Table 4.
Association of active aging determinants and quality of life.
| References | Scale for QOL | QoL determinants | Results |
|---|---|---|---|
| López-Ortega and Konigsberg (22) | SF-36 | Personal factors, behavioral determinants, determinants of social environment | Measure: β-coefficient [95% CI] Physical functioning (P < 0.01), Vitality (P < 0.001) •Marital status: Widowed (compared to single and married) •Physical functioning p < 0.05, role limitations owing to physical-health problems p < 0.01, role limitations because of emotional problems p < 0.01, vitality p < 0.05, energy and fatigue, mental-health (psychological distress and emotional wellbeing) p < 0.05, social functioning p < 0.01, bodily pain p < 0.05 •Financial status: Poor (compared to good and fair financial status) •p < 0.05 in physical functioning, role limitations because of physical health problems, role limitations owing to emotional problems, vitality, energy and fatigue, mental health comprising of psychological distress and emotional wellbeing, social functioning, bodily pain, and general health perception •Concerning living arrangements and social support, the number of contacts with family members and close friends affected only physical function (p < 0.01), vitality (p < 0. 05), mental health (psychological distress and emotional wellbeing) p < 0.01, and social functioning p < 0.01 •Chronic diseases consistently had lower scores in all SF-36 dimensions, although only physical functioning (p < 0.05) and vitality (p < 0.01) had significant statistical differences •Household members living with the respondent and occupation did not affect the 8 domains of the SF-36. •Except for the general health domain (p < 0.01), the presence of chronic diseases did not affect estimated models on HRQoL domains. |
| Liu et al. (23) | SF-36 | Personal factors, behavioral determinants, determinants of social environment | •The mental component summary (MCS) encircles the domains of Mental health, role limitations because of emotional problems, social functioning, as well as vitality. •In contrast, the physical component summary (PCS) encompasses a general perception of health, bodily pain, role limitations owing to physical problems, and physical functioning. •Older adults (married/widowed individuals) had significantly greater MCS and PCS scores compared to the never-married or divorced (P < 0.05). •Lower MCS scores were found among those who had < 5 h of sleep/day (P < 0.05) and those having a medical history of gastrointestinal disease (P < 0.001), urinary tract disease (P < 0.001), cancer (P < 0.05), or previous history of fractures (P < 0.001). •Hypertensive participants showed significantly lower PCS scores compared to non-hypertensive ones (P < 0.001). •Multivariable analysis results confirmed the descriptive comparisons, besides sleep time, which become non-significant. Unmarried or divorced participants had significantly lower PCS (P < 0.01) and MCS scores (P < 0.001). •History of chronic diseases such as gastrointestinal disease (P < 0.001), cancer (P < 0.05), urinary tract disease (P < 0.001), and previous history of fractures (P < 0.001) were associated with lower MCS scores. Only Hypertension was associated with lower PCS scores (P < 0.001). •No lifestyle factors (such as smoking) were associated with lower HRQoL on multivariable analysis. |
| Levasseur et al. (24) | The Satisfaction with Life Scale (SWLS) | Personal factors, behavioral determinants, determinants of social environment, determinants of physical environment | •There was no significant difference between the associations of SWLS with accomplishment level and satisfaction with social participation (Olkin's test: P = 0.71). In addition, the accomplishment level of social participation was not significant (P = 0.08) considering satisfaction with social participation (P = 0.02). •Younger age, no higher activity level, recent stressing event, level of activity perceived as stable, better wellbeing, and fewer obstacles in “Physical environment and accessibility” best explained higher social participation accomplishment level (R2 = 0.79; P < 0.001) •Apart from environmental factors, little variance (< 40%) was explained by each block in satisfaction with social participation compared to the accomplishment level of social participation. Better self-perceived health, level of activity perceived as stable, higher activity level, better wellbeing, and more facilitators in “Social support and attitudes” best explained greater satisfaction with social participation (R2 = 0.51; P < 0.001) |
