Determinants of Quality of Life in Ageing Populations: Results from a Cross-Sectional Study in Finland, Poland and Spain

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Abstract

Purpose

To comprehensively identify the determinants of quality of life (QoL) in a population study sample of persons aged 18–50 and 50+.

Methods

In this observational, cross-sectional study, QoL was measured with the WHOQOL-AGE, a brief instrument designed to measure QoL in older adults. Eight hierarchical regression models were performed to identify determinants of QoL. Variables were entered in the following order: Sociodemographic; Health Habits; Chronic Conditions; Health State description; Vision and Hearing; Social Networks; Built Environment. In the final model, significant variables were retained. The final model was re-run using data from the three countries separately.

Results

Complete data were available for 5639 participants, mean age 46.3 (SD 18.4). The final model accounted for 45% of QoL variation and the most relevant contribution was given by sociodemographic data (particularly age, education level and living in Finland: 17.9% explained QoL variation), chronic conditions (particularly depression: 4.6%) and a wide and rich social network (4.6%). Other determinants were presence of disabling pain, learning difficulties and visual problems, and living in usable house that is perceived as non-risky. Some variables were specifically associated to QoL in single countries: age in Poland, alcohol consumption in Spain, angina in Finland, depression in Spain, and self-reported sadness both in Finland and Poland, but not in Spain. Other were commonly associated to QoL: smoking status, bodily aches, being emotionally affected by health problems, good social network and home characteristics.

Conclusions

Our results highlight the importance of modifiable determinants of QoL, and provide public health indications that could support concrete actions at country level. In particular, smoking cessation, increasing the level of physical activity, improving social network ties and applying universal design approach to houses and environmental infrastructures could potentially increase QoL of ageing population.

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Most cited references 51

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Global physical activity questionnaire (GPAQ): nine country reliability and validity study.

Melissa Maslin, Fiona Bull, F. Bull … (2009)

Instruments to assess physical activity are needed for (inter)national surveillance systems and comparison. Male and female adults were recruited from diverse sociocultural, educational and economic backgrounds in 9 countries (total n = 2657). GPAQ and the International Physical Activity Questionnaire (IPAQ) were administered on at least 2 occasions. Eight countries assessed criterion validity using an objective measure (pedometer or accelerometer) over 7 days. Reliability coefficients were of moderate to substantial strength (Kappa 0.67 to 0.73; Spearman's rho 0.67 to 0.81). Results on concurrent validity between IPAQ and GPAQ also showed a moderate to strong positive relationship (range 0.45 to 0.65). Results on criterion validity were in the poor-fair (range 0.06 to 0.35). There were some observed differences between sex, education, BMI and urban/rural and between countries. Overall GPAQ provides reproducible data and showed a moderate-strong positive correlation with IPAQ, a previously validated and accepted measure of physical activity. Validation of GPAQ produced poor results although the magnitude was similar to the range reported in other studies. Overall, these results indicate that GPAQ is a suitable and acceptable instrument for monitoring physical activity in population health surveillance systems, although further replication of this work in other countries is warranted.

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Self-reports and general practitioner information on the presence of chronic diseases in community dwelling elderly. A study on the accuracy of patients' self-reports and on determinants of inaccuracy.

D. M. W. Kriegsman, B. Penninx, J T van Eijk … (1996)

The object of the study is to investigate the (in)accuracy of patients' self-reports, as compared with general practitioners' information, regarding the presence of specific chronic diseases, and the influence of patient characteristics. Questionnaire data of 2380 community-dwelling elderly patients, aged 55-85 years, on the presence of chronic non-specific lung disease, cardiac disease, peripheral atherosclerosis, stroke, diabetes, malignancies, and osteoarthritis/rheumatoid arthritis were compared with data from the general practitioners, using the kappa-statistic. Associations between the accuracy of self-reports and patient characteristics were studied by multiple logistic regression analyses. Kappa's ranged from 0.30 to 0.40 for osteoarthritis/rheumatoid arthritis and atherosclerosis, to 0.85 for diabetes mellitus. In the multivariate analyses, educational level, level of urbanization, deviations in cognitive function, and depressive symptomatology had no influence on the level of accuracy. An influence of gender, age, mobility limitations, and recent contact with the general practitioner was shown for specific diseases. For chronic non-specific lung disease, both "underreporting" and "overreporting" are more prevalent in males, compared to females. Furthermore, males tend to overreport stroke and underreport malignancies and arthritis, whereas females tend to overreport malignancies and arthritis. Both overreporting and underreporting of cardiac disease are more prevalent as people are older. Also, older age is associated with overreporting of stroke, and with underreporting of arthritis. The self-reported presence of mobility limitations is associated with overreporting of all specific diseases studied, except for diabetes mellitus, and its absence is associated with underreporting, except for diabetes mellitus and atherosclerosis. Recent contact with the general practitioner is associated with overreporting of cardiac disease, atherosclerosis, malignancies and arthritis, and with less frequent underreporting of diabetes and arthritis. Results suggest that patients' self-reports on selected chronic diseases are fairly accurate, with the exceptions of atherosclerosis and arthritis. The associations found with certain patient characteristics may be explained by the tendency of patients to label symptoms, denial by the patient, or inaccuracy of medical records.

