Predictors of Quality of Life among Older Residents in Rural and Urban Areas in Indonesia: An Approach Using the International Classification of Functioning, Disability, and Health.

Abstract

The International Classification of Functioning, Disability, and Health (ICF) model provides a comprehensive framework for understanding health and quality of life (QoL) in older adults in both rural and urban settings, each presenting unique advantages and challenges. This study aimed to explore the relationship between factors based on the ICF model and QoL among older residents of these areas. A cross-sectional study was conducted, involving 286 older adults aged 60 years or older from rural and urban areas of Surakarta, Central Java, Indonesia. The WHOQoL-BREF was utilized to assess QoL. The co-factors included personal factors, impairments, and activity limitations. Multiple linear regression analysis indicated that lower limb muscle strength was the most significant factor associated with QoL in older adults in rural areas (B=0.681, standard error [SE]=0.301, p=0.026), followed by static balance (B=0.085, SE=0.034, p=0.014). In urban areas, gender emerged as the most significant factor influencing QoL (B=-13.643, SE=2.499, p<0.001), followed by hemoglobin level (B=-1.847, SE=0.760, p=0.017), age (B=-0.935, SE=0.246, p<0.001), and cognitive function (B=0.493, SE=0.179, p=0.007). Efforts to improve QoL for older adults in rural areas should focus on enhance physical performance through exercise. In urban areas, the maintenance of QoL is influenced by personal factors. It is crucial to address physical performance through exercise to enhance QoL in rural settings. Meanwhile, focusing on mental health, financial security, and social connections is recommended to improve QoL for older adults in urban areas.