Skip to main content
SpringerLink
Log in

Predictors of quality of life in older people living at home and in institutions

  • Original Article
  • Published:
Aging Clinical and Experimental Research Aims and scope Submit manuscript

Abstract

Background and aims: Health-related quality of life (QOL) is considered to be the key goal for health promotion in older people. The aim of this study was to describe the correlates of QOL in home-dwelling and institutionalized elderly. Methods: One hundred and fifty-two elderly residents of long-term care homes and 160 community-dwelling elderly participated in the study. Assessment included demographic and social variables, health status, nutritional state, physical and cognitive function. Physical activity (PA) was assessed by two PA questionnaires: the Seven Day Recall PA Questionnaire and the Stanford Usual Activity Questionnaire. QOL was assessed with the Euroqol 5D questionnaire. Results: Depression was the most powerful predictor of QOL in both community-dwelling and institutionalized elderly. Complaints associated with the musculoskeletal system in community-dwelling elders and manifestations of atherosclerosis and cardiovascular diseases in institutionalized elders were the most important concomitant diseases. Regular participation in PA, preventing obesity and maintaining an adequate level of physical and cognitive function, contributed more to overall QOL in community-dwellers than in older and frailer institutionalized elderly adults. Conclusions: The relative contribution of functional and medical comorbidities, as well as health-promoting behaviors to QOL, may be different in community-dwelling and institutionalized elders. Physical and cognitive function deficits, overweight/obesity, and lack of regular PA are among primary predictors of decreased QOL in home-dwelling elders. In institutionalized subjects, these functional/behavioral data seem to be of lesser importance, the role of concomitant diseases becoming dominant.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Minicuci N, Noale M, Bardage C, et al. Cross-national determinants of quality of life from six longitudinal studies on aging: the CLESA project. Aging Clin Exp Res 2003; 15: 187–202.

    Article  PubMed  Google Scholar 

  2. Fletcher AE, Bulpitt CJ, Tuomilehto J, et al. Quality of life of elderly patients with isolated systolic hypertension: baseline date from the Syst-Eur Trial. J Hypertens 1998; 16: 1117–24.

    Article  PubMed  CAS  Google Scholar 

  3. Kahana E, Lawrence RH, Kahana B, et al. Long-term impact of preventive proactivity on quality of life of the old-old. Psychosom Med 2002; 64: 382–94.

    PubMed  Google Scholar 

  4. Stahle A, Mattsson E, Ryden L, Unden A, Nordlander R. Improved physical fitness and quality of life following training of elderly patients after acute coronary events. A 1 year follow-up randomized controlled study. Eur Heart J 1999; 20: 1475–84.

    CAS  Google Scholar 

  5. van Jaarsveld CH, Sanderman R, Miedema I, Ranchor AV, Kempen GI. Changes in health-related quality of life in older patients with acute myocardial infarction or congestive heart failure: a prospective study. J Am Geriatr Soc 2001; 49: 1052–8.

    Article  PubMed  Google Scholar 

  6. Drewnowski A, Evans WJ. Nutrition, physical activity, and quality of life in older adults: summary. J Gerontol 2001; 56 Spec No 2: 89–94.

    Google Scholar 

  7. McCall WV, Cohen W, Reboussin B, Lawton P. Effects of mood and age on quality of life in depressed inpatients. J Affect Disord 1999; 55: 107–14.

    Article  PubMed  CAS  Google Scholar 

  8. Ormel J, Rijsdijk FV, Sullivan M, van Sonderen E, Kempen GI. Temporal and reciprocal relationship between IADL/ADL disability and depressive symptoms in late life. J Gerontol 2002; 57: 338–47.

    Google Scholar 

  9. King AC, Pruitt LA, Phillips W, Oka R, Rodenburg A, Haskell WL. Comparative effects of two physical activity programs on measured and perceived physical functioning and other health-related quality of life outcomes in older adults. J Gerontol 2000; 55A: M74–83.

    Google Scholar 

  10. Cress ME, Schechtman KB, Mulrow CD, Fiatarone MA, Gerety MB, Buchner DM. Relationship between physical performance and self-perceived physical function. J Am Geriatr Soc 1995; 43: 93–101.

    PubMed  CAS  Google Scholar 

  11. Rejeski WJ, Mihalko SL. Physical activity and quality of life in older adults. J Gerontol 2001; 56 Spec No 2: 23–35.

    Google Scholar 

  12. Guigoz Y, Vellas B, Garry PJ. Mini-Nutritional Assessment: a practical assessment tool for grading the nutritional state of elderly patients. Facts and Research in Gerontology 1994; 2: 15–59.

    Google Scholar 

  13. Folstein MF, Folstein SE, McHugh PR. “Mini-Mental State”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12: 189–98.

    Article  PubMed  CAS  Google Scholar 

  14. Yesavage JA, Brink T, Lom O. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 1983; 17: 37–49.

    Article  CAS  Google Scholar 

  15. Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of illness in the aged: The index of ADL, a standardized measure of biogical and psychosocial function. JAMA 1963; 185: 914–9.

    Article  PubMed  CAS  Google Scholar 

  16. Lawton M, Brody E. Instrumental Activities of Daily Living (IADL) Scale: original observer-rated version. Psychopharmacol Bull 1988; 24: 785–92.

