Quality of Life Research

, Volume 26, Issue 6, pp 1561–1569 | Cite as

Correlates of health-related quality of life in young-old and old–old community-dwelling older adults

  • Élvio R. Quintal GouveiaEmail author
  • Bruna R. Gouveia
  • Andreas Ihle
  • Matthias Kliegel
  • José A. Maia
  • Sergi Bermudez i Badia
  • Duarte L. Freitas



This study aimed (1) to examine the role of potential correlates of HRQoL in a large representative sample of older adults, and (2) to investigate whether the relationships between HRQoL and potential factors differ as a function of HRQoL component (physical vs. mental) and/or age cohort (young-old vs. old–old).


This cross-sectional study included 802 older adults aged 60–79 years old. HRQoL was assessed using the SF-36 questionnaire. Functional fitness was assessed using the Senior Fitness Test. Physical activity was measured via the Baecke questionnaire. Demographic information, mental and health features were obtained through questionnaires.


A multiple regression analysis showed that BMI (β = −0.15, p = 0.001), body strength (β = 0.21, p < 0.001), aerobic endurance (β = 0.29, p < 0.001), physical activity (β = 0.11, p = 0.007), depressive symptoms (β = −0.19, p < 0.001), falls (β = −0.19, p < 0.001), and living alone (β = −0.16, p < 0.001) were all significantly related to HRQoL-SF-36 total score. The positive relation with aerobic endurance was significantly higher for the physical component of HRQoL, while the negative relation with living alone was significantly higher for the mental component. The positive relation of HRQoL with physical activity was significantly higher in old–old compared to young-old adults.


This data suggest that body composition, functional fitness, psycho-social factors, and falls are important correlates of HRQoL in old age. There are HRQoL-component and age-cohort differences regarding these correlates, underlying the need for specific strategies at the community level to promote HRQoL in older adults.


Health Quality of life Functional fitness Lifestyle Old age 



The authors are grateful to Ercília Fena, Joana Castro and Letícia Sousa for technical assistance in the data collection and management. We are especially grateful to the older people who took part in this study for their participation and interest. Finally, we are also grateful for the support from the LIVES Winter School 2016.

Compliance with ethical standards


This study was supported by a doctoral degree grant from the Portuguese National funding agency for science, research and technology (Reference: SFRH/BD/29300/2006). Technical assistance in collection of the data was supported by Madeira Regional Government and Regional Secretary of Education and Culture. Matthias Kliegel acknowledges the support from the Swiss National Science Foundation (SNSF). This study was also sponsored by Iberdata Equipment’s S.A.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures were in accordance with the ethical standards of an institutional research committee and with the 1964 Helsinki declaration and its later amendments.

