Background HRQoL is an indicator of individuals’ perception of their overall health, including social and environmental aspects. As a multidimensional concept, HRQoL can be influenced by a multitude of factors. Studies of HRQoL and factors associated with it among home-dwelling older adults have often been limited to inpatient settings or to a sub-population with a chronic disease. Studying HRQoL and its correlating factors among this population, by providing an ecological lens on factors beyond the individual level, can provide a better understanding of the construct and the role of the environment on how they perceive their HRQoL. Thus, we aimed to assess the HRQoL and investigate the correlates of HRQOL among home-dwelling older adults, guided by the levels of the ecological model. Methods This is a cross-sectional population survey conducted in 2019 in Canton Basel-Landschaft, in northwestern Switzerland, and includes a sample of 8786 home-dwelling older adults aged 75 and above. We assessed HRQoL by using the EQ-index and the EQ-VAS. The influence of independent variables at the macro, meso and micro level on HRQoL was tested using Tobit multiple linear regression modelling. Results We found that having a better socio-economic status as denoted by higher income, having supplementary insurance and a higher level of education were all associated with a better HRQoL among home-dwelling older adults. Furthermore, being engaged in social activities was also related to an improved HRQoL. On the other hand, older age, female gender, presence of multimorbidity and polypharmacy as well as social isolation and loneliness were found to all have a negative impact on HRQoL. Conclusions Understanding factors related to HRQoL by using an ecological lens can help identify factors beyond the individual level that impact the HRQoL of home-dwelling older adults. Our study emphasises the importance of social determinants of health and potential disparities that exists, encouraging policymakers to focus on policies to reduce socio-economic disparities using a life-course approach, which consequently could also impact HRQoL in later stages of life.

Background Healthy ageing is a complex construct which involves multiple dimensions. Previous studies of healthy ageing have focused only on measuring the intrinsic capacity of the older person. The objectives of this study were to design a multidimensional model of healthy ageing and to identify its determinants from national data in Ecuador. Methods A cross-sectional analytical study was carried out from the National Survey of Health and Well-being of the Older Adult, 2010. Sample was 1797 adults aged 65 years or more. A multidimensional model was designed based on the World Health Organization’s concept of healthy ageing. For the analysis, two groups were created: a healthy ageing and a less healthy ageing group. Bivariate and multivariate logistic regressions were performed to analyze the probability of belonging to the healthy group according to sex, age, area of ​​residence, level of education, perceived health status, perceived life satisfaction, and poverty by income level. Results The 53.15% of the sample was classified in the healthy ageing group. Women and the poorest older adults were less likely to be in the healthy ageing group (OR 0.58; 95% CI 0.464–0.737; OR 0.44; 95% CI 0.343–0.564). Older adults with secondary education or higher, who considered their health as excellent and who were satisfied with their life, had a greater probability of being in healthy ageing group (OR 2.61; 95% CI 1.586–4.309; OR 28.49; 95% CI 3.623–224.02; OR 0.23; 95% CI 0.165–0.341). Conclusions This study contributes with a multidimensional approach to healthy ageing. It proposes to evaluate the intrinsic capacity of the individual, the social and political environment and the interaction with it, through indicators that discriminate who are ageing in a healthy way and who are not. By using this model, it was identified that gender and economic situation seem to play an important role on heathy ageing of the Ecuadorian population. Public policies are necessary to promote healthy ageing, especially focused on improving socioeconomic conditions and gender equity.

Background: Healthy ageing is a complex construct, which involves multiple dimensions. The objective of this study was to design a multidimensional model of healthy ageing and to identify its determinants from national data in Ecuador. Methods: A cross-sectional analytical study was carried out from the National Survey of Health and Well-being of the Older Adult, 2010. Sample was 1797 adults aged 65 years or more (sample expanded to 898,152). A multidimensional model was designed based on the domains involved in the concept of healthy ageing from the World Organization Health´s approach, and the environment dimension. For the analysis, two groups were created per bi-stage cluster: healthy ageing and less healthy ageing. The probability of belonging to the healthiest group was analyzed with bivariate and multivariate logit for complex samples.Results: The 53.15% of the sample was classified in the healthy ageing group. Women and the poorest older adults are less likely to be in the healthy ageing group (OR 0.58; CI 95% 0.464 - 0.737; OR 0.44; CI 95% 0.343 - 0.564). Older adults with secondary education or higher, who consider their health as excellent and who are satisfied with their life have a greater probability of being in healthy ageing (OR 2.61; 95% CI 1.586 - 4.309; OR 28.49; 95% CI 3.623 - 224.02; OR 0.23; 95% CI 0.165 - 0.341). Conclusions: The model of healthy ageing addresses multidimensional variables which are summarized in three components: the intrinsic capacity, referring to the physical and mental health, the social and political environment, and the interaction of the elderly with the environment. It was found that the poorest older adults and women are less likely to belong to the healthiest group. Healthy aging plans must focus on socioeconomic conditions and gender equity.