled, multi-center, double-blind study conducted in patients with congestive heart failure, acute myocardial infarction, pneumonia, or chronic obstructive pulmonary disease. Patients received standard care + S-ONS or placebo beverage (target 2 servings/day) during hospitalization and for 90 days post-discharge. SF-36 and EQ-5D QoL outcomes were assessed at 0-, 30-, 60-, and 90-days post-discharge. To account for the missing QoL observations (27.7%) due to patient dropout, we used multiple imputation. Data represent differences between least squares mean (LSM) values with 95% Confidence Intervals for groups receiving S-ONS or placebo treatments.

RESULTS

The study population consisted of 622 patients of mean age ±standard deviation: 77.9 ± 8.4 years and of whom 52.1% were females. Patients consuming placebo had lower (worse) QoL domain scores than did those consuming S-ONS. Specifically for the SF-36 health domain scores, group differences (placebo vs S-ONS) in LSM were significant for the mental component summary at day 90 (-4.23 [-7.75, -0.71]; p = 0.019), the domains of mental health at days 60 (-3.76 [-7.40, -0.12]; p = 0.043) and 90 (-4.88 [-8.41, -1.34]; p = 0.007), vitality at day 90 (-3.33 [-6.65, -0.01]; p = 0.049) and social functioning at day 90 (-4.02 [-7.48,-0.55]; p = 0.023). Compared to placebo, differences in LSM values for the SF-36 general health domain were significant with improvement in the S-ONS group at hospital discharge and beyond: day 0 (-2.72 [-5.33, -0.11]; p = 0.041), day 30 (-3.08 [-6.09, -0.08]; p = 0.044), day 60 (-3.95 [-7.13, -0.76]; p = 0.015), and day 90 (-4.56 [-7.74, -1.38]; p = 0.005).

CONCLUSIONS

In hospitalized older adults with cardiopulmonary diseases and evidence of poor nutritional status, daily intake of S-ONS compared to placebo improved post-discharge QoL scores for mental health/cognition, vitality, social functioning, and general health. These QoL benefits complement survival benefits found in the original NOURISH trial analysis.

CLINICAL TRIAL REGISTRATION

NCT01626742.

Associations between Physical Activity and Kyphosis and Lumbar Lordosis Abnormalities, Pain, and Quality of Life in Healthy Older Adults: A Cross-Sectional Study

Significant evidence suggests that regular physical activity (PA) leads to numerous physical and psychological outcomes in the elderly. This cross-sectional study was designed to further explore this issue by investigating the associations between PA (measured by accelerometer) and kyphosis and lumbar lordosis abnormalities, pain, and quality of life (QoL) in the elderly. In this cross-sectional study, 163 older adults (73 women) over 65 years of age (mean age: 68.70 ± 3.09) from Russia acted as participants. The following instruments were used to measure research variables: ActiGraph wGT3X-BT for measuring PA, spinal-mouse for measuring kyphosis and lumbar lordosis abnormalities, and the World Health Organization Quality of Life Scale (WHOQOL-BREF) questionnaire for measuring QoL. Pain was measured using two questions. The Independent t-test and a regression analysis were used to analyze data. The results showed that our sample participated on average in 15.8 min of moderate PA (MPA) per day, which is lower than the recommended guidelines. Men were significantly more physically active than women. In addition, MPA was significantly associated with lower kyphosis and lumbar lordosis abnormalities and pain in older adults. Finally, MPA was significantly associated with higher QoL. These findings indicate that PA is a critical concern for the elderly. Accordingly, physical educators and fitness instructors should adopt appropriate strategies to promote an active lifestyle among older adults.

Quality of life profiles and their associations with depressive symptoms and cognitive impairment of community-dwelling older adults in Hong Kong

Background

This study aimed to (1) explore the quality of life (QoL) profiles of older adults in Hong Kong and (2) examine their association with predictors (age, sex, body mass index, and depressive symptoms) and distal outcome (cognitive impairment) using a person-centered approach.

Methods

A total number of 328 community-dwelling older adults in Hong Kong were invited to participate in this study. Data from 259 older adults were identified as valid for the primary analysis. Latent profile analysis was used to explore QoL profiles. Multinomial logistic regression using the R3STEP function in Mplus was used to explore the predictive role of age, sex, body mass index, and depressive symptoms in profile membership. The Bolck-Croon-Hagenaars approach was used to examine how the distal outcome of cognitive impairment differs as a function of QoL profiles.

Results

Three QoL profiles emerged from the latent profile analysis (Low, Moderate and High QoL). It was found that depression, but not age, sex, or body mass index, significantly predicted QoL profile membership. The results of the Bolck-Croon-Hagenaars analysis revealed no significant differences in cognitive impairment across the three QoL profiles.

Conclusion

This is the first study that examined the relationship between QoL, depressive symptoms and cognitive impairment of older adults using a person-centered approach. The findings provide additional information for the evidence obtained from variable-centered approach on the associations among variables abovementioned. Our additional focus on the antecedents of emergent QoL profiles also provide practical knowledge regarding timely treatment for or prevention of depressive symptoms, which we submit will be crucial for enhancing the QoL of 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.

Psychosocial Protective and Risk Factors of Quality of Life Outcomes Among Older Adults Living With HIV

HIV continues to be a public health issue for older adults. Previous studies have examined predictors of quality of life (QoL) among people living with HIV (PLWH), but the majority have been in international settings and have not focused on older adults living with HIV (OALH). The aim of this study was to examine the associations between psychosocial protective and risk factors (resilience, internalized HIV-related stigma, and depression), and overall and domains (physical, psychological, independence, social, environmental, and spiritual) of QoL among OALH. Data were obtained from 156 OALH living in South Carolina. Resilience was positively associated with all QoL domains except the spiritual domain. Internalized HIV-related stigma was associated with all QoL domains except the psychological and environmental domains. Depression was associated with the overall QoL measure and all domains. Interventions aimed at increasing resilience, attenuating internalized HIV-related stigma and depressive symptoms may be warranted for OALH, which may improve overall and varying domains of QoL.

Health-related quality of life and its association with socioeconomic status and diet diversity in Chinese older adults

Objectives

The study aimed at examining the combined association of socioeconomic status (SES) and diet diversity (DD) with health-related quality of life (HRQoL) and exploring whether DD played a mediating role in the relationship between varied SES and HRQoL among Chinese older persons.

Method

A multi-stage random sampling method was conducted in Shanxi Province of China, with 3,250 older adults participating in this cross-sectional survey. SES was divided into groups by quartiles and DD by means, and these variable groups were combined in pairs to generate a total of eight combinations. The PROCESS macro developed by Hayes was employed for the simple mediation analysis.