Informed consent

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


  1. 1.
    Spirduso, W.W., Francis, K.L., & MacRae, P.G. (2005). Physical dimensions of aging. Second Edition. Champaign IL, Human Kinetics, Inc.Google Scholar
  2. 2.
    Kerschner, H., & Pegues, J. M. (1998). Productive aging: a quality of life agenda. Journal of the American Dietetic Association, 98(12), 1445–1448.CrossRefPubMedGoogle Scholar
  3. 3.
    Rejeski, W. J., & Mihalko, S. L. (2001). Physical activity and quality of life in older adults. The journals of gerontology. Series A, Biological sciences and medical sciences, 56(2), 23–35.CrossRefPubMedGoogle Scholar
  4. 4.
    Stewart, A. L., & King, A. C. (1991). Evaluating the efficacy of physical activity for influencing quality-of-life outcomes in older adults. Annals of behavioral medicine, 13(3), 108–116.Google Scholar
  5. 5.
    Ware, J. E., & Jr, Sherbourne, C.D (1992). The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical care, 30(6), 473–483.CrossRefPubMedGoogle Scholar
  6. 6.
    Hart, P. D., Kang, M., Weatherby, N. L., Lee, Y. S., & Brinthaupt, T. M. (2015). Systematic Review of Health-Related Quality of Life Assessments in Physical Activity Research. World Journal of Preventive Medicine, 3(2), 28–39. doi: 10.12691/jpm-3-2-3.Google Scholar
  7. 7.
    Ribeiro, J.P. (2005). O importante é a saúde: estudo de adaptação de uma técnica de técnica de avaliação do estado de saúde SF-36. Lisboa, Merck Sharp & Dolme.Google Scholar
  8. 8.
    Dhana, K., Berghout, M. A., Peeters, A., Ikram, M. A., Tiemeier, H., Hofman, et al. (2016). Obesity in older adults and life expectancy with and without cardiovascular disease. International Journal of Obesity, 40(10), 1535–1540. doi: 10.1038/ijo.2016.94.CrossRefPubMedGoogle Scholar
  9. 9.
    Janssen, I. (2007). Morbidity and mortality risk associated with an overweight BMI in older men and women. Obesity, 15(7), 1827–1840.CrossRefPubMedGoogle Scholar
  10. 10.
    Wolin, K. Y., Carson, K., & Colditz, G. A. (2010). Obesity and cancer. The Oncologist, 15(6), 556–565. doi: 10.1634/theoncologist.2009-0285.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Anandacoomarasamy, A., Caterson, I., Sambrook, P., Fransen, M., & March, L. (2008). The impact of obesity on the musculoskeletal system. International Journal of Obesity, 32(2), 211–222.CrossRefPubMedGoogle Scholar
  12. 12.
    Thompson, D., Edelsberg, J., Colditz, G. A., Bird, A. P., & Oster, G. (1999). Lifetime health and economic consequences of obesity. Archives of Internal Medicine, 159(18), 2177–2183.CrossRefPubMedGoogle Scholar
  13. 13.
    Giuli, C., Papa, R., Bevilacqua, R., Felici, E., Gagliardi, C., Marcellini, F., et al. (2014). Correlates of perceived health related quality of life in obese, overweight and normal weight older adults: an observational study. BioMed Central Public Health, 15(14), 35. doi: 10.1186/1471-2458-14-35.CrossRefGoogle Scholar
  14. 14.
    Goins, R. T., Spencer, S. M., & Krummel, D. A. (2003). Effect of obesity on health-related quality of life among Appalachian elderly. Southern Medical Journal, 96(6), 552–557.CrossRefPubMedGoogle Scholar
  15. 15.
    Dale, C. E., Bowling, A., Adamson, J., Kuper, H., Amuzu, A., Ebrahim, S., et al. (2013). Predictors of patterns of change in healthrelated quality of life in older women over 7 years: evidence from a prospective cohort study. Age and Ageing, 42(3), 312–318. doi: 10.1093/ageing/aft029.CrossRefPubMedGoogle Scholar
  16. 16.
    Ozcan, A., Donat, H., Gelecek, N., Ozdirenc, M., & Karadibak, D. (2005). The relationship between risk factors for falling and the quality of life in older adults. BioMed Central Public Health, 26(5), 90.CrossRefGoogle Scholar
  17. 17.
    Sivertsen, H., Bjørkløf, G. H., Engedal, K., Selbæk, G., & Helvik, A. S. (2015). Depression and Quality of Life in Older Persons: A Review. Dementia and Geriatric Cognitive Disorders, 40(5–6), 311–339. doi: 10.1159/000437299.CrossRefPubMedGoogle Scholar
  18. 18.
    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: an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 18(10), 1301–1309.CrossRefGoogle Scholar
  19. 19.
    Hawton, A., Green, C., Dickens, A. P., Richards, S. H., Taylor, R. S., Edwards, R., et al. (2011). The impact of social isolation on the health status and health-related quality of life of older people. Quality of Life Research: an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 20(1), 57–67. doi: 10.1007/s11136-010-9717-2.CrossRefGoogle Scholar
  20. 20.
    Thiem, U., Klaaßen-Mielke, R., Trampisch, U., Moschny, A., Pientka, L., & Hinrichs, T. (2014). Falls and EQ-5D rated quality of life in community-dwelling seniors with concurrent chronic diseases: a cross-sectional study. Health and Quality of Life Outcomes, 8(12), 2. doi: 10.1186/1477-7525-12-2.CrossRefGoogle Scholar
  21. 21.
    Stenhagen, M., Ekström, H., Nordell, E., & Elmståhl, S. (2014). Accidental falls, health-related quality of life and life satisfaction: a prospective study of the general elderly population. Archives of Gerontology and Geriatrics, 58(1), 95–100. doi: 10.1016/j.archger.2013.07.006.CrossRefPubMedGoogle Scholar
  22. 22.
    Pate, R. R., O’Neill, J. R., & Lobelo, F. (2008). The evolving definition of “sedentary”. Exercise and Sport Sciences Reviews, 36(4), 173–178. doi: 10.1097/JES.0b013e3181877d1a.CrossRefPubMedGoogle Scholar
  23. 23.
    Emerson, R. W., Satcher, D., & Carmona, R. H. (2015). Physical Activity and special Populations. In R. K. Dishman, G. W. Heath & I. Lee (Eds.), Physical Activity Epidemiology (pp. 219–240). Champaign, IL: Human Kinetics.Google Scholar
  24. 24.
