Association between health related quality of life (HRQOL) and activity of daily living (ADL) among elderly in an urban setting of Assam, India

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Abstract

Background:

Ensuring better quality of life to an increasing number of elderly people is emerging as a stiff public health challenge in India. There is paucity of data on impact of functional health on health-related quality of life (HRQOL) in India.

Objectives:

The aim of this study is to explore the functional status and its association with different dimensions of HRQOL among elderly individuals in an urban setting of Assam, India.

Materials and Methods:

A total of 300 elderly were recruited in a cross-sectional study from the city of Dibrugarh, Assam, India. Eight domains of HRQOL of participants were assessed using short form 36 (SF-36). Functional status was assessed by using Barthel activity of daily living (ADL) tool. ANOVA test and binary logistic regression analysis was performed to examine the relationship between ADL status and HRQOL.

Results:

In all, 34.7% ( n = 104) of participants had limitations in one or more ADL items. We also observed a strong graded relationship between ADL and HRQOL scores. Those who scored perfect 100 ADL score also scored highest in all eight HRQOL scales, whereas those with least ADL score scored lowest in all the HRQOL scales. In age- and sex-adjusted logistic regression analysis, the probability of poor health increased with decreasing level of ADL scores.

Conclusion:

Findings of the study suggest that decline in ADL can negatively impact different dimensions of HRQOL among elderly individuals. The findings indicate that there is need to pay proper attention for restoring functional health at later life in order to improve quality of life among elderly in India.

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Most cited references 26

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The RAND-36 measure of health-related quality of life.

William Hays, David Morales (2001)

The RAND-36 is perhaps the most widely used health-related quality of life (HRQoL) survey instrument in the world today. It is comprised of 36 items that assess eight health concepts: physical functioning, role limitations caused by physical health problems, role limitations caused by emotional problems, social functioning, emotional well-being, energy/fatigue, pain, and general health perceptions. Physical and mental health summary scores are also derived from the eight RAND-36 scales. This paper provides example applications of the RAND-36 cross-sectionally and longitudinally, provides information on what a clinically important difference is for the RAND-36 scales, and provides guidance for summarizing the RAND-36 in a single number. The paper also discusses the availability of the RAND-36 in multiple languages and summarizes changes that are incorporated in the latest version of the survey.

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Social relationships, mental health and wellbeing in physical disability: a systematic review

Hannah Tough, Johannes Siegrist, Christine Fekete (2017)

Background Research has consistently found that favourable exchange with one’s proximal social environment has positive effects on both mental health and wellbeing. Adults with physical disabilities may have fewer opportunities of favourable exchange, and therefore the effects on mental health and wellbeing may be less advantageous. The aim of this study is to systematically review quantitative studies exploring associations of social relationships with mental health and wellbeing in persons with physical disabilities. Methods The databases PubMed, PsycINFO and Scopus were searched for relevant studies published between 1995 and 2016. Data was extracted on study and participants’ characteristics, independent and dependent variables, used measures and effects sizes of associations between social relationships and mental health or wellbeing. A narrative review was performed to synthesize findings along the constructs social support, social networks, negative social interactions, family functioning and relationship quality. Results Of the 63 included studies, 47 were cross-sectional and 16 longitudinal. Most studies included a measure of social support (n = 58), while other concepts were less often studied (social networks n = 6; negative social interaction n = 3; family functioning n = 2; relationship quality n = 1). Over half of studies included depression as outcome (n = 33), followed by wellbeing (n = 14), composite mental health measures (n = 10), anxiety (n = 8), psychological distress (n = 7), posttraumatic stress disorder (n = 3), and hopelessness (n = 1). Although trends for associations of social support with mental health and wellbeing were consistent, around a quarter of studies failed to report significant associations. Social networks were related to depression, but not to other mental health or wellbeing measures. Family functioning, negative social interactions and relationship quality showed consistent associations with mental health and wellbeing, however, only few studies were available. Conclusions This review indicates that social relationships play an important role in mental health and wellbeing in persons with disabilities, although findings are less consistent than in general populations and strength of associations vary between constructs. Integrating persons with disabilities into social networks seems not sufficient and rehabilitation professionals together with affected persons and their peers should ensure that high quality relationships and tailored support are available.