| Puvill et al. (25) | CASP-12 | Personal factors, behavioral determinants, determinants of social environment | •Approximately 0.17% and 0.33% of the variance in life satisfaction was attributed to ADL and IADL disability, respectively (both p < 0.001). •The impact of (I)ADL disabilities on life satisfaction was heaviest at age 50, which then decreased gradually with increasing age (p-trend < 0.001). Mental health accounted for more variance for depressive symptoms (5.75%) and loneliness (2.50%), but less variance for social resources (0.09% to 0.47%), all p < 0.001. |
| Ramia and Voicu (7) | WHQOL-BREF | Personal factors, behavioral determinants, determinants of social environment, determinants of health and social services, determinants of the physical environment, economic determinants | •The psychological domain had the least QOL score (mean ± SD: 36.7 ± 20), where more than 28% of older women had “very poor” QOL and 50.6% had moderately poor QOL. Physical- and health-related QOL had the highest mean score (49.5 ± 22), followed by environmental domain (47.38 ± 17) and social domain (43.7 ± 18), where 16.2, 16.2, and 14.4% of older women had “very poor” QOL, respectively. •Risk factors for poor QoL included absence of visits by friends and relatives (COR = 6.1, 95% CI: 1.69–21), age above 70 years (COR = 4.33, 95% CI: 2.21–8.48), neglecting attitude from family members (COR = 4.99, 2.44–10.19), and not having any role in family decisions (COR = 4.2, 95% CI: 1.83–9.56). In addition, low educational level, current and previous unemployment, and low personal and family monthly income were also risk factors, while living in urban areas was a protective factor. •Adjusted models showed age above 70 years (AOR = 11.3), non-possession of property (AOR = 9.0), neglecting attitude of family (AOR = 6.9), and absence of visit by friends and relatives AOR = 9.9) as risk factors, but urban residence, still, as a protective factor (AOR = 0.1) for poor QOL. |
| Abdelbasset et al. (26) | EQ-5D- VAS | Personal factors, behavioral determinants, determinants of social environment | •The psychological domain had the least QOL score (mean ± SD:36.7 ± 20), where more than 28% of older women had “very poor” QOL and 50.6% had moderately poor QOL. Physical- and health-related QOL had the highest mean score (49.5 ± 22), followed by environmental domain (47.38 ± 17) and social domain (43.7 ± 18), where 16.2, 16.2, and 14.4% of older women had “very poor” QOL, respectively. •Risk factors for poor QoL included absence of visits by friends and relatives (COR = 6.1, 95% CI: 1.69–21), age above 70 years (COR = 4.33, 95% CI: 2.21–8.48), neglecting attitude from family members (COR = 4.99, 2.44–10.19), and not having any role in family decisions (COR = 4.2, 95% CI: 1.83–9.56). In addition, low educational level, current and previous unemployment, and low personal and family monthly income were also risk factors, while living in urban areas was a protective factor. •Adjusted models showed that age above 70 years (AOR = 11.30, P < 0.001), non-possession of property (AOR = 9.0, P < 0.001), neglecting attitude by family members (AOR = 6.9, P < 0.001), and absence of visit by friends and relatives (AOR = 9.9, P < 0.001) were risk factors, while urban residence, still, a significant protective factor (AOR = 0.10, P < 0.001). |
| Dahlberg and McKee (29) | WHO-5 (wellbeing) | Personal factors, behavioral determinants, determinants of social environment, determinants of health and social services, determinants of physical environment, economic determinants | •Neighborhood exclusion accounted for more variance in wellbeing domain in rural compared to urban areas, while exclusion from services accounted for more variance in urban compared to rural areas. •Social exclusion domain: bivariate associations (beta coefficient) among social indicators Civic activity 1. Civic non-engagement: −0.09 2. Non-voting behavior: −0.12 3. Low competence for civic participation: −0.21 Material resources 1. Income discomfort: −0.20 2. Non-homeownership: −0.11 3. Low financial resources: −0.13 Social relations 1. Non-cohabitation: −0.08 2. Low contact with friends: −0.18 3. Low social resources: −0.34 Services 1. Poor access to care: −0.24 2. Poor access to amenities: −0.38 3. Poor public transport: −0.18 Neighborhood exclusion 1. Neighborhood alienation: −0.26 2. Neighborhood threat: 0.02 3. Neighborhood indifference: −0.12 There was no significant association between residence area (rural/urban) and age, gender, and years at the current address. |
