Skip to main content

Advertisement

SpringerLink
Log in

Association between frailty and family functionality on health-related quality of life in older adults

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Objectives

To investigate the longitudinal association between frailty and health-related quality of life (HRQoL) in older adults and to examine whether family functionality moderates the association between frailty and HRQoL.

Methods

It’s a longitudinal observational study. The sample was drawn from three waves (2006, 2010, and 2015) of the Health, Well-Being, and Aging Study (Saúde, bem-estar e envelhecimento; SABE) collected in São Paulo, Brazil with adults aged 60 years and older. HRQoL was based on the Short Form (SF-12) Health Survey, from which the physical component score (PCS) and mental component score (MCS) were obtained. Frailty status was determined according to the Fried frailty criteria. Family support was measured using the family APGAR instrument. Mixed effects linear regression was used to determine the associations of frailty on longitudinal changes in HRQoL and to examine whether family functionality attenuates this association.

Results

Being frail was negatively associated with MCS and PCS scores. Familiar functionality was found to be a protective factor for MCS only.

Conclusions

These findings are innovative and make an important contribution to the study of HRQoL among older adults in developing countries.

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.

Institutional subscriptions

Similar content being viewed by others

References

  1. 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, 267–276.

    Article  Google Scholar 

  2. Camelo, L. V., Giatti, L., & Barreto, S. M. (2016). Health related quality of life among elderly living in region of high vulnerability for health in Belo Horizonte, Minas Gerais. Revista Brasileira de Epidemiologia,19(2), 280–293.

    Article  PubMed  Google Scholar 

  3. Brown, D. S., Thompson, W. W., Zack, M. M., Arnold, S. E., & Barile, J. P. (2015). Associations between health-related quality of life and mortality in older adults. Prevention Science,16(1), 21–30.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Henchoz, Y., Botrugno, F., Cornaz, S., Bula, C., Charef, S., & Santos-Eggimann, B. (2017). Determinants of quality of life in community-dwelling older adults: Comparing three cut-offs on the excellent-to-poor spectrum. Quality of Life Research,26, 283–289.

    Article  PubMed  Google Scholar 

  5. Lima, M. G., Barros Marilisa, B. A., César, C. L. G., Goldbaum, M., Carandina, L., & Alves, M. C. G. P. (2011). Health-related behavior and quality of life among the elderly: A population-based study. Revista de Saúde Pública,45(3), 485–493.

    Article  PubMed  Google Scholar 

  6. Kim, J., Choi, Y., Park, S., Cho, K. H., Ju, Y. J., & Park, E. C. (2017). The impact of living arrangements on quality of life among Korean elderly: Findings from the Korean longitudinal study of aging (2006–2012). Quality of Life Research,26(5), 1303–1314.

    Article  PubMed  Google Scholar 

  7. Maatouk, I., Wild, B., Wesche, D., Herzog, W., Raum, E., Muller, H., et al. (2012). Temporal predictors of health-related quality of life in elderly people with diabetes: Results of a German cohort study. PLoS ONE,7(1), e31088.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Kojima, G., Iliffe, S., Jivraj, S., & Walters, K. (2016). Association between frailty and quality of life among community dwelling older people: A systematic review and meta-analysis. Journal of Epidemiology and Community Health,70(7), 716–721.

    Article  PubMed  Google Scholar 

  9. Crocker, T. F., Brown, L., Clegg, A., Farley, K., Franklin, M., Simpkins, S., et al. (2019). Quality of life is substantially worse for community-dwelling older people living with frailty: Systematic review and meta-analysis. Quality of Life Research,28(8), 2041–2056.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Andrade, J. M., Duarte, Y. A. O., Alves, L. C., Andrade, F. C. D., Souza Junior, P. R. B., Lima-Costa, M. F., et al. (2018). Frailty profile in Brazilian older adults: ELSI-Brazil. Revista de Saúde Pública,52(Suppl. 2), 17s.