Results

Compared with the reference group (those with both high SES and high DD), older adults who were classified to have lower SES or DD had elevated odds of having worse HRQoL: low SES/ low DD (OR = 1.65, 95% CI 1.41-2.92); low SES/ high DD (OR = 1.45, 95% CI 1.17-1.80); middle low SES/ low DD (OR = 1.43, 95% CI 1.24-1.65); middle low SES/ high DD (OR = 1.23, 95% CI 1.03-1.47); upper high SES/ low DD (OR = 1.41, 95% CI 1.21-1.65); and high SES/ low DD (OR = 1.30, 95%CI 1.10-1.53). The mediation analysis revealed that DD mediated the relationship between SES and HRQoL (B=0.011, 95% CI 0.008-0.013), with its indirect effects accounting for 39.29% of the total effects.

Conclusions

These findings highlighted the role of DD as a mediator of the relationship between SES and HRQoL. As DD could be protective, modifiable, and easy for older adults to understand and implement, village clinics and community health stations should work collaboratively to design proper DD intervention measures for better HRQoL.

Psychological health outcome of Sub-Saharan African migrants in Germany

African migrants living in Europe have an increased risk of adverse psychological health outcomes compared to people without a migration background. The increased vulnerability may be due to their migration experience and possible challenges in adapting and integrating into the host community. This study explores the association between community solidarity and psychological health outcome among Sub-Saharan African (SSA) migrants in Germany.<br /> The study used data from 518 SSA migrants in Germany collected in a cross-sectional survey across the 16 German federal states. A correlation matrix was computed to evaluate the bivariate relationship between psychological health, community solidarity, and socioeconomic, and demographic features. Furthermore, regression models were calculated to predict the effect of community solidarity on psychological health outcomes and the added predictive effects of socioeconomic and demographic characteristics.<br /> Community solidarity shows a moderately significant positive association with psychological health (r=.41; p≤.01). A linear regression model suggests that community solidarity, education and age explained 19% of the variance in psychological health scores for SSA migrants in Germany.<br /> These results confirm community solidarity as a significant but multi-layered determinant of various factors that affect migrants’ psychological wellbeing. It supports implementing policies that promote community solidarity to facilitate SSA migrants’ wellbeing.

Social support and links to quality of life among middle-aged and older autistic adults

LAY ABSTRACT

Social support can take many forms, such as practical help, time spent socially with others, or the satisfaction with personal relationships. Social support is known to affect quality of life (QoL) in both non-autistic older and autistic young adults. QoL reflects how satisfied an individual is with their life either overall or in a certain area. We know little about middle-aged and older autistic adults' experiences of social support or QoL. In this study, 388 adults aged 40-83 years old, completed online questionnaires asking about background such as age and sex, depression and anxiety symptoms, QoL (physical, psychological, social, environmental, and autism-specific), and different types of social support. Even after taking into account background, depression, and anxiety, social support was important for individuals' QoL. To our knowledge this is the first paper to examine the relationship between social support and QoL in middle-aged and older autistic adults. Improving social support may have a significant impact on the QoL of older autistic adults. Future studies should examine whether age-related changes in social support (size, content, and arrangement of social networks) that are common in non-autistic aging, also occur among older autistic adults.

Multivariate analysis of independent determinants of ADL/IADL and quality of life in the elderly

BACKGROUND

This study evaluated the determinants of disability and quality of life in elderly people who participated at the multi-centred RubiN project (Regional ununterbrochen betreut im Netz) in Germany.

METHODS

Baseline data of the subjects aged 70 years and older of the RubiN project were used and only subjects with complete data sets were considered for the ensuing analysis (complete case analysis (CCA)). Disability was examined using the concepts of ADL (activities of daily living) and IADL (instrumental activities of daily living). Subjects exhibiting one or more deficiencies in ADL respectively IADL were considered as ADL respectively IADL disabled. Quality of life was assessed using the WHOQOL-BREF and the WHOQOL-OLD. Applying multivariate analysis, sociodemographic factors, psychosocial characteristics as well as the functional, nutritional and cognitive status were explored as potential determinants of disability and quality of life in the elderly.

RESULTS

One thousand three hundred seventy-five subjects from the RubiN project exhibited data completeness regarding baseline data. ADL and IADL disability were both associated with the respective other construct of disability, sex, a reduced cognitive and functional status as well as domains of the WHOQOL-BREF. Furthermore, ADL disability was related to social participation, while IADL disability was linked to age, education and social support. Sex, ADL and IADL disability, income, social support and social participation as well as the functional status were predictors of the domain 'Physical Health' (WHOQOL-BREF). The facet 'Social Participation' (WHOQOL-OLD) was affected by both ADL and IADL disability, income, social participation, the nutritional and also the functional status.

CONCLUSIONS

Several potential determinants of disability and quality of life were identified and confirmed in this study. Attention should be drawn to prevention schemes as many of these determinants appear to be at least partly modifiable.

Correlations of Accelerometer-Measured Physical Activity with Body Image and Quality of Life among Young and Older Adults: A Pilot Study

Significant evidence suggests that regular physical activity (PA) is correlated with numerous psychological benefits in adults such as improving body image and quality of life. However, this issue has not been differentiated between young and older adults. In addition, most previous studies used a self-reported questionnaire for measuring PA, the objectivity of which is limited in several ways. Hence, by using accelerometer technology for monitoring PA, this study was designed to examine the correlations of PA with body image and quality of life in young and older adults. In this cross-sectional study, we used objective actigraphy and survey data from 147 young and older adults, including 77 young and 70 older adults from Tehran, Iran. To examine our variables and hypothesis, the following instruments were implemented: the Persian version of the Multidimensional Body-Self Relations Questionnaire (MBSRQ), the Persian version of the Quality-of-Life Questionnaire (WHOQOL-BREF), and the ActiGraph wGT3X-BT for measuring PA. An independent t-test and a multivariate regression analysis were used to analyze the data. The weekly PA of both young and older adults was found to be lower than the recommended amount. Young adults engaged in significantly more weekly PA than older adults. For young adults, PA (including MPA, VPA, and MVPA) was generally found to be significantly correlated with body image and quality of life. For older adults, however, we found only significant correlations between VPA and quality of life. These findings indicated that PA is a critical concern in adults, particularly older adults. Accordingly, it is necessary to adopt appropriate strategies to promote an active lifestyle among adults.

Assessing Quality of Life with Community Dwelling Elderly Adults: A Mass Survey in Taiwan

BACKGROUND

With the growing life expectancy for older adults, this study aims to examine the correlation among sociodemographic characteristics and the combined effect of QoL-related domains including physical health, psychological health, social relationships, and environmental factors with the overall QoL level of older adults in Taiwan.