| Neri et al. (28) | CASP-19 | Personal factors, behavioral determinants, determinants of social environment | •Perceived QoL was associated with age, mobility, schooling, sociability, instrumental, and emotional support •Participation in social activities (proximal levels); No = 27.6%, Yes = 28.1%, and PR (95% CI): 1.07 (0.87–1.34) Participation in social activities (intermediate level); No = 28.2%, Yes = 27.9%, PR (95% CI): 1.06 (0.94–1.18) •Participation in social activities (distal level); No = 27.0%, Yes = 28.9%, PR (95% CI): 1.11 (1.01–1.22) |
| Kim et al. (27) | SF 12 | Personal factors, behavioral determinants, determinants of social environment | •Lower PCS scores were associated with older age (OR = 0.97, 95%CI: 0.94–1.00), having more social support from significant others (OR = 0.88, 95% CI: 0.79–0.97), and having an income level of (300,000–390,000 KRW) (OR = 0.68, 95%CI: 0.47–0.99). •Good MCS scores were associated with living alone for over 20 years (OR = 0.63, 95%CI: 0.45–0.89), performing moderate physical activity (OR = 1.61, 95%CI: 1.08–2.38), and receiving social support from significant others (OR = 1.20, 95%CI: 1.08–1.34) and friends (OR = 1.19, 95%CI: 1.07–1.33). •On controlling for significant demographic variables, social support from significant others had a significant association with a lower PCS score (OR = 0.88, 95%CI: 0.79–0.98). However, social support from significant others (OR = 1.18, 95%CI: 1.05–1.33) and friends (OR = 1.16, 95%CI: 1.03–1.30) has a significant association with higher MCS scores. |
| Zhang et al. (30) | SF 36; WHQOL-OLD | Personal factors, behavioral determinants, determinants of social environment, determinants of health and social services, determinants of physical environment, economic determinants | •Regarding the physical component of the older participants' HRQOL, exercise, and labor-related factors accounted for the most change in the R2 value (0.116) •While concerning the mental component, sleep-related (0.054) and leisure-time-activity-related factors (0.053) accounted for the most change in the R2 value. •Regarding the older adults-specific HRQOL, the leisure-time-activity-related factors caused the biggest change in the R2 value (0.119), then exercise-and-labor-related factors (0.078). |
| He et al. (31) | SF-36 | Personal factors, behavioral determinants, determinants of social environment | •Participating in social activities was associated with higher scores of health-related QoL. High educational level (OR = 1.59, 95%CI: 1.01–2.29), living alone or with a spouse (OR = 1.51, 95%CI: 1.08–2.12), high support utilization (OR = 1.13, 95%CI: 1.07–1.21), and high objective social support (OR = 1.08, 95%CI: 1.00–1.17) were associated with more social participation among older men. For the older women, high personal income (OR = 1.74, 95%CI: 1.25–2.43), single marital status (OR = 1.53, 95%CI: 1.11–2.10), overweight (OR = 2.28, 95%CI 1.24–4.19), normal weight (OR = 1.92, 95%CI: 1.10–3.34), living alone or with a spouse (OR = 1.55, 95%CI: 1.20–2.00), subjective (OR = 1.15, 95%CI: 1.10–1.20), and objective (OR = 1.11, 95%CI: 1.04–1.18) social support and were associated with more social participation. |
| Ju et al. (32) | VAS | Personal factors, behavioral determinants, determinants of social environment, economic determinants | •Participants who did not receive a national pension had a QoL of −4.40 (SE = 1.73; P = 0.0109), compared to those who had received one. •Moreover, those without a national pension and a low household income had the most significant decrease in QoL (−10.42; SE = 4.53; P = 0.0214). •Participants without national pensions and low wealth levels had a considerable decrease in QoL than those with a national pension and low wealth levels (−8.34; SE = 4.14; P = 0.0438). |
| Choi et al. (33) | VAS | Personal factors, behavioral determinants, determinants of social environment | •Individuals with changes from “participation to no participation” (b =2.25, P < 0.001), “no participation to participation” (b =3.35, P < 0.001), and “consistent participation” (b = 6.62, P < 0.001) were more likely to be satisfied with their lives compared to those with “consistent non-participation” (trend: P < 0.001). Furthermore, the impact of the positive relationship between consistent participation in social activity and quality of life changed across various aspects of social activity. •Religious activities, leisure/culture clubs, friendship organizations, family/school reunions, and voluntary work particularly had positive associations with consistent participation. |
| Rugbeer et al. (34) | SF 36 | Personal factors, behavioral determinants, determinants of social environment | •A significant difference was found in social function post-training 2 times a week and 3 times a week. •Training three times a week showed an additional benefit in vitality. Improvements in the mental component summary scale post-training two times a week and three times a week were further noted. |
