Factors associated with health-related quality of life among home-dwelling older adults aged 75 or older in Switzerland: a cross-sectional study

Abstract

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.

Factors associated with health-related quality of life among community-dwelling older adults: the APPCARE study

“…Consistent with previous ndings, women were more likely than men to have reduced physical HRQOL (9,10,36). A possible explanation for differences in HRQOL by gender is rooted in the pattern of chronic conditions.…”

“…The results of this study con rm that HRQOL is in uenced by multiple factors, including sociodemographic characteristics, indicators of health and lifestyle factors (10). Longitudinal research is needed to comprehensively examine the (bi-) directional associations between determinants and HRQOL over time.…”

“…In contrast, higher age was associated with increased mental HRQOL in the multivariate regression model. This result was not reported in the literature (10). Gooding et al (45) suggest that older-old adults (≥ 80 years) have a better developed capacity for resilience, particularly regarding emotional regulation and problem solving, compared to younger-old adults (65-79 years) which could explain these ndings.…”

“…Interpretation and publication of these data can help to allocate resources based more e ciently and to monitor the effectiveness of community interventions (5). Previous studies have identi ed associations between HRQOL and sociodemographic factors, including gender and lower education (9,10). Furthermore, chronic conditions, frailty, low levels of physical activity, and lack of social support have been associated with poor self-reported HRQOL (10)(11)(12)(13).…”

“…Previous studies have identi ed associations between HRQOL and sociodemographic factors, including gender and lower education (9,10). Furthermore, chronic conditions, frailty, low levels of physical activity, and lack of social support have been associated with poor self-reported HRQOL (10)(11)(12)(13).…”