METHODS

The WHOQOL-BREF Taiwanese Version questionnaire was adopted and conducted using a randomized telephone interview system from community household elders. In total, 1078 participants aged 65 years and older were recruited. A multiple regression model was used to examine the statistical significance between the overall QoL score as the dependent variable and the sociodemographic characteristics, and 26 items of QoL-related questionnaires as the independent variables.

RESULTS

Categories including female, aged 85 years and above, higher education level, and better financial situation had significantly higher overall QoL level. Except the physical health domain and six items, the correlations among all other domains and their including items of questionnaires with overall QoL level were significant.

CONCLUSION

The Taiwanese WHOQOL-BREF questionnaire can be used to examine the overall QoL level of elders in Taiwan. Nevertheless, the robust systems of universal health care and long-term care in Taiwan may have led to the no significance of the six items.

Association between lower serum vitamin D (25-hydroxy-cholecalciferol) concentrations and cognitive impairment in older adults: data from a populational-based cohort study in a middle-income country

OBJECTIVE

To investigate the association between serum vitamin D (25-hydroxy-cholecalciferol) (25(OH)D) concentrations and cognitive impairment in older adults living in Southern Brazil.

DESIGN

Cross-sectional analysis using data from the second follow-up wave of the populational-based EpiFloripa Aging Cohort Study was collected in 2013-2014.

SETTING

Cognitive impairment was evaluated using the Mini-Mental State Examination (MMSE). Blood samples were collected to measure serum vitamin D concentrations using a chemiluminescent microparticle immunoassay. Vitamin D concentrations were distributed in quartiles (Q1: 4·0-20·7 ng/ml; Q2: 20·8-26·6 ng/ml; Q3: 26·7-32·0 ng/ml and Q4: 32·1-60·1 ng/ml), and its association with cognitive impairment was tested by crude and adjusted logistic regression (sociodemographic, behavioural and health aspects) using Q4 as a reference group.

PARTICIPANTS

200 men and 371 women aged 60 years or older participated in this study.

RESULTS

The prevalence of probable cognitive impairment was 21·7 %. Those without cognitive impairment had a higher mean of vitamin D serum concentrations (26·8 v. 24·6, P = 0·014). In the crude analysis, only individuals in Q2 of vitamin D presented an increased risk for probable cognitive impairment compared with Q4 (highest quartile) (OR 2·65, 95 % CI 1·46, 4·81), remaining significant in the adjusted analysis (OR 6·04, 95 % CI 2·78, 13·13). While Q1 (lowest quartile) was not associated in the crude analysis, but when adjusted, an increased risk of cognitive impairment was observed.

CONCLUSION

The lowest quartile of vitamin D was directly associated with probable cognitive impairment in older adults in Southern Brazil. More studies are needed to investigate whether maintaining adequate serum levels may represent a significant factor in preventing age-related neurological disorders as well as to verify the need for new cutoff points for this age group.

Aging and Family Relationships among Aymara, Mapuche and Non-Indigenous People: Exploring How Social Support, Family Functioning, and Self-Perceived Health Are Related to Quality of Life

Family relationships play a central role in wellbeing among older adults in Chile. Based on the theory of social production functions, this study examined the relationship between perceived social support from children, partners and relatives, family functioning, self-perceived health and quality of life (QoL) among Chilean older adults. The study used a multi-ethnic sample of Chilean older adults living in rural areas in the regions of Arica and Parinacota (north) and Araucanía (south). A model was analyzed that emphasizes relationships differentiated by the source of support, family functioning and self-perceived health in the explanation of QoL. The results obtained from the structural equation modelling (SEM) analysis showed the existence of indirect relationships of social support from children, partners and other family members via family functioning, while self-perceived health was directly associated with QoL. The findings indicate that family functioning is a main variable in the contrasted model, in addition to confirming the importance of distinguishing the role of the various sources of support. Research is needed to examine in detail intergenerational relationships and other relationships with family members who are significant in the wellbeing of older adults. This research corroborates that family relationships have a specificity that needs to be addressed in gerontological social intervention, as well as continuing along the lines of strengthening or improving existing family ties (more quality) over the quantity of social relationships.

Development of Elderly Life Quality Database in Thailand with a Correlation Feature Analysis

Understanding the context of the elderly is very important for determining guidelines that improve their quality of life. One problem in Thailand, in this context, is that each organization involved in caring for the elderly has its own separate data collection, resulting in mismatches that negatively affect government agencies in their monitoring. This study proposes the development of a central database for elderly care and includes a study of factors affecting their quality of life. The proposed system can be used to collect data, manage data, perform data analysis with multiple linear regression, and display results via a web application in visualizations of many forms, such as graphs, charts, and spatial data. In addition, our system would replace paper forms and increase efficiency in work, as well as in storage and processing. In an observational case study, we include 240 elderly in village areas 5, 6, 7, and 8, in the Makham Tia subdistrict, Muang district, Surat Thani province, Thailand. Data were analyzed with multiple linear regression to predict the level of quality of life by using other indicators in the data gathered. This model uses only 14 factors of the available 39. Moreover, this model has an accuracy of 86.55%, R-squared = 69.11%, p-Value < 2.2×10−16, and Kappa = 0.7994 at 95% confidence. These results can make subsequent data collection more comfortable and faster as the number of questions is reduced, while revealing with good confidence the level of quality of life of the elderly. In addition, the system has a central database that is useful for elderly care organizations in the community, in support of planning and policy setting for elderly care.

Quality of Life and Community Wellbeing of Members Associated With Village Savings and Loans Associations as a Model of Sharing Economy in the Least Developing Countries: A Case of Mzuzu City in Northern Malawi, Southern Africa

This study was aimed at examining the impacts of the Sharing economy on the individual and community Quality of Life (QOL) and wellbeing by looking at their associated influencing factors using Village Savings and Loans Associations as a model of sharing economy in Malawi. An online community-based cross-sectional study design was conducted from November 2020 through January 2021. In the survey, 402 Village Savings and Loans Associations (VSLAs) members from the Mzuzu City area participated, recruited using snowball and respondent-driven sampling techniques. The sample size was computed using a single population proportion using the Yamane formula. Descriptive statistics and ordinal logistic regression model techniques were also employed. Additionally, we used the Chi-Square test, two-way ANOVA, and Ordinal regression model to determine statistical associations between socioeconomic data and QOL and wellbeing variables with a 5% level of significance. On the aspect of community wellbeing, the findings of our study indicated that income (levels and disposal) provided members with options to live a better QOL and wellbeing within the community by either facilitating payment for better education, eating healthier foods, acquiring assets, etc. Further, the absence of discrimination provided a platform for voice, inclusion, and social trust, enhancing freedom of expression. We also found that education facilitated better earnings and knowledge of public health-related issues. As for the contribution to the sharing economy, our study has emphasized the role played by trust in enhancing sharing economy. We recommend and encourage people to join these VSLAs so as to improve their QOL and wellbeing. However, there is a need to replicate the study on a larger scale to validate our study findings for effective policy formulation and implementation geared to improving the overall quality of people's lives. Based on these findings, we further recommend that authorities reinstate programs like National Strategy for Financial Inclusion 2016-2020 and Savings and Loan Groups Best Practice Guidelines (SLG BPGs) 2016-2017 that could further enhance the future of VSLAs, which are vital for QOL and community wellbeing of the people in developing countries like Malawi.

