Quality Of Life In Community-dwelling Older Adults Research Articles

Balance Confidence and Balance Performance, But Not Fall History Are Associated With Quality of Life in Community-Dwelling Older Adults: A Cross Sectional Study.

Fear of falling (FoF) is highly prevalent in community-dwelling older adults and is associated with low health-related quality of life (QoL). Low QoL is associated with increased health care utilization and is a predictor of future falls, but few studies have examined the relationship between high-level balance and dynamic gait performance and QoL in community-dwelling older adults. The purpose of this cross-sectional study was to determine whether there is a relationship between FoF avoidance behaviors, balance confidence, performance on measures of high-level mobility, and QoL in community-dwelling older adults. The secondary purpose was to determine whether older adults who fall have a different QoL than older adults who have not fallen in the past year. Eighty-nine community-dwelling older adults (76.33 ± 6.84 years, 54 female, 34 fallers) completed the World Health Organization Quality of Life-BREF (WHOQOL-BREF), Activities-specific Balance Confidence Scale (ABC), Fear of Falling Avoidance Behavior Questionnaire (FFABQ), Functional Gait Assessment (FGA), and Community Balance and Mobility Scale (CB&M). Correlation and multiple regression analyses were calculated to determine the relationship between the outcome measures and domains on the WHOQOL-BREF. Significant correlations were observed between the WHOQOL-BREF physical health domain and the ABC, FFABQ, FGA, and CB&M (ρ= 0.524, -0.509, 0.348, and r = 0.423, respectively), the WHOQOL-BREF psychological domain and the ABC (ρ= 0.284) and FFABQ (ρ=-0.384), and the WHOQOL-BREF environment domain and the ABC (ρ= 0.343) and FFABQ (ρ=-0.406). No correlations were found between WHOQOL-BREF domain scores and a history of falls. Performance-based outcome measures that measure high-level mobility such as the CB&M and FGA, and patient-reported outcome measures for balance confidence and FoF avoidance behavior such as the ABC and FFABQ, are correlated with the physical health QoL domain on the WHOQOL-BREF. The ABC and FFABQ are correlated with psychological and environment QoL. Fall history was not correlated with QoL. Interventions to decrease FoF or improve high-level mobility may improve QoL in community-dwelling older adults.

Association Between Physical Activity and Osteoarthritis of Knee with Quality of Life in Community-Dwelling Older Adults.

Older adults are relatively physically active compared to other age group. A lack of physical activity (PA) can cause chronic diseases including osteoarthritis of knee (OA knee) and might eventually reduce quality of life (QOL). This present study was aimed to investigate association between levels of PA and OA knee with levels of QOL in community-dwelling older adults. One thousand and sixty-seven community-dwelling older persons were recruited to this descriptive study. PA activity questionnaire was invented. Standardized Oxford knee score and World Health Organization's Quality of Life scale (WHOQOL-BREF) were used to measure OA knee and QOL levels. Results showed that levels of PA in older adults were significantly associated with levels of OKS (χ2 = 78.565, P-value < .001) and levels of OA knee in older adults were significantly associated with levels of overall QOL (χ2 = 57.738, P-value < .001). Pearson's correlation also showed interrelation among PA, OA knee, and QOL. In conclusion, PA, OA knee, and QOL are interrelated. Therefore, close monitoring and design of proper PA activity should be implemented in community-dwelling older adults with OA knee.

The Prevalence of Depressive and Insomnia Symptoms, and Their Association With Quality of Life Among Older Adults in Rural Areas in China.