| Onunkwor et al. (35) | WHOQOL-BREF | Personal factors, behavioral determinants, determinants of social environment, determinants of health and social services, determinants of physical environment, economic determinants | •Gender had significant associations with all domains of QoL (p[[Inline Image]] < [[Inline Image]]0.05), and age was significantly associated with only the physical domain (p = 0.01). •The educational level had a significant association with the physical, psychological, and social domains (all p=0.01). Economic status had a significant association with the physical, psychological, and social domains (all p[[Inline Image]] < [[Inline Image]]0.05). •Duration of residence had a significant association with the psychological, social, and environment domains (all p=0.01). •Type of accommodation had a significant association with the psychological, social, and environment domains (all p[[Inline Image]] < 0.05). •Outdoor leisure activity, social support, and chronic co-morbidity had significant associations with all QoL domains (p ≤ 0.05). •Multivariable models showed that age, gender, economic status, outdoor leisure activity, chronic co-morbidities, and social support had a significant association with the physical QoL domain •The psychological domain had a significant association with gender, educational level, economic status, chronic co-morbidities, outdoor leisure activity, and social support. •The social domain had a significant association with gender, education level, duration of residence, outdoor leisure activity, chronic co-morbidities, and social support. Only chronic co-morbidities and social support had a significant association with the environment domain. |
| Haider et al. (36) | WHQOL-BREF | Personal factors, behavioral determinants, determinants of social environment | •Appendicular skeletal muscle mass (ASMM) had no role in the QoL context of prefrail and frail older adults, but balance and Daily Physical Activity had a role, as they had an association with social participation and autonomy. •Model 1: Daily physical activity, handgrip strength, and balance had significant associations with “overall QoL”. Balance was significantly associated with the QoL domains of physical health, psychological health, autonomy, environment, and social participation. Gait speed and chair stands were only associated with “social participation” only. •In model 2, independent variables explained overall QoL (R2 = 0.32), physical health (R2 = 0.20), autonomy (R2 = 0.247), and social participation (R2 = 0.356), and in which balance was the strongest determinant. |
| Marques et al. (37) | CASP-16 | Personal factors, behavioral determinants, determinants of social environment | •Overall QoL mean score was 37.6% (95%CI: 37.2–38.1). •Older people with no probable cognitive deficit had higher QoL scores. •Individuals who remained living alone, continued to use the internet, began to work, and began to join groups also had higher QoL scores. QoL mean score of those who remained and became physically active was 41.5 and 40.1%, respectively. •Older adults who continued living with the family reduced QoL by 1.98 points (95% CI: −3.47; −0.50) compared to those who remained alone. However, those who started and remained working had higher QoL, 2.30 (95% CI: 0.45–4.16) and 3.90 (95% CI: 2.36, 5.44), respectively. •Regarding the internet, continued use was associated with a higher QoL score compared to those who stopped using it. All aspects of physical activity have a positive association with QoL scores compared to those who remained less active. •On multivariable analysis, older adults who remained living with their family had reduced QoL scores at 3.33 points (95% CI: −5.06; −1.60) compared to those who lived alone. Older adults who started to work had a positive QoL score (β = 2.82, 95% CI: 1.42–4.22). •Those who continued using the internet had 2.11 more QoL score points (95% CI: 0.85–3.36) compared to those who never used it. •Older adults who began participating in groups had higher QoL scores by 1.68 points (95% CI: 0.19–3.17) compared to those who did not participate. Regarding physical activity, all aspects remained with significant association. Older adults who remained physically active had higher QoL scores (β = 4.47, 95% CI: 3.32–5.63) than those who remained less active. Those who were sufficiently active in the first wave, but became less active, still had higher scores than those who remained less active. •Sensitivity analysis revealed associations only among older adults who moved with their family or a caregiver and those who remained working. |