Factors associated with anxiety and quality of life of the Wuhan populace during the COVID-19 pandemic

In December 2019, COVID-19 broke out in Wuhan, China, affecting the mental health and quality of life (QoL) of its inhabitants. This study aimed at investigating the factors associated with anxiety and QoL in the Wuhan populace during the COVID-19 pandemic. An online questionnaire survey was carried out during July 6-10, 2020. The questionnaire collected information on demography, anxiety, QoL, and social-environmental support. The main statistical methods included descriptive statistics, independent-samples t-test, one-way analysis of variance, and multivariate regression analysis. In total, 226 participants were recruited. The findings showed that females, elderly, middle-income, poor health status, shortage of medical supplies, and insufficient basic commodities were associated with anxiety significantly. Multiple regression analysis indicated that social-environmental support was significantly related to anxiety. Higher social-environmental support was significantly associated with a higher QoL. Our findings showed that the social-environmental support may reduce anxiety and improve the QoL for those living in an area heavily affected by the pandemic.

Positive self-perception of health among non-long-lived and long-lived older adults and associated factors

This work aimed to identify the prevalence of positive self-perceived health among non-long-lived and long-lived older adults and associated factors. This is a study with older adults in the Family Health Strategy of Montes Claros. The Brazilian Older Americans Resources and Services Multidimensional Function Assessment Questionnaire was used. Bivariate and multiple analyses were performed using Poisson Regression. A total of 1,750 older adults participated in the study, of which 1,420 were non-long-lived older adults, and 330 were long-lived older adults. Positive self-perception was reported among 71.9% of the non-long-lived older adults and 67.8% of the long-lived older adults. Among the non-long-lived, positive self-perceived health was associated with five years of schooling (PR=1.12); household income from two to less than three minimum wages (PR=1.13) and ≥three minimum wages (PR=1.12); preserved vision (PR=1.13); proper chewing (PR=1.16); preserved sleep (PR=1.23); absence of polypathologies (PR=1.29); absence of diabetes (PR=1.15); falls in the last year (PR=1.13); and physical activity (PR=1.11). Among the long-lived older adults, it was associated with the use of prosthesis, sleeping disorders, and polypathologies and physical activities. Positive self-perception of health is associated with social and health determinants.

Association of visual impairment with cognitive decline among older adults in Taiwan

This study investigated the association between visual impairment and cognitive decline among the elderly in Taiwan. The data were obtained from a government-sponsored, annual physical examination program for elderly citizens ≥ 65 years in Taipei City during 2005-2012. Distance presenting visual acuity was measured using the Snellen chart. Visual impairment was classified into low vision and blindness. The Short Portable Mental Status Questionnaire (SPMSQ) was selected to measure cognitive decline. The confounding factors including age, sex, sociodemographic factors: living status, marital status, education level, health behaviors: smoking, alcohol consumption, betel nut chewing, and physical comorbidities: BMI, hypertension, diabetes, cholesterol and triglyceride were collected for analysis. We recruited 105,208 participants and 4542 (4.3%) have abnormal SPMSQ. The abnormal SPMSQ had significantly higher prevalence of low vision (44.52% vs 18.79%) and blindness (8.89% vs 0.93%) compared with normal SPMSQ. The hazard ratios of abnormal SPMSQ in low vision and blindness were 2.34 (95% CI 2.17-2.52), and 5.13 (95% CI 4.50-5.85), after adjustment for confounders. In conclusion, visual impairment was independently and significantly associated with greater incident cognitive decline among elderly Asian people. Prevention of visual impairment may help to reduce the incidence of cognitive decline in the aged Asian population.

Quality of life and health status of hospitalized adults with congenital heart disease in Vietnam: a cross-sectional study

BACKGROUND

Little is known about the quality of life (QOL) and health status of adults with congenital heart disease (CHD) in developing countries. Therefore, this study aimed to describe the QOL and health status of hospitalized adults with CHD in Vietnam and investigate the association between QOL and their biological-social characteristics.

METHODS

A cross-sectional study was conducted with 109 adults with CHD, hospitalized in the Vietnam National Heart Institute, between June and December 2019. Validated instruments to assess QOL and health status describing patient-reported outcomes were used, including the EuroQOL-5 Dimensions-5 Level, Satisfaction with Life Scale, and Hospital Anxiety and Depression Scale.

RESULTS

The mean scores on the EuroQOL-descriptive system (EQ-DS) and EuroQOL visual analogue scale (EQ-VAS) were 0.792 (SD = 0.122, 95% confidence interval [CI] 0.769-0.815) and 66.3 (SD = 12.5, 95% CI 63.9-68.7), respectively. A total of 9.2% (n = 9) patients experienced life dissatisfaction. The prevalence of anxiety and depression were 18.7% (n = 20) and 11% (n = 12), respectively. Scores of QOL in patients aged > 30 years were lower than in those aged ≤ 30 years. Stratified multivariate logistic regression revealed that poor QOL related to being unemployed/unstable employment (OR 4.43, 95% CI 1.71-11.47, p = 0.002), life dissatisfaction associated with unmarried status (OR 4.63, 95% CI 1.2-17.86, p = 0.026), anxiety regarding unemployment/unstable employment (OR 3.88, 95% CI 1.27-11.84, p = 0.017) and complex CHD/PAH (OR 4.84, 95% CI 1.33-17.54, p = 0.016), and depression regarding unemployment/unstable employment (OR 4.63, 95% CI 1.22-17.59, p = 0.003).

CONCLUSIONS

Reduced QOL and elevated psychological problems were common experiences among hospitalized adults with CHD in Vietnam. Biological-social characteristics such as unmarried status, unemployment/unstable employment, and complex CHD/PAH related to poor QOL, life dissatisfaction, anxiety, and depression.

