Social Indicators Research

, Volume 106, Issue 1, pp 27–39

The Relative Contribution of Health Status and Quality of Life Domains in Subjective Health in Old Age

  • Maria-Eugenia Prieto-Flores
  • Antonio Moreno-Jiménez
  • Gloria Fernandez-Mayoralas
  • Fermina Rojo-Perez
  • Maria João Forjaz


To analyze the influence of different health status dimensions and quality of life (QoL) domains on older adults’ subjective health, and to assess the role that residential satisfaction plays in these relationships. A QoL survey was conducted on a representative sample of the community-dwelling older adult population in Madrid province (Spain). Logistic regression models were applied to studying: the health status dimensions associated with satisfaction with health; the relationship between satisfaction with health and other QoL domains; and, the influence of these domains on satisfaction with life. Sociodemographic and residential characteristics were included in all the models. The determinants of satisfaction with health in the first model were: mobility, usual activities, morbidity, and satisfaction with neighborhood. QoL domains associated with health were: leisure activities, neighborhood, and finances. Satisfaction with life was explained by these three domains, along with age, family and health. In sum, leisure, neighborhood, and finances showed a positive effect on satisfaction with health and with life.


Older adults Quality of life Subjective health Residential satisfaction Spain 


  1. Andrews, G. J., Cutchin, M., McCracken, K., Phillips, D. R., & Wiles, J. (2007). Geographical gerontology: The constitution of a discipline. Social Science and Medicine, 65(1), 151–168.CrossRefGoogle Scholar
  2. Andrews, G. J., & Phillips, D. R. (Eds.). (2005). Ageing and place. Perspectives, policy, practice. London: Routledge, Taylor & Francis Group.Google Scholar
  3. Azpiazu, M., Cruz, A., Villagrasa, J. R., Abanades, J., García, N., & Álvarez de Mon Rego, C. (2003). Calidad de vida en mayores de 65 años no institucionalizados de dos áreas sanitarias de Madrid [Quality of life among non- institutionalized persons aged over 65 years in two health care districts in Madrid]. Atención Primaria, 31(5), 285–294.CrossRefGoogle Scholar
  4. Azpiazu, M., Cruz, A., Villagrasa, J. R., Abanades, J. C., García, N., & Alvear, F. (2002). Factores asociados a mal estado de salud percibido o a mala calidad de vida en personas mayores de 65 años [Factors associated with poor perceived health status or poor quality of life among persons aged over 65 years]. Revista Española de Salud Pública, 76(6), 683–699.CrossRefGoogle Scholar
  5. Badía, X., Schiaffino, A., Alonso, J., & Herdman, M. (1998). Using the EuroQoL 5-D in the Catalan general population: Feasibility and construct validity. Quality of Life Research, 7(4), 311–322.CrossRefGoogle Scholar
  6. Borglin, G., Edberg, A.-K., & Rahm Hallberg, I. (2005). The experience of quality of life among older people. Journal of Aging Studies, 19(2), 201–220.CrossRefGoogle Scholar
  7. Bowling, A., Banister, D., Sutton, S., Evans, O., & Windsor, J. (2002). A multidimensional model of the quality of life in older age. Aging and Mental Health, 6(4), 355–371.CrossRefGoogle Scholar
  8. Bowling, A., Farquhar, M., Grundy, E., & Formby, J. (1993). Changes in life satisfaction over a two and a half year period among very elderly people living in London. Social Science and Medicine, 36(5), 641–655.CrossRefGoogle Scholar
  9. Browne, J. P., O’Boyle, C. A., McGee, H. M., Joyce, C. R. B., McDonald, N. J., O’Malley, K., et al. (1994). Individual quality of life in the healthy elderly. Quality of Life Research, 3(4), 235–244.CrossRefGoogle Scholar
  10. Browne, J. P., O’Boyle, C. A., McGee, H. M., McDonald, N. J., & Joyce, C. R. B. (1997). Development of a direct weighting procedure for quality of life domains. Quality of Life Research, 6(4), 301–309.CrossRefGoogle Scholar
  11. Commission on Social Determinants of Health. (2007). A conceptual framework for action on the social determinants of health. Geneva: WHO.Google Scholar
  12. Cummins, R. A. (2005). Moving from the quality of life concept to a theory. Journal of Intellectual Disability Research, 49(10), 699–706.CrossRefGoogle Scholar