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A systematic review of built environment and health.

Arlene Renalds, Tracey Smith, Patty Hale (2009)

The built environment can be considered a foundation for health and wellness. This structure, whether it be neighborhood layout or safe walking trails, impacts decisions relating to individual and community health outcomes. This review compiled the published research that examined the relationship between built environment and health. Findings from the 23 articles reviewed indicate that neighborhoods that are characterized as more walkable, either leisure-oriented or destination-driven, are associated with increased physical activity, increased social capital, lower overweight, lower reports of depression, and less reported alcohol abuse.

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Author and article information

Contributors

Aamir Nazir: Role: Editor

Journal

Journal ID (nlm-ta): PLoS One

Journal ID (iso-abbrev): PLoS ONE

Journal ID (publisher-id): plos

Journal ID (pmc): plosone

Title: PLoS ONE

Publisher: Public Library of Science (San Francisco, CA USA )

ISSN (Electronic): 1932-6203

Publication date (Electronic): 19 July 2016

Publication date Collection: 2016

Volume: 11

Issue: 7

Electronic Location Identifier: e0159293

Affiliations

[1 ]Neurological Institute C. Besta IRCCS Foundation, Neurology, Public Health and Disability Unit, Milan, Italy

[2 ]National Council Research, Neuroscience Institute, Padova, Italy

[3 ]World Health Organization, Information, Evidence and Research Unit, Geneva, Switzerland

[4 ]IRCCS Istituto Centro San Giovanni di Dio-Fatebenefratelli, Laboratory of Alzheimer's Neuroimaging and Epidemiology, Brescia, Italy

[5 ]Memory Clinic and LANVIE, University Hospitals and University of Geneva, Geneva, Switzerland

[6 ]Parc Sanitari Sant Joan de Déu, University of Barcelona, CIBERSAM, Barcelona, Spain

[7 ]National Institute for Health and Welfare, Population Health Research Unit, Helsinki, Finland

[8 ]E. Medea Scientific Institute, Conegliano-Pieve di Soligo Research Centre, Conegliano Veneto, Italy

[9 ]Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain

[10 ]Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain

[11 ]Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IP), Madrid, Spain

[12 ]Department of Medical Sociology, Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Krakow, Poland

CSIR-Central Drug Research Institute, INDIA

Author notes

Competing Interests: The authors have declared that no competing interests exist.

Conceived and designed the experiments: AR NM SC GBF JMH SK AM MM BTA ML. Performed the experiments: AR JMH SK MM BTA ML. Analyzed the data: AR BC NM LDT. Wrote the paper: AR BC NM RQ DS LDT SC GBF JMH SK AM MM BTA ML.

* E-mail: alberto.raggi@ 123456istituto-besta.it

Author information

Alberto Raggi http://orcid.org/0000-0002-7433-7779

Article

Publisher ID: PONE-D-16-07918

DOI: 10.1371/journal.pone.0159293

PMC ID: 4951007

PubMed ID: 27434374

SO-VID: 1f016131-3253-4009-8ba3-63bb252bc88b

License:

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

History

Date received : 24 February 2016

Date accepted : 30 June 2016

Page count

Figures: 0, Tables: 2, Pages: 17

Funding

Funded by: European Commission (BE)

Award ID: HEALTH-F2-2009-223071

Award Recipient : Matilde Leonardi

Funded by: funder-id http://dx.doi.org/10.13039/501100000780, European Commission;

Award ID: 316795

Award Recipient : Matilde Leonardi

The authors acknowledge funding from the European Commission's Seventh Framework Programme, project no HEALTH-F2-2009-223071 (COURAGE in Europe), and from the Commission's Seventh Framework Programme under REA grant agreement n° 316795 (MARATONE). AR takes full responsibility for the data, the analysis, the interpretation, and the conduct of the research. AR has full access to all of the data. All authors report no conflicts of interest. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The views expressed in this paper are those of the authors, and do not necessarily represent the views or policies of the World Health Organization.

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Determinants of Quality of Life in Ageing Populations: Results from a Cross-Sectional Study in Finland, Poland and Spain

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PLOS Global Public Health

Most cited references 51

Global physical activity questionnaire (GPAQ): nine country reliability and validity study.

Self-reports and general practitioner information on the presence of chronic diseases in community dwelling elderly. A study on the accuracy of patients' self-reports and on determinants of inaccuracy.

A systematic review of built environment and health.

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