Quality of Life Research

, Volume 21, Issue 3, pp 527–534 | Cite as

Factors associated with quality of life in older adults in the United States

  • Marianne Baernholdt
  • Ivora Hinton
  • Guofen Yan
  • Karen Rose
  • Meghan Mattos
Article

Abstract

Purpose

According to the World Health Organization, quality of life (QOL) includes physical and mental health, emotional well-being, and social functioning. Using an adaptation of Andersen’s behavioral model, we examined the associations between the three dimensions of QOL and needs and health behaviors in a nationally representative sample of adults 65 years and older.

Methods

A representative sample from the 2005–2006 National Health and Nutrition Examination Survey (NHANES) was used. NHANES over-samples persons 60 years and older, African Americans, and Hispanics. Frequencies and distribution patterns were assessed, followed by bivariate and multiple regression analyses.

Results

These older adults reported high levels of QOL. However, associations between needs and health behaviors and QOL varied across dimensions. Activities of daily living (ADL) were associated with all three dimensions. Depression was associated with two dimensions and memory problems with one dimension. Physical activity was linked to social functioning, and health care utilization was linked to emotional well-being.

Conclusions

The differences in associations with different dimensions of QOL confirm that this is a multidimensional concept. Since depression, memory problems, and ADL function were all associated with some dimension of QOL, future interventions to improve QOL in older adults should include screening and treatment for these problems.

Keywords

Quality of life Social functioning Emotional well-being Older adults NHANES 2005–2006 