Gender differences in the association between physical activity and health-related quality of life among community-dwelling elders

BACKGROUND

Physical activity can improve health-related quality of life (HRQoL) in older adults. However, the differential effects of gender on quality of life are unclear.

AIMS

To determine the association between physical activity and HRQoL in men and women.

METHODS

This was a cross-sectional study conducted from March to August 2011. Community-dwelling older people aged 65 years or older were eligible. Physical activity in kcal per week was measured with the International Physical Activity Questionnaire (IPAQ)-Taiwan version. HRQoL was measured with the 36-Item Short Form Survey (SF-36) questionnaire. Cognitive function and depression were assessed using the Mini-Mental State Examination (MMSE) and Patient Health Questionnaire-9 (PHQ-9). The relationship between physical activity and HRQoL in men and women was investigated by a multiple linear regression model.

RESULTS

A total of 188 older people (M: 50.5%) participated in this study. The mean ages of men and women were 71.9 ± 5.3 and 77.1 ± 6.4 years, respectively (p < 0.001). Older women had higher physical activity levels than men (4786.1 ± 1065.6 vs 4422.2 ± 1114.3 kcal/week, p = 0.023). After adjusting for covariates, multiple linear regression analysis showed that older men with higher physical activity levels had better scores on both the physical component summary (PCS) (p = 0.031) and mental component summary (MCS) (p = 0.007) than men with lower levels. Furthermore, older men with higher moderate-vigorous physical activity levels had better scores on the PCS than older men with lower activity levels, and older men with higher walking physical activity levels had better scores on the MCS than older men with lower activity levels.

CONCLUSIONS

In this study, older women were more physically active than older men. However, older men (but not older women) with higher physical activity had better HRQoL. The association between physical activity and HRQoL differed between men and women.

The contribution of social participation to differences in life expectancy and healthy years among the older population: A comparison between Chile, Costa Rica and Spain

We study the health trajectories of the population aged over 60, comparing between one European and two Latin American countries (Spain, Chile and Costa Rica) which have similar longevity patterns. Our focus is on functional limitation and mortality risks, considering differences by gender, education and social participation. Data come from national panel surveys (EPS, CRELES, SHARE). Multistate modelling is used to estimate transition probabilities between two health states: healthy to unhealthy, unhealthy to healthy as well as the transition to death from healthy or unhealthy states, to estimate the duration of stay in a specific state (computing healthy and unhealthy life expectancies) and the effect of the selected covariates. Results show that older Costa Ricans have the smallest gender gap in life expectancy but women have a lower healthy life expectancy compared to those in Chile and Spain. Participation in social activities leads to higher healthy life expectancy among the elderly in Costa Rica and Spain, whilst there were no relevant educational differences observed in longevity in the analysed countries. To conclude: despite the different patterns observed in health transitions and survival across the three countries, social participation is associated with greater health and longevity among people of old age, with little effect coming from educational attainment. Public policies should therefore be aimed at reducing unhealthy life years and dependency at advanced ages by promoting more engagement in social activities, especially among vulnerable groups who are more likely to experience impairment from a younger age.

Quality of life and associated factors amongst older adults in a remote community, Nepal

Purpose

The purpose of the study is to assess the quality of life (QOL) of older adults and explore factors associated with it.

Design/methodology/approach

A cross-sectional study was conducted in a remote community in Nepal. A total of 671 older adults aged 60 years were enrolled in the study. QOL was measured by WHOQOL-OLD questionnaire. Data were analyzed using multiple logistic regression.

Findings

Most participants were female (53.0%), illiterate (70.6%), married (64.2%) and living with family (59.3%). Among participants, 82.4% had fair QOL, and the autonomy domain received the lowest score (average = 10.98). After adjusting the model, the elderly aged <70 years had 11.07 times better QOL (aOR = 11.070; 95% CI = 2.546–48.123), elderly with high sufficient income had 2.73 times better QOL (aOR = 2.738; 95% CI = 1.183–6.337) and elderly free from depression had 9.45 times better QOL (aOR = 9.452; 95% CI = 3.466–25.773) compared to their counterparts. The elderly receiving social support had 9.97 times better QOL than those who did not (aOR = 9.976; 95% CI = 3.152–31.574), and those able to afford healthcare services had 4.69 times better QOL than those who could not afford it (aOR = 4.694; 95% CI = 1.046–21.063).

Originality/value

The five predictors – age, income sufficiency, depression, social support and healthcare service affordability – were found to significantly affect QOL. This study suggests special care strategies for vulnerable older adults addressing the issues that affect geriatric depression. This article provides relevant information to the government to consider increment of income, encourage family and community for social support and make health services affordable for older adults.

Perceived Physical Functioning and Gait Speed as Mediators in the Association Between Fear of Falling and Quality of Life in Old Age

Preserving Quality of Life (QoL) in old age gains in importance, but Fear of Falling (FoF) considerably limits QoL. The aim of our study was to understand how physical mediators may translate FoF to QoL. At Time 1, FoF, subjective leg strength, balance, QoL, and objective gait speed were assessed. QoL was reassessed after 6 months, at Time 2 (n = 125). A sequential mediation analysis examined whether the relationship between FoF and QoL could be mediated by leg strength, balance, and gait speed. FoF was directly associated with QoL (β = -.27; 95% CI [-0.007, -0.001]) as well as indirectly via leg strength, balance, and gait speed (specific sequential indirect effect: β = -.03; 95% CI [-0.06, -0.001]; R² = .40 in QoL; controlled for age, QoL at Time 1). An intervention approach could be to address FoF and foster physical functioning and gait speed to maintain QoL.

Social Capital and Its Predictive Role in Quality of Life among the Elderly Referring to Health Centers in Tabriz, Iran: A Community- Based Study

Introduction: Paying attention to the quality of life (QOL) in the elderly life is an important issue, given the criticality of this period. The Objective of the present study is to determine social capital and its predictive role on QOL among elderly people living in Tabriz, East- Azerbaijan province, Iran. Methods: The present cross-sectional study was accomplished in 2018 on 522 elderly people referred to the health centers in city of Tabriz. A multi-stage random cluster sampling was implemented. The data were collected, using a demographical questionnaire, Onyx-Bullen social capital, and WHOQOL-BREF QOL questionnaires. Then, they were analyzed by SPSS software version 15 and descriptive (frequency, percentage, mean (SD) and inferential statistics (Pearson, and Multivariate linear regression) were provided. Results: The mean age of the participants was 65.7 years, 58% were women, 85.5% were married, and 37.5% were illiterate. The mean )SD (of social capital score was 71.87 (10.51) (in the range of 36-144) and for QOL, it was 64.64 (10.81) (in the range of 0-100). Social capital had positive and direct relation with QOL. Out of all the variables studied; marital status, education, economic status, health status, the absence of cardiovascular diseases (CVDs), and joint pains had significant relation with QOL. By some modifications in context factors, social capital was considered to be a predictive factor for QOL [β (95%CI): 0.28 to 0.36)]. Conclusion: For the promotion of QOL among the elderly, certain strategies must be implemented by health policy makers to enhance social capital among elderly people.