  13. Diener, E. (1994). Assessing subjective well-being: Progress and opportunities. Social Indicators Research, 31, 103–157.CrossRefGoogle Scholar
  14. EuroQoL Group. (1990). EuroQoL—A new facility for the measurement of health-related quality of life. Health Policy, 16(3), 199–208.CrossRefGoogle Scholar
  15. EuroQoL Group. (2007). EQ-5D user guide version 1.0 (p. 24). Rotterdam.Google Scholar
  16. Farquhar, M. (1995). Elderly people’s definitions of quality of life. Social Science and Medicine, 41(10), 1439–1446.CrossRefGoogle Scholar
  17. Fernández Ballesteros, R., Montorio, I., & Fernández de Trocóniz, M. I. (1998). Personal and environmental relationships among the elderly living in residential settings. Archives of Gerontology and Geriatrics, 26(2), 185–198.CrossRefGoogle Scholar
  18. Fernández-Mayoralas, G., Martínez Martín, P., Rojo Pérez, F., Forjaz, M. J., Prieto Flores, M. E., García Izaguirre, C., et al. (2007a). El significado de la salud en la Calidad de Vida de los Mayores [The meaning of health in the quality of life of older people]. Madrid: Portal Mayores. Accessed 2 Dec 2010.
  19. Fernández-Mayoralas, G., Prieto Flores, M. E., & Rojo Pérez, F. (2007b). Geografías de la salud: Desde la Ecología de la enfermedad a la Calidad de Vida [From disease ecology to quality of life]. In G. D. Buzai (Ed.), Métodos cuantitativos en geografía de la salud (pp. 33–40). Luján, Argentina: Universidad Nacional de Luján.Google Scholar
  20. Fernández-Mayoralas, G., Rojo Pérez, F., & Rojo Abuín, J. M. (2004). Components of the residential environment and sociodemographic characteristics of the elderly. Journal of Housing for the Elderly, 18(1), 25–49.CrossRefGoogle Scholar
  21. Forjaz, M. J., & Martínez Martín, P. (2006). Determinantes de calidad de vida: Contribución de los modelos de ecuaciones estructurales [Determinants of quality of life: Contribution of structural equation models]. In P. Martínez Martín (Ed.), Calidad de vida en neurología [Quality of life in neurology] (pp. 115–133). Barcelona: Ars Medica.Google Scholar
  22. Grewal, I., Lewis, J., Flynn, T., Brown, J., Bond, J., & Coast, J. (2006). Developing attributes for a generic quality of life measure for older people: Preferences or capabilities? Social Science and Medicine, 62(8), 1891–1901.CrossRefGoogle Scholar
  23. Guallar-Castillón, P., Redondo Sendino, A., Banegas, J. R., Lopez-Garcia, E., & Rodriguez-Artalejo, F. (2005). Differences in quality of life between women and men in the older population of Spain. Social Science and Medicine, 60(6), 1229–1240.CrossRefGoogle Scholar
  24. Halvorsrud, L., & Kalfoss, M. (2007). The conceptualization and measurement of quality of life in older adults: A review of empirical studies published during 1994–2006. European Journal of Ageing, 4(4), 229–246.CrossRefGoogle Scholar
  25. Instituto de Estadística de la Comunidad de Madrid. (2004). Padrón municipal de habitantes [Municipal Census]. Accessed 2 Dec 2010.
  26. Kearns, R. A. (1993). Place and health: Towards a reformed medical geography. Professional Geographer, 45(2), 139–147.CrossRefGoogle Scholar
  27. Michalos, A. C., Zumbo, B. D., & Hubley, A. (2003). Health on the QoL. In A. C. Michalos (Ed.), Essays on the quality of life (pp. 153–182). Dordrecht: Kluwer Academic Publishers. Social Indicators Research serie, vol. 19.Google Scholar
  28. Nair, K. (2005). The physically ageing body and the use of space. In G. J. Andrews & D. R. Phillips (Eds.), Ageing and place. Perspectives, policy, practice (pp. 110–117). London: Routledge, Taylor and Francis Group.Google Scholar
  29. Olivera, A. (2006). Geografía y discapacidad [Geography and disability]. In J. Nogué & J. Romero (Eds.), Las otras geografías (pp. 527–542). Valencia: Tirant lo Blanch.Google Scholar
  30. Oswald, F., & Wahl, H.-W. (2004). Housing and health in later life. Reviews of Environmental Health, 19(3), 223–252.Google Scholar
  31. Pfeiffer, E. (1975). A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. Journal of American Geriatric Society, 23(10), 433–441.Google Scholar
  32. Prieto-Flores, M. E., Fernandez-Mayoralas, G., Rosenberg, M. W., & Rojo-Perez, F. (2010). Identifying connections between the subjective experience of health and quality of life in old age. Qualitative Health Research, 11(20), 1491–1499.CrossRefGoogle Scholar