References

  1. 1.
    National Institute on Aging. (2007). Why population aging matters: A global perspective. National Institute of Health Publication # 07–6134.Google Scholar
  2. 2.
    Zahran, H. S., Kobau, R., Moriarty, D. G., Zack, M. M., Holt, J., Donehoo, R., et al. (2005). Health-related quality of life surveillance-United States, 1993–2002. MMWR. Surveillance Summaries: Morbidity and Mortality Weekly Report. Surveillance Summaries/CDC, 54(4), 1–35.Google Scholar
  3. 3.
    World Health Organization. (1993). Measuring quality of life: The development of the world health organization quality of life instrument (WHOQOL). Geneva, Switzerland: World Health Organization.Google Scholar
  4. 4.
    Hambleton, P., Keeling, S., & McKenzie, M. (2009). The jungle of quality of life: Mapping measures and meanings for elders. Australasian Journal on Ageing, 28(1), 3–6.PubMedCrossRefGoogle Scholar
  5. 5.
    White, S. M., Wojcicki, T. R., & McAuley, E. (2009). Physical activity and quality of life in community dwelling older adults. Health and Quality of Life Outcomes, 7(10). http://www.hqlo.com/content/7/1/10. Accessed Dec 12, 2010.
  6. 6.
    Lawton, M. (1999). Quality of life in chronic illness. Gerontology, 45, 181–183.PubMedCrossRefGoogle Scholar
  7. 7.
    WHO. (2010). Definition of older or elderly person. The World Health Organization. Health statistics and health information systems. http://www.who.int/healthinfo/survey/ageingdefnolder/en/index.html. Accessed Dec 12, 2010.
  8. 8.
    Michael, Y. L., Colditz, G. A., Coakley, E., & Kawachi, I. (1999). Health behaviors, social networks, and healthy aging: Cross-sectional evidence from the nurses’ health study. Quality of Life Research, 8, 711–722.PubMedCrossRefGoogle Scholar
  9. 9.
    Andersen, R. M. (2008). National health surveys and the behavioral model of health services use. Medical Care, 46(7), 647–653.PubMedCrossRefGoogle Scholar
  10. 10.
    Bandiera, F. C., Pereira, D. B., Arif, A. A., Dodge, B., & Asal, N. (2008). Race/ethnicity, income, chronic asthma, and mental health: A cross-sectional study using the behavioral risk factor surveillance system. Psychosomatic Medicine, 70(1), 77–84.PubMedCrossRefGoogle Scholar
  11. 11.
    Skarupski, K. A., Mendes de Leon, C. F., Bienias, J. L., Scherr, P. A., Zack, M. M., Moriarty, D. G., et al. (2007). Black-white differences in health- related quality of life among older adults. Quality of Life Research, 16(2), 287–296.PubMedCrossRefGoogle Scholar
  12. 12.
    Fryback, D. G., Dunham, N. C., Palta, M., Hanmer, J., Buechner, J., Cherepanov, D., et al. (2007). US Norms for six generic health-related quality-of-life indexes from the national health measurement study. Medical Care, 45(12), 1162–1170.PubMedCrossRefGoogle Scholar
  13. 13.
    Hopman, W. M., Harrison, M. B., Coo, H., Friedberg, E., Buchanan, M., & VanDen Kerkhof, E. G. (2009). Associations between chronic disease, age and physical and mental health status. Chronic Diseases in Canada, 29(3), 108–116.PubMedGoogle Scholar
  14. 14.
    Borders, T. F., Aday, L. A., & Xu, K. T. (2004). Factors associated with health-related quality of life among an older population in a largely rural western region. Journal of Rural Health, 20(1), 67–75.PubMedCrossRefGoogle Scholar
  15. 15.
    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.PubMedCrossRefGoogle Scholar
  16. 16.
    Fortin, M., Lapointe, L., Hudon, C., Vanasse, A., Ntetu, A. L., & Maltais, D. (2004). Relationship between multimorbidity and quality of life in primary care: a systematic review. Health and Quality of Life Outcomes, 2(51). http://www.hqlo.com/content/2/1/51. Accessed Dec 20, 2010.
  17. 17.
    Fortin, M., Bravo, G., Lapointe, L., Almirall, J., Dubois, M. F., & Vanesse, A. (2006). Relationship between multimorbidity and health-related quality of life of patients in primary care. Quality of Life Research, 15(1), 83–91.PubMedCrossRefGoogle Scholar
  18. 18.
    Lima, M. G., Barros, M. B. A., Cesar, C. L. G., Goldbaum, M., Carandina, L., & Ciconelli, R. M. (2009). Impact of chronic disease on quality of life among the elderly in the state of Sao Paulo, Brazil: A population-based study. Revista Panamericana De Salud Publica = Pan American Journal of Public Health, 25(4), 314–321.Google Scholar
  19. 19.
    Larson, C. O., Belue, R., Schlundt, D. G., & McClellan, L. (2006). Relationship between symptoms of depression, functional health status, and chronic disease among a residential sample of African Americans. Journal of Ambulatory Care Management, 29(2), 133–140.PubMedGoogle Scholar
  20. 20.
    Davis, J. C., Marra, C. A., Najafzadeh, M., & Liu-Ambrose, T. (2010). The independent contribution of executive functions to health related quality of life in older women. BMC Geriatrics, 10, 16.PubMedCrossRefGoogle Scholar
  21. 21.
    Federal Interagency Forum on Aging-Related Statistics. (2008). Older Americans 2008: Key indicators of well-being. Washington, DC: US Government printing office.Google Scholar
  22. 22.
    Rust, G., Fryer, G. E., Phillips, R. L., Daniels, E., Strothers, H., & Satcher, D. (2004). Modifiable determinants of healthcare utilization within the African-American population. Journal of the National Medical Association, 96(9), 1169–1177.PubMedGoogle Scholar
  23. 23.
    Simmons, L. A., Anderson, E. A., & Braun, B. (2008). Health needs and health care utilization among rural, low-income women. Women and Health, 47(4), 53–69.CrossRefGoogle Scholar
  24. 24.
    Williams, S. A., Wagner, S., Kannan, H., & Bolge, S. C. (2009). The association between asthma control and health care utilization, work productivity loss and health-related quality of life. Journal of Occupational and Environmental Medicine, 51(7), 780–785.PubMedCrossRefGoogle Scholar
  25. 25.
    Gallegos-Carrillo, K., Garcia-Pena, C., Duran-Munoz, C., Mudgal, J., Duran-Arenas, L., & Salmeron-Castro, J. (2008). Health care utilization and health-related quality of life perception in older adults: A study of the Mexican social security institute. Salud Publica de Mexico, 50(3), 207–217.PubMedCrossRefGoogle Scholar
  26. 26.
    Center for Disease Control and Prevention (CDC). (2009). National Health and Nutrition Examination Survey. http://www.cdc.gov/nchs/nhanes/about_nhanes.htm. Accessed Sept 22, 2009.
  27. 27.
    Moriarty, D. G., Zack, M. M., & Kobau, R. (2003). The center for disease control and prevention’s healthy days measures—population tracking of perceived physical and mental health over time. Health and Quality of Life Outcomes, 1(37), 1–8. http://www.hqlo.com/content/1/1/37. Accessed Dec 12, 2010.
  28. 28.
    Toet, J., Raat, H., & van Ameijden, E. J. (2006). Validation of the Dutch version of the CDC core healthy days measures in a community sample. Quality of Life Research, 15(1), 179–184.PubMedCrossRefGoogle Scholar
  29. 29.
    Ford, E. S., Merritt, R. K., Heath, G. W., Powell, K. E., Washburn, R. A., Kriska, A., et al. (1991). Physical activity behaviors in lower and higher socioeconomic status populations. American Journal of Epidemiology, 133(12), 1246–1256.PubMedGoogle Scholar
  30. 30.
    Cook, C. E., Richardson, J. K., Pietrobon, R., Braga, L., Silva, H. M., & Turner, D. (2006). Validation of the NHANES ADL scale in a sample of patients with report of cervical pain: Factor analysis, item response theory analysis, and line item validity. Disability and Rehabilitation, 28(15), 929–935.PubMedCrossRefGoogle Scholar
  31. 31.
    Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613.PubMedCrossRefGoogle Scholar
  32. 32.
    Nobrega, T. C., Jaluul, O., Machado, A. N., Paschoal, S. M., & Filho, W. J. (2009). Quality of life and multimorbidity of elderly outpatients. Clinics Sao Paulo Brazil, 64(1), 45–50.CrossRefGoogle Scholar
  33. 33.
    Berkman, L. F., & Syme, S. L. (1979). Social networks, host resistance, and mortality: A 9 year follow-up study of Alameda county residents. American Journal of Epidemiology, 109(2), 186–204.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • Marianne Baernholdt
    • 1
  • Ivora Hinton
    • 2
  • Guofen Yan
    • 3
  • Karen Rose
    • 2
  • Meghan Mattos
    • 2
  1. 1.School of Nursing and Department of Public Health SciencesUniversity of VirginiaCharlottesvilleUSA
  2. 2.School of NursingUniversity of VirginiaCharlottesvilleUSA
  3. 3.Department of Public Health SciencesUniversity of VirginiaCharlottesvilleUSA

Personalised recommendations