Social isolation undermines quality of life in older adults

OBJECTIVE

Several studies have documented associations between social isolation and poor physical health or well-being. However, little is known of the importance of social support among older adults on specific topics about their quality of life. The purpose of the present study was to determine the relationship between social isolation and quality of life among older adults.

DESIGN

A cross-sectional study.

SETTING

Mexico City.

PARTICIPANTS

1,252 subjects aged ≥ 60 years living at home.

MEASUREMENTS

We used the Abbreviated Version of the Lubben Social Network Scale (LSNS-6) to assess social isolation and the World Health Organization Quality of Life Instrument-Older Adults Module (WHOQOL-Old) to assess quality of life. Socio-demographic and health factors were collected through face-to-face interviews. A series of linear regression analyses were used to investigate relationship between social isolation and quality of life. The statistical models were controlled for socio-demographic and health factors.

RESULTS

A total of 750 women (60%) and 502 men (40%) participated in the study. According to their LSNS-6 scores, 426 participants (34.0%) were classified into the highest group of isolation (range 0-10 points). Older adults with higher scores of social isolation exhibited lower quality of life. Regression analyses indicated that social isolation correlated with lower levels of global quality of life, autonomy, intimacy, and past, present, and future activities.

CONCLUSIONS

Coping with life from a socially isolated situation entails serious difficulties concerning quality of life. Interventions that foster environments where older adults can forge social bonds might improve their quality of life.

Depression and quality of life in old age: a closer look

Depressive disorders are among the most widespread mental disorders in old age, with negative consequences for quality of life (QOL). Understanding QOL as a multidimensional construct, in this article we have a closer look on what specific aspects are affected by depression. We used a representative sample of the German population (n = 805) and one of individuals diagnosed with depression (n = 106) to compare QOL using the WHOQOL-BREF and the WHOQOL-OLD. Multivariate analysis showed that individuals diagnosed with depression exhibited lower QOL with regard to WHOQOL-BREF-dimensions physical health, psychological, social relationships and global QOL and with regard to WHOQOL-OLD-facets sensory abilities, past, present, and future activities and social participation. In addition, in the regression analysis, there were no significant differences between individuals with and without depression with regard to environment (WHOQOL-BREF), autonomy, death and dying, intimacy and overall (WHOQOL-OLD). Associations between depression and QOL in older age are selective in terms of which aspects of QOL are affected. From a methodological perspective, a multidimensional approach to QOL is recommended. From a clinical perspective, our research highlights those areas of QOL that are relevant for health professionals working with older people and that could be the focus of interventions.

Health-related quality of life among community-dwelling people aged 80 years and over: a cross-sectional study in France

Background

The proportion of people living to a very old age is continuously increasing. One of the possibilities explored in policies and services to meet this health and societal challenge is to encourage the very old to continue living at home. This initiative is in line with the wishes of most elderly people. However, owing to the great changes that occur during old age attention should be paid to health-related quality of life (HRQoL). The aims of this study were to assess HRQoL in French community-dwelling people aged 80 years and over and to investigate the sociodemographic and health characteristics and life events associated with HRQoL.

Methods

A cross-sectional study was conducted in France to assess the HRQoL of people aged 80 years or more living at home. All people recruited were sent a letter explaining the aim of the study and requesting their consent to take part. Those who accepted then received a series of sociodemographic and medical questionnaires, a questionnaire concerning life events of the previous 12 months and the LEIPAD questionnaire, which assesses HRQoL in elderly people.

Results

The data of 184 participants (54.9% female) with a mean age of 83.9 years (almost 40% older than 85 years), were analysed. Low scores, indicating better HRQoL, were obtained on the ‘Self-Care’ and ‘Depression and Anxiety’ scales with 50.9 and 40.8% of responders, respectively, having the minimum score of zero. The highest score was found on the ‘Sexual Functioning’ scale, with 59.1% of participants having the maximum score of 100. Elderly females declared a significantly less satisfactory HRQoL. Deteriorating health, an unsatisfactory environment, not being able to drive, perceived modest income and financial worries negatively affected HRQoL.

Conclusion

Identifying factors in our study that are potential determinants of HRQoL would be of direct benefit for individuals. Concrete public policy initiatives concerning means of transport, living environment and financial resources could then be implemented to improve the HRQoL of very old community-dwelling individuals.

Women's Quality of Life in Iran: A Mixed Method Study

Background:

Quality of life drives from the individuals' perceptions of their position in life long and allows holistic assessment of the effects of health conditions beyond the symptoms, signs, and complications. This study aimed to assess the quality of life and recognize females' point of view about the quality of life aspects. Hence, perhaps it could be a step toward improving women's health status.

Materials and Methods:

This study was an explanatory mixed method research one which was conducted in the two following steps. In the quantitative step, five hundred women aged 15–49 years were selected from varied zone of Tehran Province, using cluster random sampling method. In order to assess the quality of life, Short Form SF-36 instrument was used. In the qualitative step, forty women were selected by purposive sampling in a different range of quality of life based on the result of the first step. Data were collected through semistructured, in-depth individual interviews, which continued up to data saturation point. Data analysis was performed through conventional content analysis.

Results:

Among different aspects of quality of life, the highest and the lowest means (SD) were related to physical functioning mean (SD) 70.58 (24.52) and general health 67.72 (27.66), and mental health 55.27 (30.22) and social functioning 57.02 (30.62), respectively. From the interviews, three main themes were extracted as the following: (i) financial support, (ii) informational support, and (iii) service-based social support.

Conclusions:

The present study revealed that Tehranian women do not have high experience related to the quality of life; however, a sense of receiving support from different sources could help them to wrestle with a complicated condition in everyday life.

Quality of life and its association with psychiatric symptoms and socio-demographic characteristics among people with schizophrenia: A hospital-based cross-sectional study

OBJECTIVES

To identify sociodemographic and illness-related factors associated with quality of life among people with Schizophrenia.

METHODS

A hospital-based cross-sectional study design was employed among 351 people with schizophrenia and attending the followup service at Jimma University Medical Center, psychiatric clinic during the study period. Participants were recruited using a systematic random sampling method and a sample fraction of two was used after the first person was identified by a lottery method. Data entry was done using EpiData version 3.1 and then exported to Statistical Package for Social Sciences version 25 for analysis. Multiple regression analysis was used to determine the statistically significant association between quality of life and independent variables.

