Influence of Social Determinants of Health on the Quality of Life of Older Adults in Europe: A Sex Analysis

Abstract

Introduction: The global aging population poses challenges for society such as health inequalities among older persons and between genders. Objectives: To determine how Social Determinants of Health (SDH) influence the quality of life (QoL) of individuals over 50 years old in various European countries, taking a gender perspective in a longitudinal study. Materials and methods: Sample of 11,493 individuals from 13 European countries from Waves 5 (2013), 6 (2015), and 7 (2017) of the SHARE study. Instruments: CASP-12 (QoL), EURO-D (depression), SDH: gender, age, educational level, socioeconomic status, ethnicity, place of residence, and European region. Sociodemographic and clinical variables. Statistical analysis: Bivariate and multivariate mixed linear models. Results: The bivariate analysis showed higher economic hardship and lower education in women compared to men. The CASP-12 score was higher in men than in women. In the multivariate analysis, the variables associated with lower QoL scores among men and women from Wave 5 to Wave 7 were: (β:-0.196, 95% CI: -0.345; -0.047) vs (β:0.038, 95% CI: -0.122; 0.197); economic hardship; and the European region between South and North (β: 2.709, 95% CI: 2.403; 3.015) vs men (β: 2.224, 95% CI: 1.896; 2.551). Conclusions: The main SDH associated with poorer QoL were female gender, advanced age, economic hardship, educational level, and geographic location within Europe. Depression in women and in Southern Europe were associated with a decrease in QoL scores.