Abstract
Purpose
The main objective of this study was to determine the relationship between quality of life, social functioning, depressive symptoms, self-efficacy, physical function, and socioeconomic status (SES) in community-dwelling older adults.
Methods
A cross-sectional design was used to examine the relationships. A sample of 193 community-dwelling older adults completed the measurements. Structural equation modeling with full information maximum likelihood in LISREL was used to evaluate the relationships between the latent variables (SES, social functioning, depressive symptoms, self-efficacy, physical function, and quality of life).
Results
The path analysis exhibited significant effects of SES on physical function, social functioning, depressive symptoms, and self-efficacy (γ = 0.42–0.73), and significant effects in regard to social functioning, depressive symptoms, and self-efficacy on quality of life (γ = 0.27–0.61). There was no direct effect of SES on the quality of life. The model fit indices demonstrated a reasonable fit (χ 2 = 98.3, df = 48, p < 0.001), matching the relative Chi-square criterion and the RMSEA criterion. The model explained 55.5 % of the variance of quality of life.
Conclusions
The path analysis indicated an indirect effect of SES on the quality of life by social functioning, depressive symptoms, and self-efficacy in community-dwelling older adults. Physical function did not have a direct effect on the quality of life. To improve the quality of life in older adults, additional focus is required on the socioeconomic psychosocial differences in the community-dwelling older population.
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References
Moons, P., Budts, W., & De Geest, S. (2006). Critique on the conceptualisation of quality of life: A review and evaluation of different conceptual approaches. International Journal of Nursing Studies, 43(7), 891–901.
Barcaccia, B., Esposito, G., Matarese, M., Bertolaso, M., Elvira, M., & De Marinis, M. G. (2013). Defining quality of life: A wild-goose chase? Europe’s Journal of Psychology, 9(1), 185–203.
Holmes, S. (2005). Assessing the quality of life: Reality or impossible dream? A discussion paper. International Journal of Nursing Studies, 42(4), 493–501.
Brown, J., Bowling, A., & Flynn, T. (2004). Models of quality of life: A taxonomy, overview and systematic review of the literature. Bristol, London: European Population Forum for Ageing Research
Farquhar, M. (1995). Elderly people’s definitions of quality of life. Social Science and Medicine, 41(10), 1439–1446.
Gasper, D. (2010). Understanding the diversity of conceptions of well-being and quality of life. The Journal of Socio-Economics, 39(3), 351–360.
WHOQOL group. (1995). The World Health Organization quality of life assessment (WHOQOL): Position paper from the World Health Organization. Social Science & Medicine, 41(10), 1403–1409.
Wilhelmson, K., Andersson, C., Waern, M., & Allebeck, P. (2005). Elderly people’s perspectives on quality of life. Ageing and Society, 25(4), 585–600.
Gabriel, Z., & Bowling, A. (2004). Quality of life from the perspectives of older people. Ageing and Society, 24(5), 675–691.
Netuveli, G., & Blane, D. (2008). Quality of life in older ages. British Medical Bulletin, 85, 113–126.
Ruta, D., Camfield, L., & Donaldson, C. (2007). Sen and the art of quality of life maintenance: Towards a general theory of quality of life and its causation. The Journal of Socio-Economics, 36(3), 397–423.
Costanza, R., Fisher, B., Ali, S., Beer, C., Bond, L., Boumans, R., et al. (2007). Quality of life: An approach integrating opportunities, human needs, and subjective well-being. Ecological Economics, 61(2), 267–276.
George, L. K. (2010). Still happy after all these years: Research frontiers on subjective well-being in later life. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 65(3), 331–339.
Huguet, N., Kaplan, M. S., & Feeny, D. (2008). Socioeconomic status and health-related quality of life among elderly people: Results from the Joint Canada/United States Survey of Health. Social Science and Medicine, 66(4), 803–810.
Pinquart, M., & Sörensen, S. (2000). Influences of socioeconomic status, social network, and competence on subjective well-being in later life: A meta-analysis. Psychology and Aging, 15(2), 187–224.
Zaninotto, P., Falaschetti, E., & Sacker, A. (2009). Age trajectories of quality of life among older adults: Results from the English Longitudinal Study of Ageing. Quality of Life Research, 18(10), 1301–1309.
Brett, C. E., Gow, A. J., Corley, J., Pattie, A., Starr, J. M., & Deary, I. J. (2012). Psychosocial factors and health as determinants of quality of life in community-dwelling older adults. Quality of Life Research, 21(3), 505–516.
Bowling, A., Seetai, S., Morris, R., & Ebrahim, S. (2007). Quality of life among older people with poor functioning. The influence of perceived control over life. Age and Ageing, 36(3), 310–315.
Netz, Y., Wu, M., Becker, B. J., & Tenenbaum, G. (2005). Physical activity and psychological well-being in advanced age: A meta-analysis of intervention studies. Psychology and Aging, 20(2), 272.