RESULTS

Among the four domains of quality of life, respondents scored the lowest mean in the social relationships domain (10.14 ± 3.12). Final adjusted multiple regression model revealed, being divorced was negatively associated with the physical domain (β = -0.72, p = 0.02), having no formal education was negatively associated with physical health domain (β = -0.69, p = 0.001) and age was positively associated with the psychological domain (β = 0.371, p = 0.071). Being rural resident was negatively associated with physical domain (β = -0.48, p = 0.01), with environmental domain (β = -0.64, p = 0.03), with social relationships domain (β = -0.45, p = 0.04), and with overall quality of life (β = -1.93, p = 0.006). Positive symptoms (β = -0.22, p = 0.001), negative symptoms (β = -0.36, p = 0.001), and general psychopathology (β = -0.098, p = 0.006) were inversely associated with overall quality of life.

CONCLUSION

In this study, the social relationship domain of quality of life among people with schizophrenia has the lowest mean score. Some socio-demographic variables and psychiatric symptoms were found to be key significant associated factors of quality of life. Priority interventions to improve the social deficits and addressing psychiatric symptoms of people with schizophrenia is essential to improve their quality of life.

The Association Between the Changes in General, Family, and Financial Aspects of Quality of Life and Their Effects on Cognitive Function in an Elderly Population: The Korean Longitudinal Study of Aging, 2008-2016

Background The growing aging population is a global phenomenon and a major public health challenge. Among Organization for Economic Co-operation and Development countries, Korea is the fastest aging country. We aimed to investigate the relationship between changes in quality of life (QOL) and cognitive function in older adults. Method: Data from the Korean Longitudinal Study of Aging collected from 2008 to 2016 were used. In 3453 participants (men: 1943; women: 1541), QOL was measured by three aspects: general, financial, and familial. Changes in QOL status were assessed by four categories: remained poor, worsened, improved, and remained good. The level of cognitive function was measured by the Mini-Mental State Examination score (MMSE, normal range cut-off value: 24 or above). For the statistical analysis, the generalized equation model (GEE) was performed. Results: For all three aspects of QOL measured, participants whose QOL score remained poor were associated with cognitive decline that their odds ratios (OR) were statistically significant (general: OR = 1.33; familial: OR = 1.39; financial: OR = 1.40). For subgroup analysis by gender, the highest OR in men was the financial aspect of QOL (OR = 1.45); in women, the highest OR was the familial aspect of QOL (OR = 1.75). Conclusion: This study showed an association between QOL and cognitive function in a Korean elderly population. Our findings suggest that QOL measurements with a gender-specific approach can be used as a tool to detect cognitive changes in older adults and help prevent or delay cognitive decline.

Factors That Influence the Relationship Between Social Support and Health-Related Quality of Life of Older People Living in the Community

As the proportion of older people in Greece grows and the need for promoting healthy aging is apparent, it becomes increasingly important to investigate the relationship between social support and health-related quality of life (HRQoL) of older people in the community. A cross-sectional study was conducted in 451 older people living in the community in greater Athens, Greece, with an anonymous questionnaire, including demographics, and the EQ5D including EuroQol-visual analogue scale (EQ-VAS) and the Multidimensional Scale of Perceived Social Support. Multivariate linear regression analysis was applied to identify independent factors related to perceived social support and HRQoL. The majority of older people were women, married or widowed, living with their family or alone. Perceived social support was medium and higher from significant others and family. A statistically significant positive relationship was found between social support from significant others/friends and HRQoL, as well as between social support from friends/family/significant others and EQ-VAS. In conclusion, HRQoL of older people is influenced by the received social support.

The Effect of Treatment during A Haze/Post-Haze Year on Subsequent Respiratory Morbidity Status among Successful Treatment Tuberculosis Cases

The purpose of this study was to evaluate the respiratory morbidity status within the two to three years among successful (completed/cured) treatment of tuberculosis cases during a haze year (2015) and a post-haze year (2016). The study was conducted among 133 cases of a 2015 group and 103 cases of a 2016 group between January to March 2018 in Pekanbaru city, Indonesia. The St George Respiratory Questionnaire (SGRQ) was used to assess respiratory morbidity status. A higher score corresponds to worse respiratory morbidity. Based on a directed acyclic graph, quantile regression models were constructed to assess the associations between haze/post-haze year and the SGRQ (symptom, activity, impact, and total) domains score. The subsequent respiratory morbidity status of tuberculosis (TB) cases was poorer among respondents treated during a haze year (2015). Among SGRQ domains, only the activity domain score showed significant difference, in which the median for the 2015 group was 23.7 (inter-quartile range (IQR); 17.2, 30.9) compared to 18.4 (IQR; 11.9, 24.8) for the 2016 group. The effect was limited to the 2015 group who were exposed by an average PM₁₀ index ≥ 55 during TB treatment. This raises concern for monitoring and improving the quality of life of TB patients treated during a haze year.

Therapeutic Approaches for the Management of Sleep Disorders in Geriatric Population

OBJECTIVE

Aging is a natural biological phenomenon that occurs in human beings. With increasing of age, there is an appearance of deleterious changes related to progression onto pathological conditions, including hypertension, heart disease, diabetes, hearing and vision impairments, as well as sleep disorders. It is important to recognize that some sleep disturbances reported by aged subjects include insomnia, obstructive sleep apnea, restless legs syndrome, among others. Moreover, accumulating evidence indicates that coexistence of medical issues with sleep disorders constitutes clinical challenges for treatment of comorbidities in elderly. Here, we have attempted to review and summarize the available literature that assesses the sleep disturbances in aging. In addition, we highlight the management of sleep disorders associated with aging. Due to the particular health condition of aged adults, the development of effective pharmacological interventions for sleep disorders treatment in aging is warranted.

METHODS

Review of studies retrieved from the PubMed.

RESULTS

The sleep-wake cycle includes abnormalities classified as sleep disorders. Comorbidity between sleep disturbances and aging-related health issues will represent a public health challenge to be addressed in the near future. Moreover, this scenario will suggest an area that requires further drug investigation and design of new pharmacological and pharmaceutical strategies to treat sleep disorders in the elderly population.

CONCLUSION

The review highlights the sleep disturbances in aging. We focus on current knowledge in medicinal chemistry and further design of new treatments tools for managing sleep disturbances in the aged population.