Background: There are few studies on the epidemiology of depression, insomnia, and their association with quality of life (QOL) in older adults living in rural China. This study examined the prevalence of depressive and insomnia symptoms, and their association with QOL in community-dwelling older adults in a rural area in Anhui province, China.Methods: This was a cross-sectional study conducted in the rural areas of four cities (Hefei, Huaibei, Anqing, and Xuancheng) in Anhui province between July and October, 2019 using random sampling method. All community-dwelling residents from the selected villages who met the study entry criteria were invited to participate in this study. Depressive and insomnia symptoms and QOL were assessed with the Chinese version of self-reported Center for Epidemiological Survey Depression Scale (CES-D), the Insomnia Severity Index (ISI) and the 26-item World Health Organization Quality of Life Brief version (WHOQOL-BREF), respectively.Results: A total of 871 older adults were included. The prevalence of overall depressive symptoms, insomnia symptoms, and comorbid depressive and insomnia symptoms were 34.0% [95% confidence intervals (95% CI): 30.8–37.1%], 45.7% (95% CI: 42.4–49.0%) and 20.3% (95% CI: 17.6–23.0%), respectively. Older adults with depressive symptoms, insomnia symptoms, and comorbid depressive and insomnia symptoms had lower scores in QOL compared to those without. Depressive symptoms were positively associated with living with families [Odd Ratio (OR) = 1.82, 95% CI: 1.31–2.54] and negatively associated with current drinking (OR = 0.49, 95% CI: 0.33–0.72). Insomnia symptoms were negatively associated with fair and good financial status (fair: OR = 0.53, 95% CI = 0.38–0.75; good: OR = 0.30, 95% CI = 0.14–0.64) and current drinking (OR = 0.64, 95% CI = 0.45–0.93), and positively associated with more frequent major medical conditions (OR = 1.32, 95% CI = 1.16–1.51). Comorbid depressive and insomnia symptoms were positively associated with living with families (OR = 2.02, 95% CI = 1.36–3.00), and negatively associated with fair and good financial status (fair: OR = 0.61, 95% CI = 0.41–0.89; good: OR = 0.34, 95% CI = 0.12–0.95) and current drinking (OR = 0.57, 95% CI = 0.35–0.92).Conclusion: Depressive and insomnia symptoms were common in older adults living in rural areas in China. Considering the negative health outcomes caused by depressive and insomnia symptoms, regular screening and effective treatments should be developed for this population.

Health-Related Quality of Life in Community-Dwelling Older People with Cognitive Impairment: EQ-5D-3L Measurement Properties

Assessing quality of life (QoL) in older people with cognitive impairment is a challenge. There is no consensus on the best tool, but a short, user-friendly scale is advised. This study aimed to assess the psychometric properties of the self-reported and generic EQ-5D (including the EQ index and EQ visual analog scale [VAS]) in community-dwelling older adults with cognitive impairment. Cross-sectional study analyzing the feasibility, acceptability, reliability, and validity of the EQ-5D based on 188 self-administered questionnaires in a sample of community-dwelling older adults with Mini-Mental State Examination (MMSE) scores of 10 to 24 points. The EQ index was 0.69 (±0.27) and the EQ VAS was 63.8 (±28.54). Adequate measurement properties were found in acceptability and feasibility. Cronbach's alpha was 0.69. Good validity was observed in the correlation of each dimension of the EQ-5D with geriatric assessment scales. Higher validity was observed for the EQ index compared to the EQ VAS. The EQ-5D scale could be a good tool for assessing health-related QoL in community-dwelling older adults with cognitive impairment, though it is necessary to assess the dimensions and the EQ index.

Social support as a mediator between depression and quality of life in Chinese community-dwelling older adults with chronic disease

The older adults with chronic disease usually show poor mental health and experience low quality of life (QOL). This study aimed to examine the mediating role of social support in the relationship between depression and QOL in community-dwelling older adults with chronic disease. A total of 387 Chinese older adults aged 60 or above with chronic disease were included in this cross-sectional study. Social support was negatively associated with depression and positively associated with physical component scale (PCS) and mental component scale (MCS). Depression and social support were all predictors of PCS and MCS. Mediation analysis suggested that social support partially mediated the impact of depression on PCS and MCS. Understanding the mediating role of social support might be beneficial in reducing the adverse impact of depression on QOL in community-dwelling older adults with chronic disease.

Day care centre attendance and quality of life in depressed older adults living in the community.

Late-life depression is associated with disabled functioning and a poor quality of life (QOL). The aim of this cross-sectional study was to find out whether the attendance of a day care centre (DC) was associated with QOL in community-dwelling older adults suffering from a depressive disorder without dementia. The study enrolled 149 depressed older adults aged 70 or older, who consecutively underwent a comprehensive geriatric assessment from April to July 2008 at the Geriatric Medicine Unit of the Fondazione Ospedale Maggiore Policlinico in Milan, Italy. QOL was evaluated by means of the European Quality of Life Visual Analogue Scale (EuroQol VAS). DC attendance was quantified as number of days of attendance per week in the past month. Participants attending a DC at least once a week (n=17) had a higher mean EuroQol VAS score than non-attendants (n=132) (mean±SD 58.8±19 vs. 45.3±22.5; P=0.019). In multiple linear regression analysis a higher weekly attendance of DCs was related to a better quality of life according to the EuroQol VAS score (unstandardized coefficient 3.048, 95% CI 0.063-6.033, P=0.045) after correction for age, sex, balance and gait abilities, comorbidity, pharmacotherapy, living alone, and severity of depression. Therefore, in older outpatients suffering from a depressive disorder without dementia the attendance of a DC was an independent correlate of the QOL. A randomized controlled longitudinal study will be necessary to determine whether attending a DC is really effective on the QOL in the management of late-life depression.