| Tavares et al. (38) | WHQOL-BREF, WHQOL-OLD | Determinants of social environment | •The highest QoL mean scores were found in the social relationships domain (71.19) and topic of death and dying (74.30), while the environment domain (60.39) and topic of social participation (63.06) had the lowest scores. •The average score for self-esteem was (9.36 ± 4.09). •Lower self-esteem was associated with significantly lower QoL scores in all the WHOQOL-BREF domains and WHOQOL-OLD aspects (except death and dying) (p < 0.001). |
| Top and Dikmetaş (39) | WHQOL-OLD | Personal factors, behavioral determinants, determinants of social environment | •There was a significant association between QoL and attitudes to the aging of older adults. •The psychological growth subscale of attitudes to aging and sensory abilities subscale of QoL (r = 0.579, P < 0.01) had the most significant relationship. Overall, QoL had a significant positive association with overall attitudes to aging (r = 0.408, P < 0.01). •Dimensions of attitudes to aging (psychosocial loss, physical change, and psychological growth) were significant determinants of QoL among older adults. •Although gender did not affect overall QOL among older adults, happiness was a significant predictor of overall QOL. |
| Park et al. (40) | EQ-5D | Personal factors, behavioral determinants, determinants of social environment, | •Average QoL increased with the increasing amount of social activities individuals participated in (zero = 89.30, one = 93.28, two = 95.25, three = 96.27, four = 96.85). When individuals participated in one social activity, social activity had the strongest association with EQ-5D in the older adults age group regardless of gender. Moreover, more participation had a positive association with higher EQ-5D (p for trend < 0.0001). Among women, participating in relationship organizations was associated with a higher EQ-5D compared to participating in other types of social activities |
| Bilgili and Arpaci (41) | WHQOL-OLD | Personal factors, behavioral determinants, determinants of social environment, determinants of health and social services, determinants of physical environment, economic determinants | •Older men showed higher average scores for the sub-scales of sensory abilities, social participation, autonomy, past-present-and-future activities, and death-and-dying. However, older women showed higher average scores for the intimacy sub-scales and total average scores. Gender showed significant differences in the mean scores of sub-scales of autonomy, past-present-and-future activities, and intimacy (all p < 0.01). •Married older adults showed higher scores in the sub-scales of autonomy, social participation, past-present-and-future activities, and death-and-dying. However, unmarried older adults showed higher scores in the sub-scales of intimacy and sensory abilities. A significant difference in marital status showed significant differences in the mean scores of sub-scales of past-present and future activities, social participation, and death-and-dying (t = −2.00; (all p < 0.05). Married older adults had significantly higher total scores of QoL than the unmarried, (p < 0.05). •Older adults having a child showed higher scores in the sub-scales of sensory abilities and death-and-dying, while those without a child showed higher scores in other sub-scales. Furthermore, older adults with social security showed higher scores in the sub-scales of autonomy, social participation, past-today-and-future activities, and death-and-dying (all p < 0.01). Older adults having social security showed significantly higher total scores (p < 0.01). •Those with diseases showed significantly higher scores in the sensory abilities sub-scale than those without diseases (p < 0.01). However, older adults without the disease showed higher scores in the sub-scales of autonomy, social participation, and past-today and future activities (all p < 0.01). There was a statistically significant difference in the average total score of QoL according to disease state (p < 0.01). •Age (75 years and above) showed significant differences only in sensory abilities, social participation, and intimacy sub-scales (all p < 0.01). Those of 75 years and above had lower scores in social participation and intimacy sub-scales but higher scores in sensory abilities compared to those aged 60–65 and 66–74 years. •Educational levels of older adults showed significant differences in sensory abilities, autonomy, social participation, past-present and future activities, and death-and-dying (all p < 0.05) sub-scales (high school with higher scores, except in sensory abilities). •The person whom the older adults lived with showed significant differences in the QOL sub-scales of sensory abilities, past-today and future activities, death-and-dying, social participation, and intimacy (all p < 0.05).