Subjective integration and quality of life of Sub-Saharan African migrants in Germany

OBJECTIVE

This article presents empirical evidence on the quality of life (QoL) of Sub-Saharan African (SSA) migrants in Germany, exploring its association with subjective integration and the influence of some socio-economic and sociodemographic characteristics.

STUDY DESIGN

This is a cross-sectional study design using quantitative data from 518 SSA migrants collected across the 16 federal states of Germany, and these data were analysed in this study.

METHODS

Association between participants' QoL, measured by the four domains of the Bref version of the World Health Organisation QoL measure, subjective integration and sociodemographic characteristics were evaluated using Pearson product-moment correlations. Stepwise multiple linear regressions were performed to explore the contribution of predictor variables on the QoL domain.

RESULTS

Participants' age averaged 32.5 years (standard deviation [SD] 7.93). The sample reported a low QoL score with a mean score of 64.3 (SD 14.4, range 70.2). Multiple linear regression analyses revealed that subjective integration, age, education and gender had significant associations and explained up to 27% of the variance in the QoL domain scores.

CONCLUSION

The findings of this study support the conclusion that subjective integration positively and significantly associates with the physical health, psychological health, social relationships and environmental domains of SSA migrants' QoL in Germany.

Quality of life reported by survivors after hospitalization for Middle East respiratory syndrome (MERS)

INTRODUCTION

Data are lacking on impact of Middle East Respiratory Syndrome (MERS) on health-related quality of life (HRQoL) among survivors.

METHODS

We conducted a cross-sectional survey of MERS survivors who required hospitalization in Saudi Arabia during 2016-2017, approximately 1 year after diagnosis. The Short-Form General Health Survey 36 (SF-36) was administered by telephone interview to assess 8 quality of life domains for MERS survivors and a sample of survivors of severe acute respiratory infection (SARI) without MERS. We compared mean SF-36 scores of MERS and non-MERS SARI survivors using independent t-test, and compared categorical variables using chi-square test. Adjusted analyses were performed using multiple linear regression.

RESULTS

Of 355 MERS survivors, 83 were eligible and 78 agreed to participate. MERS survivors were younger than non-MERS SARI survivors (mean ± SD): (44.9 years ±12.9) vs (50.0 years ±13.6), p = 0.031. Intensive care unit (ICU) admissions were similar for MERS and non-MERS SARI survivors (46.2% vs. 57.1%), p = 0.20. After adjusting for potential confounders, there were no significant differences between MERS and non-MERS SARI survivors in physical component or mental component summary scores. MERS ICU survivors scored lower than MERS survivors not admitted to an ICU for physical function (p = 0.05), general health (p = 0.01), vitality (p = 0.03), emotional role (p = 0.03) and physical component summary (p < 0.02).

CONCLUSIONS

Functional scores were similar for MERS and non-MERS SARI survivors. However, MERS survivors of critical illness reported lower quality of life than survivors of less severe illness. Efforts are needed to address the long-term medical and psychological needs of MERS survivors.

Association between health behaviors and mood disorders among the elderly: a community-based cohort study

BACKGROUND

According to a WHO report, nearly 15% of adults aged 60 and over suffer from a mental disorder, constituting 6.6% of the total disability for this age group. Taipei City faces rapid transformation towards an aging society, with the proportion of elderly in the total population rising from 12% in 2008 to 16% in 2016. The aim of this study is to identify the prevalence of mental disorders among the elderly in Taipei City and to elucidate risk factors contributing to mental disorders.

METHODS

The elderly health examination database was obtained from the Department of Health, Taipei City government, from 2005 to 2012. A total of 86,061 people underwent publicly funded health examinations, with 348,067 visits. Each year, there are around 43,000 elderly persons in Taipei City using this service. We used a mental health questionnaire including five questions to estimated relative risks among potential risk factors with the generalized estimating equations (GEE) model to measure the mental health status of the elderly. Mood disorders were measured with the Brief Symptom Rating Scale (BSRS-5) questionnaire. Age, education level, gender, marital status, living alone, drinking milk, eating vegetables and fruits, long-term medication, smoking status, frequency of alcohol consumption, frequency of physical activity, BMI, and number of chronic diseases were included as covariates.

RESULTS

The results show that being male (odds ratio (OR) 0.57; 95% CI = 0.56, 0.59), higher education (OR 0.88; 95% CI = 0.82, 0.95), no long-term medication (OR 0.57; 95% CI = 0.56, 0.58), and exercising three or more times per week (OR 0.94; 95% CI = 0.91, 0.98) were all positively correlated with better emotional status. However, being divorced (OR = 1.22, 95% CI = 1.09, 1.36), not drinking milk (OR = 1.12, 95% CI = 1.09, 1.14), not eating enough vegetables and fruits every day (OR = 1.78, 95% CI = 1.73, 1.83), daily smoking (OR = 1.15, 95% CI = 1.01, 1.32), and having more chronic diseases (OR = 1.02, 95% CI = 1.01, 1.03) were all correlated with poor mental status among the elderly.

CONCLUSIONS

The findings of this research can both estimate the prevalence of mood disorders at the community level, and identify risk factors of mood disorders at the personal level.

Associations of exercise, nutritional status, and smoking with cognitive decline among older adults in Taiwan: Results of a longitudinal population-based study

This study aimed to explore the long-term effects of exercise, smoking, and nutritional status on cognitive reserve and changes in cognitive function among Taiwanese adults aged ≥65 years. Data were obtained from the Taiwan Longitudinal Study of Aging, a national representative population-based cohort study. Results showed that the average baseline scores on the Short Portable Mental Status Questionnaire (SPMSQ) and Mini-Nutritional Assessment (MNA) were 9.07 and 26.01, respectively. The proportions of smoking and exercising at baseline were 24.12% and 58.67%, respectively. A linear regression analysis indicated that old adults who were current and consistent exercisers had better subsequent 4-year SPMSQ scores than those who were not exercisers (P < 0.05). The MNA score was positively associated with subsequent 4- and 8-year SPMSQ scores for the 65-74-year-old adults (P <  0.05). The logistic regression analysis showed that current and consistent exercise was negatively associated with subsequent 4-year cognitive decline (P < 0.05). Previous exercise experience was positively associated with subsequent 8-year cognitive decline for the ≥75-year-old adults (P < 0.05). The MNA score was negatively correlated with subsequent 4- and 8-year cognitive decline among the 65-74-year-old adults. Among the adults aged ≥75 years, consistent smoking was positively associated with cognitive decline over 4 years (P < 0.05). Therefore, current and consistent exercise and good nutritional status benefit cognitive function and reserve, and have protective effects on cognitive decline among old adults, whereas discontinued exercise, poor nutrition, and cigarette smoking are likely to raise the risk of cognitive decline.