    PubMed Central  Google Scholar 

  11. Ferrer, A., Formiga, F., Cunillera, O., Megido, M. J., Corbella, X., Almeda, J., et al. (2015). Predicting factors of health-related quality of life in octogenarians: A 3-year follow-up longitudinal study. Quality of Life Research,24, 2701–2711.

    Article  PubMed  Google Scholar 

  12. Provencher, V., Sirois, M. J., Émond, M., Perry, J. J., Daoust, R., Lee, J. S., et al. (2016). Frail older adults with minor fractures show lower health-related quality of life (SF-12) scores up to six months following emergency department discharge. Health and Quality of Life Outcomes. https://doi.org/10.1186/s12955-016-0441-7.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Lenardt, M. H., Carneiro, N. H. K., Binotto, M. A., Willig, M. H., Lourenço, T. M., & Albino, J. (2016). Frailty and quality of life in elderly primary health care users. Revista Brasileira de Enfermagem,69(3), 448–453.

    Article  Google Scholar 

  14. Varela, F. R. A., Ciconelli, R. M., Campolina, A. G., & Soarez, P. C. (2015). Quality of life evaluation of frail elderly in Campinas, São Paulo. Revista de Associação Médica Brasileira,61(5), 423–430.

    Article  Google Scholar 

  15. Brito, T. R. P., Nunes, D. P., Duarte, Y. A. O., & Lebrão, M. L. (2019). Social network and older people’s functionality: Health, Well-being, and Aging (SABE) study evidences. Revista Brasileira de Epidemioligia,21(Suppl. 02), e180003.

    Google Scholar 

  16. Holt-Lunstad, J., Smith, T. B., & Layton, J. B. (2010). Social relationships and mortality risk: A meta-analytic review. PLoS Medicine,7(7), e1000316.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Campos, A. C. V., Rezende, G. P., Ferreira, E. F., Vargas, A. M. D., & Gonçalves, L. H. T. (2017). Family functioning of Brazilian elderly people living in community. Acta Paulista de Enfermagem,30(4), 358–367.

    Article  Google Scholar 

  18. Brettschneider, C., Leicht, H., Bickel, H., Dahlhaus, A., Fuchs, A., Gensichen, J., et al. (2013). Relative impact of multimorbid chronic conditions on health-related quality of life—Results from the multicare cohort study. PLoS ONE,8(6), e66742.

    Article  PubMed  PubMed Central  Google Scholar 

  19. de Lima Silva, V., de Medeiros, C. A. C. X., Guerra, G. C. B., Ferreira, P. H. A., de Araújo Junior, R. F., de Araújo Barbosa, S. J., et al. (2017). Quality of life, integrative community therapy, family support, and satisfaction with health services among elderly adults with and without symptoms of depression. Psychiatric Quarterly,88(2), 359–s369.

    Article  PubMed  Google Scholar 

  20. Alvarenga, M. R. M., Oliveira, M. A. C., Domingues, M. A. R., Amendola, F., & Faccenda, O. (2011). Social support networks for elderly patients attended by Family Health teams. Ciências e Saúde Coletiva,16(5), 2603–2611.

    Article  Google Scholar 

  21. Torres, G. V., Reis, L. A., Reis, L. A., & Fernandes, M. H. (2009). Quality of life and associated factors in functionally dependent elderly in the hinterland of Northeast Brazil. Jornal Brasileiro de Psiquiatria,58(1), 39–44.

    Article  Google Scholar 

  22. Abdala, G. A., Kimura, M., Duarte, Y. A. O., Lebrão, M. L., & Santos, B. (2015). Religiousness and health-related quality of life of older adults. Revista de Saúde Pública,49(55), 1–9.

    Google Scholar 

  23. Prazeres, F., & Santiago, L. (2016). Relationship between health-related quality of life, perceived family support and unmet health needs in adult patients with multimorbidity attending primary care in Portugal: A multicentre cross-sectional study. Health and Quality of Life Outcomes,14(1), 156.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Smilkstein, G. (1978). The family APGAR: A proposal for a family function test and its use by physicians. The Journal of Family Practice,6(6), 1231–1239.