    Google Scholar 

  17. Blair SN, Haskell WL, Ho P, et al. Assessment of habitual physical activity by a seven-day recall in a community survey and controlled experiments. Am J Epidemiol 1985; 122: 794–804.

    PubMed  CAS  Google Scholar 

  18. Sallis J, Haskell W, Wood P. Physical activity assessment methodology in the Five-City Project. Am J Epidemiol 1985; 121: 91-106.

    PubMed  CAS  Google Scholar 

  19. Bonnefoy M, Normand S, Pachiaudi C, Lacour JR, Laville M, Kostka T. Simultaneous validation of ten physical activity questionnaires in older men: a doubly labeled water study. J Am Geriatr Soc 2001; 49: 28–35.

    Article  PubMed  CAS  Google Scholar 

  20. Kind P, Dolan P, Gudex C, Williams A. Variations in population health status: results from a United Kingdom national questionnaire survey. BMJ 1998; 316: 736–41.

    Article  PubMed  CAS  Google Scholar 

  21. Burstrom K, Johannesson M, Diderichsen F. Swedish population health-related quality of life results using the EQ-5D. Qual Life Res 2001; 10: 621–35.

    Article  PubMed  CAS  Google Scholar 

  22. Tidermark J, Zethraeus N, Svensson O, Tornkvist H, Ponzer S. Femoral neck fractures in the elderly: functional outcome and quality of life according to EuroQol. Qual Life Res 2002; 11: 473–81.

    Article  PubMed  Google Scholar 

  23. Coucill W, Bryan S, Bentham P, Buckley A, Laight A. EQ-5D in patients with dementia: an investigation of inter-rater agreement. Med Care 2001; 39: 760–71.

    Article  PubMed  CAS  Google Scholar 

  24. Bourdel-Marchasson I, Dubroca B, Manciet G, Decamps A, Emeriau JP, Dartigues JF. Prevalence of diabetes and effect on quality of life in older French living in the community: the PAQUID Epidemiological Survey. J Am Geriatr Soc 1997; 45: 295–301.

    PubMed  CAS  Google Scholar 

  25. Redekop WK, Koopmanschap MA, Stolk RP, Rutten GE, Wolf-fenbuttel BH, Niessen LW. Health-related quality of life and treatment satisfaction in Dutch patients with type 2 diabetes. Diabetes Care 2002; 25: 458–63.

    Article  PubMed  Google Scholar 

  26. Parkatti T, Deeg DJ, Bosscher RJ, Launer LL. Physical activity and self-rated health among 55- to 89-year-old Dutch people. J Aging Health 1998; 10: 311–26.

    Article  PubMed  CAS  Google Scholar 

  27. Ruuskanen JM, Ruoppila I. Physical activity and psychological well-being among people aged 65 to 84 years. Age Ageing 1995; 24: 292–6.

    Article  PubMed  CAS  Google Scholar 

  28. Hilleras PK, Jorm AF, Herlitz A, Winblad B. Activity patterns in very old people: a survey of cognitively intact subjects aged 90 years or older. Age Ageing 1999; 28: 147–52.

    Article  PubMed  CAS  Google Scholar 

  29. Capodaglio P, Facioli M, Burroni E, Giordano A, Ferri A, Scaglioni G. Effectiveness of a home-based strengthening program for elderly males in Italy. A preliminary study. Aging Clin Exp Res 2002; 14: 28–34.

    Article  CAS  Google Scholar 

  30. Damush TM, Damush JGJ. The effects of strength training on strength and health-related quality of life in older adult women. Gerontologist 1999; 39: 705–10.

    Article  PubMed  CAS  Google Scholar 

  31. MacRae PG, Asplund LA, Schnelle JF, Ouslander JG, Abrahamse A, Morris C. A walking program for nursing home residents: effects on walk endurance, physical activity, mobility, and quality of life. J Am Geriatr Soc 1996; 44: 175–80.

    PubMed  CAS  Google Scholar 

  32. Bonnefoy M, Jauffret M, Kostka T, Jusot JF. Usefulness of calf circumference measurement in assessing the nutritional state of hospitalized elderly people. Gerontology 2002; 48: 162–9.

    Article  PubMed  CAS  Google Scholar 

  33. Magri F, Borza A, del Vecchio S, et al. Nutritional assessment of demented patients: a descriptive study. Aging Clin Exp Res 2003; 15: 148–53.

    Article  PubMed  Google Scholar 

  34. Dominick KL, Ahern FM, Gold CH, Heller DA. Relationship of health-related quality of life to health care utilization and mortality among older adults. Aging Clin Exp Res 2002; 14: 499–508.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Preventive Medicine, Medical University, WHO Collaborating Center for Noncommunicable Diseases Prevention and Control, Pl. Hallera 1, 90-647, Lodz, Poland

    Ewa Borowiak & Tomasz Kostka

  2. Institute of Nursing, Medical University of Lodz, Lodz, Poland

    Ewa Borowiak

Authors
  1. Ewa Borowiak
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tomasz Kostka
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ewa Borowiak.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Borowiak, E., Kostka, T. Predictors of quality of life in older people living at home and in institutions. Aging Clin Exp Res 16, 212–220 (2004). https://doi.org/10.1007/BF03327386

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03327386

Key Words

Search

Navigation