Garatachea, N., Molinero, O., Martínez-García, R., Jiménez-Jiménez, R., González-Gallego, J., & Márquez, S. (2009). Feelings of well being in elderly people: Relationship to physical activity and physical function. Archives of Gerontology and Geriatrics, 48(3), 306–312.
Olivares, P. R., Gusi, N., Prieto, J., & Hernandez-Mocholi, M. A. (2011). Fitness and health-related quality of life dimensions in community-dwelling middle aged and older adults. Health and Quality of Life Outcomes, 9, 117.
Chang, M., Kim, H., Shigematsu, R., Nho, H., Nishijima, T., & Tanaka, K. (2001). Functional fitness may be related to life satisfaction in older Japanese adults. International Journal of Aging and Human Development, 53(1), 35–50.
Takata, Y., Ansai, T., Soh, I., Awano, S., Yoshitake, Y., Kimura, Y., et al. (2010). Quality of life and physical fitness in an 85-year-old population. Archives of Gerontology and Geriatrics, 50(3), 272–276.
Spirduso, W. W., & Cronin, D. L. (2001). Exercise dose–response effects on quality of life and independent living in older adults. Medicine and Science in Sports and Exercise, 33(6), S598–S608.
Brydon, L., Edwards, S., Mohamed-Ali, V., & Steptoe, A. (2004). Socioeconomic status and stress-induced increases in interleukin-6. Brain, Behavior, and Immunity, 18(3), 281–290.
Cohen, S., & Janicki-Deverts, D. (2012). Who’s stressed? Distributions of psychological stress in the United States in probability samples from 1983, 2006, and 2009. Journal of Applied Social Psychology, 42(6), 1320–1334.
Broese van Groenou, M. I., & Van Tilburg, T. (2003). Network size and support in old age: Differentials by socio-economic status in childhood and adulthood. Ageing and Society, 23(05), 625–645.
Stringhini, S., Berkman, L., Dugravot, A., Ferrie, J. E., Marmot, M., Kivimaki, M., et al. (2012). Socioeconomic status, structural and functional measures of social support, and mortality: The British Whitehall II Cohort Study, 1985–2009. American Journal of Epidemiology, 175(12), 1275–1283.
Savikko, N., Routasalo, P., Tilvis, R. S., Strandberg, T. E., & Pitkälä, K. (2005). Predictors and subjective causes of loneliness in an aged population. Archives of Gerontology and Geriatrics, 41(3), 223–233.
Kubzansky, L. D., Subramanian, S., Kawachi, I., Fay, M. E., Soobader, M., & Berkman, L. F. (2005). Neighborhood contextual influences on depressive symptoms in the elderly. American Journal of Epidemiology, 162(3), 253–260.
Mair, C., Roux, A. D., & Galea, S. (2008). Are neighbourhood characteristics associated with depressive symptoms? A review of evidence. Journal of Epidemiology and Community Health, 62(11), 940–946.
Stimpson, J. P., Ju, H., Raji, M. A., & Eschbach, K. (2007). Neighborhood deprivation and health risk behaviors in NHANES III. American Journal of Health Behavior, 31(2), 215–222.
Koster, A., Bosma, H., van Groenou, M. I. B., Kempen, G. I., Penninx, B. W., van Eijk, J. T., et al. (2006). Explanations of socioeconomic differences in changes in physical function in older adults: Results from the Longitudinal Aging Study Amsterdam. BMC Public Health, 6(1), 244.
Broese van Groenou, M. I., Deeg, D. J., & Penninx, B. W. (2003). Income differentials in functional disability in old age: Relative risks of onset, recovery, decline, attrition and mortality. Aging Clinical and Experimental Research, 15(2), 174–183.
Joreskog, K., & Sorbom, D. (1989). LISREL 7: A guide to the program and applications. Chicago, IL: SPSS Inc.
Thomas, S., Reading, J., & Shephard, R. J. (1992). Revision of the physical activity readiness questionnaire (PAR-Q). Canadian Journal of Sport Sciences, 17(4), 338–345.
Statistics Netherlands. (1989). Health interview survey in the Netherlands. Voorburg/Heerlen: Statistics Netherlands.
Ruwaard, D., Kramers, P., Van den Berg Jeths, A., & Achterberg, P. (1993). Public health status and forecasts. The health status of the Dutch population over the period 1950–2010. The Hague, The Netherlands: National Institute for Public Health and the Environment.
Hyde, M., Wiggins, R. D., Higgs, P., & Blane, D. B. (2003). A measure of quality of life in early old age: The theory, development and properties of a needs satisfaction model (CASP-19). Aging & Mental Health, 7(3), 186–194.
Bowling, A. (2009). The psychometric properties of the older people’s quality of life questionnaire, compared with the CASP-19 and the WHOQOL-OLD. Current Gerontology and Geriatrics Research, 2009, 298950.
Gierveld, J. D. J., & Van Tilburg, T. (2006). A 6-item scale for overall, emotional, and social loneliness confirmatory tests on survey data. Research on Aging, 28(5), 582–598.