    CAS  PubMed  Google Scholar 

  25. Lim, A. T. C., Manching, J., & Penserga, E. G. (2012). Correlation between Family APGAR scores and health-related quality of life of Filipino elderly patients with knee osteoarthritis. International Journal of Rheumatic Diseases,15(4), 407–413.

    Article  PubMed  Google Scholar 

  26. Gonçalves, L. H. T., Leite, M. T., Hildebrandt, L. M., Bisogno, S. C., Biasuz, S., & Falcade, B. L. (2013). Living together and family care at the fourth age: Quality of life for seniors and their caregivers. Revista Brasileira de Geriatria e Gerontologia,16(2), 315–325.

    Article  Google Scholar 

  27. Lebrão, M. L., Duarte, Y. A. O., Santos, J. L. F., & Silva, N. N. (2018). 10 Years of SABE study: Background, methodology and organization of the study. Revista Brasileira de Epidemiologia,21(2), e180002.

    Article  Google Scholar 

  28. Ware, J. E., Kosinski, M., Turner-Bowker, D. M., & Gandek, M. S. (2007). User’s Manual for the SF-12v2TM Health Survey: With a Supplement Documenting SF-12 Health Survey. Lincoln, RI: Quality Metric Incorporated.

    Google Scholar 

  29. Camelier, A. A. (2004). Avaliação da Qualidade de Vida Relacionada à Saúde em Pacientes com DPOC: Estudo de Base Populacional com o SF-12 na Cidade de São Paulo-SP. São Paulo: Tese (Doutorado em Ciências) – Faculdade de Medicina Universidade Federal de São Paulo.

    Google Scholar 

  30. Fried, L. P., Tangen, C. M., Walston, J., Newman, A. B., Hirsch, C., Gottdiener, J., et al. (2001). Frailty in older adults: Evidence for a phenotype. The Journals of Gerontology Series A,56(3), M146–M157.

    Article  CAS  Google Scholar 

  31. Guigoz, Y., Vellas, B., & Garry, P. J. (1996). Assessing the nutritional status of the elderly: The mini nutritional assessment as part of the geriatric evaluation. Nutrition Reviews,54(1 Pt 2), S59–S65.

    CAS  PubMed  Google Scholar 

  32. Simonsick, E. M., Maffeo, C. E., Rogers, S. K., Skinner, E. A., Davis, D., Guralnik, J. M., et al. (1997). Methodology and feasibility of a home-based examination in disabled older women: The women’s health and aging study. The Journals of Gerontology Series A,52(5), M264–M274.

    Article  CAS  Google Scholar 

  33. The IPAQ Group. (2005). Guidelines for Data Processing and Analysis of the International Physical Activity Questionnaire (IPAQ)—Short and Long Forms. IPAQ Research Committee.

  34. Duarte, Y. A. O. (2001). Família: rede de suporte ou fator estressor. A ótica de idosos e cuidadores familiares. São Paulo: Tese (Doutorado em Enfermagem) – Escola de Enfermagem Universidade de São Paulo.

    Google Scholar 

  35. Ribeiro, K. T. (2011). Fatores associados à qualidade de vida relacionada à saúde de idosos residentes no Município de São Paulo – Estudo SABE: Saúde, Bem-Estar e Envelhecimento [tese de doutorado]. São Paulo: Universidade de São Paulo.

    Google Scholar 

  36. Instituto Brasileiro de Geografia e Estatística. (2013). Pesquisa Nacional de Saúde 2013. Rio de Janeiro: IBGE; 2013. Retrieved 25 August, 2019, from https://www.pns.icict.fiocruz.br/arquivos/Novos/Questionario%20PNS.pdf.