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Morbidity profile and its relationship with disability and psychological distress among elderly people in Northern India.

Subaschandrabose kumar, K. Joshi, Ajit Avasthi (2003)

Morbidity among elderly people has an important influence on their physical functioning and psychological well-being. Evaluation of the morbidity profile and its determinants, which have implications for elderly people, are not available. The objective of this study is to assess morbidity, co-morbidity, and patterns of treatment seeking, and to determine relationship of morbidity with disability, psychological distress, and socio-demographic variables among the elderly population in northern India. A cross-sectional survey of 200 subjects over 60 years old (100 each from the urban population of Chandigarh City and the rural population of Haryana State of India) was carried out using a cluster sampling technique. The study period was July 1999-April 2000. Various socio-demographic characteristics were recorded at baseline. A clinical diagnosis was made by a physician based on reported illness, clinical examination, and cross-checking of medical records and medications held by the subjects. Psychological distress and disability was assessed using the PGI-Health Questionnaire-N-1 and the Rapid Disability Rating Scale-2, respectively. ANOVA, Kruskal-Wallis H test, correlation coefficient, and multivariate analysis were used to assess the relationship and association of morbidity with other variables. Of the total sample, 88.9% reported illness based on their perception, and of these 43.5% were seeking treatment and actually taking medicines, and 42.5% were diagnosed as having 4-6 morbidities. The mean number of morbidities among elderly people was 6.1 (SD 2.9). A total of 87.5% had minimal to severe disabilities and 66% of elderly people were distressed physically, psychologically, or both. The most prevalent morbidity was anaemia, followed by dental problems, hypertension, chronic obstructive airway disease (COAD), cataract, and osteoarthritis. Morbidities like asthma, COAD, hypertension, osteoarthritis, gastrointestinal disorders, anaemia, and eye and neurological problems were significantly associated with disability and distress. Higher number of morbidities was associated with greater disability and distress. In univariate analysis, socio-demographic variables like age, locality, caste, education, occupation, and income were important determinants of morbidity. Multivariate analysis was undertaken to find out the independent relationship of socio-demographic variables with morbidity. Morbidity was significantly associated with age (b value 0.06, 95% CI: 0.01, 0.12), sex (b value 1.03, 95% CI: 0.02, 2.05), and occupation (b value 0.20, 95% CI: 0.07, 0.33). A high mean number of morbidities (6.1, SD 2.9) was observed. Elderly subjects with higher morbidity had increasing disability and distress. Age, sex, and occupation were important determinants of morbidity. Assessment of the morbidity profile and its determinants will help in the application of interventions, both medical and social, to improve the health status and thus the quality of life of the elderly in Northern India.

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Author and article information

Journal

Journal ID (nlm-ta): J Family Med Prim Care

Journal ID (iso-abbrev): J Family Med Prim Care

Journal ID (publisher-id): JFMPC

Title: Journal of Family Medicine and Primary Care

Publisher: Wolters Kluwer - Medknow (India )

ISSN (Print): 2249-4863

ISSN (Electronic): 2278-7135

Publication date (Print): May 2019

Volume: 8

Issue: 5

Pages: 1760-1764

Affiliations

[1 ] Department of Community Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Mawdiangdiang, Shillong, Meghalaya, India

[2 ] Department of Pulmonary Medicine, Gauhati Medical College, Guwahati, Assam, India

Author notes

Address for correspondence: Dr. Jogesh Sarma, Department of Pulmonary Medicine, Gauhati Medical College, Guwahati - 781 032, Assam, India. E-mail: jsarma15@ 123456yahoo.in

Article

Publisher ID: JFMPC-8-1760

DOI: 10.4103/jfmpc.jfmpc_270_19

PMC ID: 6559106

PubMed ID: 31198751

SO-VID: 6aa16561-cd5b-4534-892a-b6f80bccaca3

License:

This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Association between health related quality of life (HRQOL) and activity of daily living (ADL) among elderly in an urban setting of Assam, India

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Conclusion:

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Most cited references 26

The RAND-36 measure of health-related quality of life.

Social relationships, mental health and wellbeing in physical disability: a systematic review

Morbidity profile and its relationship with disability and psychological distress among elderly people in Northern India.

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