Lubben, J., Blozik, E., Gillmann, G., Iliffe, S., von Renteln Kruse, W., Beck, J. C., et al. (2006). Performance of an abbreviated version of the Lubben Social Network Scale among three European community-dwelling older adult populations. The Gerontologist, 46(4), 503–513.
Kempen, G., & Van Eijk, L. (1995). The psychometric properties of the SSL12-I, a short scale for measuring social support in the elderly. Social Indicators Research, 35(3), 303–312.
Bouma, J., Ranchor, A. V., Sanderman, R., & Van Sonderen, E. (2012). Assessment of symptoms of depression by means of the CES-D: A manual. Groningen: Stichting Drukkerij Regenboog.
Lewinsohn, P. M., Seeley, J. R., Roberts, R. E., & Allen, N. B. (1997). Center for Epidemiologic Studies Depression Scale (CES-D) as a screening instrument for depression among community-residing older adults. Psychology and Aging, 12(2), 277.
Sherer, M., Maddux, J. E., Mercandante, B., Prentice-Dunn, S., Jacobs, B., & Rogers, R. W. (1982). The self-efficacy scale: Construction and validation. Psychological Reports, 51(2), 663–671.
Bosscher, R. J., & Smit, J. H. (1998). Confirmatory factor analysis of the general self-efficacy scale. Behaviour Research and Therapy, 36(3), 339–343.
Rikli, R. E., & Jones, C. J. (1999). Development and validation of a functional fitness test for community-residing older adults. Journal of Aging and Physical Activity, 7, 129–161.
Podsiadlo, D., & Richardson, S. (1991). The timed “Up & Go”: A test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society, 39(2), 142.
Brown, A. F., Ettner, S. L., Piette, J., Weinberger, M., Gregg, E., Shapiro, M. F., et al. (2004). Socioeconomic position and health among persons with diabetes mellitus: A conceptual framework and review of the literature. Epidemiologic Reviews, 26(1), 63–77.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Lawrence Erlbaum.
Enders, C. K., & Bandalos, D. L. (2001). The relative performance of full information maximum likelihood estimation for missing data in structural equation models. Structural Equation Modeling, 8(3), 430–457.
Allison, P. (2012). Handling missing data by maximum likelihood. Cary, NC: SAS Institute Inc. (paper 312-2012).
Wheaton, D. (1977). Assessing reliability and stability in panel models. Sociological Methodology, 8, 84–136.
Tabachnick, B., & Fidell, L. (2001). Using multivariate statistics. Boston: Pearson Education, Allyn & Bacon.
Barrett, P. (2007). Structural equation modelling: Adjudging model fit. Personality and Individual Differences, 42(5), 815–824.
Steiger, J. H. (2007). Understanding the limitations of global fit assessment in structural equation modeling. Personality and Individual Differences, 42(5), 893–898.
Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1–55.
Bentler, P. M. (1990). Comparative fit indexes in structural models. Psychological Bulletin, 107(2), 238.
MacCallum, R. C., Browne, M. W., & Sugawara, H. M. (1996). Power analysis and determination of sample size for covariance structure modeling. Psychological Methods, 1(2), 130.
Ahuvia, A. C. (2002). Individualism/collectivism and cultures of happiness: A theoretical conjecture on the relationship between consumption, culture and subjective well-being at the national level. Journal of Happiness Studies, 3(1), 23–36.
Schenk, L., Meyer, R., Behr, A., Kuhlmey, A., & Holzhausen, M. (2013). Quality of life in nursing homes: results of a qualitative resident survey. Quality of Life Research, 22(10), 2929–2938.
White, S. M., Wójcicki, T. R., & McAuley, E. (2009). Physical activity and quality of life in community dwelling older adults. Health and Quality of life outcomes, 7(10).
Bandura, A. (1997). Self-efficacy: The exercise of control. New York: Freeman.
Gallo, L. C., Bogart, L. M., Vranceanu, A., & Matthews, K. A. (2005). Socioeconomic status, resources, psychological experiences, and emotional responses: A test of the reserve capacity model. Journal of Personality and Social Psychology, 88(2), 386.
Acknowledgments
The study was funded by ZonMw: The National Care for the Elderly Program (The Netherlands), Contract No.: 60.61900.98.452.
Ethical standard
The study has been approved by the ethical committee of the Institute of Human Movement Sciences Groningen and has been performed in accordance with the ethical standards as stated in the 1964 Declaration of Helsinki and its later amendments. All persons granted their informed consent prior to their inclusion in the study.
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Bielderman, A., de Greef, M.H.G., Krijnen, W.P. et al. Relationship between socioeconomic status and quality of life in older adults: a path analysis. Qual Life Res 24, 1697–1705 (2015). https://doi.org/10.1007/s11136-014-0898-y
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DOI: https://doi.org/10.1007/s11136-014-0898-y