  37. Rao, J. N. K., & Scott, A. J. (1984). On chi-squared tests for multiway contingency tables with cell proportions estimated from survey data. The Annals of Statistics,12, 46–60.

    Article  Google Scholar 

  38. Verbeke, G. (1997). Linear mixed models for longitudinal data. In G. Verbeke (Ed.), Linear mixed models in practice (pp. 63–153). New York: Springer.

    Chapter  Google Scholar 

  39. Cameron, A. C., & Miller, D. L. (2015). A practitioner’s guide to cluster-robust inference. Journal of Human Resources,50(2), 317–372.

    Article  Google Scholar 

  40. Clegg, A., Young, J., Iliffe, S., Rikkert, M. O., & Rockwood, K. (2013). Frailty in elderly people. Lancet,381, 752–762.

    Article  PubMed  Google Scholar 

  41. Webb, E., Blane, D., McMunn, A., & Netuveli, G. (2011). Proximal predictors of change in quality of life at older ages. Journal of Epidemiology & Community Health,65(6), 542–547.

    Article  Google Scholar 

  42. Antonucci, T. C. (1991). Attachment, social support, and coping with negative life events in mature adulthood. In E. M. Cummings, A. L. Greene, & K. H. Karraker (Eds.), Life-span developmental psychology: Perspectives on stress and coping (pp. 261–276). Hillsdale, NJ: Lawrence Erlbaum.

    Google Scholar 

  43. Camarano, A. A., & Kanso, S. (2010). As instituições de longa permanência para idosos no Brasil. Revista Brasileira de Estudo de População,27(1), 232–235.

    Article  Google Scholar 

  44. Chiavegatto Filho, A. D. P., Lebrão, M. L., & Kawachi, I. (2012). Income inequality and elderly self-rated health in São Paulo(Brazil)hema. Annals of Epidemiology,22(12), 863–867.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We acknowledge Maria Lucia Lebrão, the principal investigator and coordinator of the Saúde, Bem-Estar e Envelhecimento (Health, Well-Being, and Aging) Study, in memoriam.

Funding

Juliana Mara Andrade received a doctoral scholarship from Coordenação de Aperfeicoamento de Pessoal de Nível Superior (CAPES).

Author information

Authors and Affiliations

  1. PhD candidate Postgraduate Program in Public Health, René Rachou Institute, Oswaldo Cruz Foundation (FIOCRUZ), Belo Horizonte, Brazil

    Juliana Mara Andrade

  2. School of Social Work, University of Illinois At Urbana-Champaign, Urbana, IL, USA

    Flávia Cristina Drumond Andrade

  3. School of Public Health, University of São Paulo, São Paulo, Brazil

    Yeda Aparecida de Oliveira Duarte

  4. René Rachou Institute, Oswaldo Cruz Foundation (FIOCRUZ), Av. Augusto de Lima, 1715 - Barro Preto, Belo Horizonte, MG, 30.190-002, Brazil

    Fabíola Bof de Andrade

Authors
  1. Juliana Mara Andrade
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Flávia Cristina Drumond Andrade
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yeda Aparecida de Oliveira Duarte
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Fabíola Bof de Andrade
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Conception and design of the research project, data analysis, interpretation and drafting of the article, critical review of the manuscript by JMA. Data analysis, interpretation, critical review of the manuscript by FCDA. Critical review of the manuscript by YAOD. Conception and design of the research project, interpretation, critical review of the manuscript by FBA. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Fabíola Bof de Andrade.

Ethics declarations

Conflict of interest

The authors have no conflict of interest to declare.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Human Research Ethics Committee at the School of Public Health, University of São Paulo—COEP, the National Committee for Research Ethics, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Andrade, J.M., Drumond Andrade, F.C., de Oliveira Duarte, Y.A. et al. Association between frailty and family functionality on health-related quality of life in older adults. Qual Life Res 29, 1665–1674 (2020). https://doi.org/10.1007/s11136-020-02433-5

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-020-02433-5

Keywords

Search

Navigation