  33. Puga González, M. D. (2002). Dependencia y necesidades asistenciales de los ancianos en España. Previsión al año 2010 [Dependency and healthcare needs of the elderly in Spain. Forecast until 2010]. Madrid: Fundación Pfizer.Google Scholar
  34. Relph, E. (2008). Senses of place and emerging social and environmental challenges. In J. Eyles & A. Williams (Eds.), Sense of place, health and quality of life (pp. 31–44). Hampshire: Ashgate.Google Scholar
  35. Rojo Pérez, F., Fernández-Mayoralas, G., Pozo Rivera, E., & Rojo Abuín, J. M. (2001). Ageing in place: Predictors of residential satisfaction of elderly. Social Indicators Research, 54(2), 173–208.CrossRefGoogle Scholar
  36. Rojo-Pérez, F., Fernández-Mayoralas, G., Rodríguez-Rodríguez, V., & Rojo-Abuín, J.-M. (2007). The environments of ageing in the context of the global quality of life among older people living in family housing. In H. Mollenkopf & A. Walker (Eds.), Quality of life in old age. International and multidisciplinary perspectives (Vol. 31, pp. 123–150). Dordrecht: Springer.Google Scholar
  37. Rosenberg, M. W. (1998). Medical or health geography? Populations, peoples and places. International Journal of Population Geography, 4(3), 211–226.CrossRefGoogle Scholar
  38. Seymour, D. G., Starr, J. M., Fox, H. C., Lemmon, H. A., Deary, I. J., Prescott, G. J., et al. (2008). Quality of life, its correlates in octogenarians. Use of the SEIQoL-DW in wave 5 of the Aberdeen Birth Cohort 1921 study (ABC1921). Quality of Life Research, 17, 11–20.CrossRefGoogle Scholar
  39. Smith, J., Borchelt, M., Maier, H., & Jopp, D. (2002). Health and well-being in the young old and oldest old. Journal of Social Issues, 58(4), 715–732.CrossRefGoogle Scholar
  40. Steverink, N., Westerhof, G. J., Bode, C., & Dittmann-Kohli, F. (2001). The personal experience of aging, individual resources, and subjective well-being. Journal of Gerontology: Psychological Sciences, 56B(6), 364–373.CrossRefGoogle Scholar
  41. Valenzuela Rubio, M. (1995). El entorno residencial como medio ambiente. Un horizonte para la integración social y la calidad de vida [The residential context as environment. A horizon for social integration and quality of life]. Anales de Geografía de la Universidad Complutense, 5, 769–778.Google Scholar
  42. Veenhoven, R. (2002). Why social policy needs subjective indicators. In M. R. Hagerty, J. Vogek, & V. Møller (Eds.), Assessing quality of life and living conditions to guide national policy: The state of the art (pp. 33–45). Dordrecht, Boston: Kluwer Academic Publishers. Series: Social indicators research, vol. 11.CrossRefGoogle Scholar
  43. Wilkinson, R., & Marmot, M. (Eds.). (2003). Social determinants of health: The solid facts (Second Ed. ed.). Copenhagen: World Health Organization.Google Scholar
  44. Willson, I. B., & Cleary, P. D. (1995). Linking clinical variables with health related quality of life. JAMA, 273(1), 59–65.CrossRefGoogle Scholar
  45. Wilson, K., Elliott, S., Law, M., Eyles, J., Jerrett, M., & Keller-Olaman, S. (2004). Linking perceptions of neighbourhood to health in Hamilton, Canada. Journal of Epidemiology and Community Health, 58(3), 192–198.CrossRefGoogle Scholar
  46. World Health Organization. (2002). Active ageing: A policy framework. Geneva: WHO.Google Scholar
  47. Yanguas Lezaun, J. J. (2006). Análisis de la calidad de vida relacionada con la salud en la vejez desde una perspectiva multidimensional [Analysis of health-related quality of life in old age from a multidimensional perspective]. Madrid: Ministerio de Trabajo y Asuntos Sociales.Google Scholar

Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • Maria-Eugenia Prieto-Flores
    • 1
  • Antonio Moreno-Jiménez
    • 2
  • Gloria Fernandez-Mayoralas
    • 3
  • Fermina Rojo-Perez
    • 3
  • Maria João Forjaz
    • 1
  1. 1.National School of Public HealthCarlos III Institute of HealthMadridSpain
  2. 2.Department of GeographyAutonomous University of MadridMadridSpain
  3. 3.Centre for Human and Social SciencesSpanish National Research CouncilMadridSpain

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