    Meneguci, J., Sasaki, J. E., Santos, A., Scatena, L. M., & Damião, R. (2015). Sitting time and quality of life in older adults: A population-based study. Journal of Physical Activity and Health, 12(11), 1513–1519. doi: 10.1123/jpah.2014-0233.CrossRefPubMedGoogle Scholar
  25. 25.
    Rosenkranz, R. R., Duncan, M. J., Rosenkranz, S. K., & Kolt, G. S. (2013). Active lifestyles related to excellent self-rated health and quality of life: cross sectionalfindings from 194,545 participants in The 45 and Up Study. BioMed Central Public Health, 13(13), 1071. doi: 10.1186/1471-2458-13-1071.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Wanderley, F. A., Silva, G., Marques, E., Oliveira, J., Mota, J., & Carvalho, J. (2011). Associations between objectively assessed physical activity levels and fitness and self-reported health-related quality of life in community-dwelling older adults. Quality of Life Research: an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 20(9), 1371–1378. doi: 10.1007/s11136-011-9875-x.CrossRefGoogle Scholar
  27. 27.
    Haider, S., Luger, E., Kapan, A., Titz, S., Lackinge, C., Schindle, K. E., et al. (2016). Associations between daily physical activity, handgrip strength, muscle mass, physical performance and quality of life in prefrail and frail community-dwelling older adults. Quality of Life Research: an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation. doi: 10.1007/s11136-016-1349-8.Google Scholar
  28. 28.
    Stewart, K. J., Turner, K. L., Bacher, A. C., DeRegis, J. R., Sung, J., Tayback, M., et al. (2003). Are fitness, activity, and fatness associated with health-related quality of life and mood in older persons? Journal of Cardiopulmonary Rehabilitation, 23(2), 115–121.CrossRefPubMedGoogle Scholar
  29. 29.
    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, 22(9), 117. doi: 10.1186/1477-7525-9-117.CrossRefGoogle Scholar
  30. 30.
    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. doi: 10.1016/j.archger.2009.04.005.CrossRefPubMedGoogle Scholar
  31. 31.
    Lin, C. C., Li, C. I., Chang, C. K., Liu, C. S., Lin, C. H., Meng, N. H., et al. (2011). Reduced health-related quality of life in elders with frailty: a cross sectional study of community-dwelling elders in Taiwan. Public Library of Science one, 6(7), e21841. doi: 10.1371/journal.pone.0021841.PubMedPubMedCentralGoogle Scholar
  32. 32.
    Rikli, R. E., & Jones, C. J. (2001). Senior fitness test manual. Development and validation of a functional fitness test for community-residing older adults. Champaign, IL: Human Kinetics.Google Scholar
  33. 33.
    Instituto Nacional de Estatística (2014). Estatísticas Demográficas 2013. Lisboa, Instituto Nacional de Estatística, I.P. Eds.Google Scholar
  34. 34.
    Instituto Nacional de Estatística: Census 2001. (2002). Resultados Definitivos. Lisboa, Instituto Nacional de Estatística, I.P. Eds.Google Scholar
  35. 35.
    American College of Sports Medicine (2006). ACSM’s guidelines for exercise testing and prescription (7th edn.). Philadelphia: Lippincott Williams & Wilkins.Google Scholar
  36. 36.
    Baecke, J., Burema, J., & Frijters, J. (1982). A short questionnaire for the measurement of habitual physical activity in epidemiological studies. The American Journal of Clinical Nutrition, 36(5), 936–942.PubMedGoogle Scholar
  37. 37.
    R Core Team (2014). R: A language and environment for statistical computing. Vienna, Austria R Foundation for Statistical Computing.Google Scholar
  38. 38.
    Sayer, A. A., Syddall, H. E., Martin, H. J., Dennison, E. M., Roberts, H. C., & Cooper, C. (2006). Is grip strength associated with health-related quality of life? Findings from the Hertfordshire cohort study. Age and ageing, 35(4), 409–415.CrossRefPubMedGoogle Scholar
  39. 39.
    Kelley, G. A., Kelley, K. S., Hootman, J. M., & Jones, D. L. (2009). Exercise and health-related quality of life in older community-dwelling adults: a meta-analysis of randomized controlled trials. Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society, 28, 369–394.CrossRefGoogle Scholar
  40. 40.
    Balboa-Castillo, T., León-Muñoz, L. M., Graciani, A., Rodríguez-Artalejo, F., & Guallar-Castillón, P. (2011). Longitudinal association of physical activity and sedentary behavior during leisure time with health-related quality of life in community-dwelling older adults. Health and Quality of Life Outcomes, 27, 9–47. doi: 10.1186/1477-7525-9-47.Google Scholar
  41. 41.
    Antunes, H. K., Stella, S. G., Santos, R. F., Bueno, O. F., & de Mello, M. T. (2005). Depression, anxiety and quality of life scores in seniors after an endurance exercise program. Brazilian Journal of Psychiatry, 27(4), 266–271.PubMedGoogle Scholar
  42. 42.
    Tajvar, M., Arab, M., & Montazeri, A. (2008). Determinants of health-related quality of life in elderly in Tehran, Iran. BioMed Central Public Health, 22(8), 323. doi: 10.1186/1471-2458-8-323.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Department of Physical Education and SportUniversity of MadeiraFunchalPortugal
  2. 2.Center for the Interdisciplinary Study of Gerontology and VulnerabilityUniversity of GenevaGenevaSwitzerland
  3. 3.Saint Joseph of Cluny Higher School of NursingFunchalPortugal
  4. 4.Swiss National Center of Competences in Research LIVES-Overcoming Vulnerability: Life Course PerspectivesGenevaSwitzerland
  5. 5.Department of PsychologyUniversity of GenevaGenevaSwitzerland
  6. 6.CIFI2D, Faculty of SportUniversity of PortoPortoPortugal
  7. 7.Exact Sciences and Engineering Faculty and Madeira Interactive Technologies InstituteUniversity of MadeiraFunchalPortugal
  8. 8.Department of Mathematical SciencesUniversity of EssexColchesterUK

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