•Income level also showed significant differences in the sub-scales of autonomy, intimacy, past-today and future activities, death-and-dying, and social participation (all p < 0.01). Additionally, the total average score of the QOL sub-scales of the older adults was associated with their income (p < 0.01), with those in much/extreme financial difficulties having lower scores except for intimacy sub-scale scores •Correlation analysis showed a significant positive association of age with sensory abilities, but a negative association between age and social participation and intimacy scores (all p < 0.01). Additionally, the total average QoL score was positively associated with education but negatively associated with financial difficulties |
| Sampaio et al. (42) | WHQOL-OLD, WHQOL-BREF | Behavioral determinants, determinants of social environment | •Physical activity (β=0.21, P < 0.01) had the highest influence on WHOQOL-BREF. This was followed by art activity (β = 0.17, P < 0.01) and reading and writing (β=0.14, P < 0.01). •Social activity (β=0.22, P < 0.01) showed the highest influence on WHOQOL-OLD and then reading and writing activity (β = 0.12, P < 0.05). |
| Layte et al. (43) | CASP-19 | Personal factors, behavioral determinants, determinants of social environment | •The average CASP-19 score was 43.8% (95% CI: 43.6–44.1) and was higher than the average score of the English Longitudinal Study of Aging, 42.5% (95%C1: 42.3–42.7). •Longevity was positively associated with high QoL provided it was accompanied by good levels of mental and physical health, social participation, and high-quality relationships. •Unadjusted analysis showed that CASP-19 was curvilinear with age, peaked at 67 years, and fell after that, while in the adjusted analysis, CASP-19 continued to rise, at a decreasing rate, with increasing age. •Variance in CASP-19 was largely attributed to mental health (7.6%) •Adjusting for variables in the mental health domain showed the lowest slope coefficient for the primary age term, which fell by 50% on adjusting for variables in all of the domains at once. There was a slight reduction in the positive slope coefficient of CASP-19 with age since the quadratic age term was significant and negative in all models |
| Sewo Sampaio and Ito (44) | WHQOL-OLD, WHQOL-BREF | Personal factors, behavioral determinants, determinants of social environment, determinants of physical environment | •Individuals living in urban areas showed higher total mean QoL scores compared to those in rural areas. •According to WHOQOL-BREF, those living in urban areas showed higher mean scores in the physical, psychological, and environmental domains (all P < 0.01) •Participants from urban areas also showed higher participation in reading and writing, contacts with distant friends and family, physical activities, and art activities compared to those from rural areas (all P < 0.01). However, those from rural areas were more engaged in work activities compared to their urban counterparts (p < 0.01). •There was a difference in essential activities in the occupational routine between urban and rural participants For the urban participants, the best model included work activity, physical activity, and reading and writing, while for the rural participants, art activity showed a relationship with QOL, other activities were not included. |
| Guedes et al. (45) | WHOQOL-OLD | Personal factors, determinants of social environment | •More physically active older adults (both genders) showed higher scores in the sensory ability, autonomy, and intimacy domains, as well as significantly higher overall QoL scores (all P < 0.05). •For women, those who were active and very active showed significantly higher scores in the social participation domain compared to sedentary women (p = 0.01), and the variation in scores also varied between genders. •Furthermore, significant differences were noted among men between those who were very active and sedentary, while among women, significant differences were noted between the active and the sedentary. |
| Gureje et al. (46) | WHQOL-BREF | Personal factors, behavioral determinants, determinants of social environment, economic determinants | •Economic status had a significant association with all four QoL domains. •Considering health variables, functional disability, and self-rated overall health were the most significant, while participation in community activities was the most significant social determinant |