Sex differences in relation patterns between health-related quality of life of older adults and its correlates: a population-based cross-sectional study in Madeira, Portugal

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Abstract

A population-based cross-sectional study aimed to examine sex differences in health-related quality of life (HRQoL) of older adults, and investigate whether the relation patterns between HRQoL and its correlates differed between sexes. A stratified proportional and representative sample included 802 volunteers, aged 60–79. HRQoL (36-item Short Form Health Survey), functional fitness (Senior Fitness Test), physical activity (PA) (Baecke questionnaire), demographic information and health features (questionnaires) were assessed. Men showed significantly higher HRQoL ( P<0.001). Body mass index, body strength, aerobic endurance, PA, depressive symptoms, falls, and living alone were significantly related to HRQoL. With sex as moderator, these relations were not significant, except for PA ( β=0.12, P=0.004). A significant interaction of sex with PA on HRQoL ( β=0.08, P=0.037) was found, indicating that this relation was higher in men. A similar relation pattern was found for HRQoL physical component. HRQoL and its correlates differed between sexes, demanding a sex specific approach to promote HRQoL.

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Depression and Quality of Life in Older Persons: A Review

Heidi Sivertsen, Guro Bjørkløf, Knut Engedal … (2015)

Background: Depression is a prevalent and disabling condition in older persons (≥60 years) that increases the risk of mortality and negatively influences quality of life (QOL). The relationship between depression, or depressive symptoms, and QOL has been increasingly addressed by research in recent years, but a review that can contribute to a better understanding of this relationship in older persons is lacking. Against this background, we undertook a literature review to assess the relationship between depression and QOL in older persons. Summary: Extensive electronic database searches revealed 953 studies. Of these, 74 studies fulfilled our criteria for inclusion, of which 52 were cross-sectional studies and 22 were longitudinal studies. Thirty-five studies were conducted in a clinical setting, while 39 were community-based epidemiological studies. A clear definition of the QOL concept was described in 25 studies, and 24 different assessment instruments were employed to assess QOL. Depressed older persons had poorer global and generic health-related QOL than nondepressed individuals. An increase in depression severity was associated with a poorer global and generic health-related QOL. The associations appeared to be stable over time and independent of how QOL was assessed. Key Messages: This review found a significant association between severity of depression and poorer QOL in older persons, and the association was found to be stable over time, regardless which assessment instruments for QOL were applied. The lack of a definition of the multidimensional and multilevel concept QOL was common, and the large variety of QOL instruments in various studies make a direct comparison between the studies difficult.

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Critical perspectives on successful aging: does it "appeal more than it illuminates"?

Stephen I Katz, Toni Calasanti (2015)

"Successful aging" is one of gerontology's most successful ideas. Applied as a model, a concept, an approach, an experience, and an outcome, it has inspired researchers to create affiliated terms such as "healthy," "positive," "active," "productive," and "effective" aging. Although embraced as an optimistic approach to measuring life satisfaction and as a challenge to ageist traditions based on decline, successful aging as defined by John Rowe and Robert Kahn has also invited considerable critical responses. This article takes a critical gerontological perspective to explore such responses to the Rowe-Kahn successful aging paradigm by summarizing its empirical and methodological limitations, theoretical assumptions around ideas of individual choice and lifestyle, and inattention to intersecting issues of social inequality, health disparities, and age relations. The latter point is elaborated with an examination of income, gender, racial, ethnic, and age differences in the United States. Conclusions raise questions of social exclusion and the future of successful aging research.

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Gender differences in health-related quality of life among the elderly: the role of objective functional capacity and chronic conditions.

Jordi Alonso, Rosa Lamarca, Antònia Domingo-Salvany … (2006)

Although worse Health-Related Quality of Life (HRQL) among women has been widely described, it remains unclear whether this is due to differential reporting patterns, or whether there is a real difference in health status. The objective of this study was to evaluate to what extent gender differences in HRQL among the elderly might be explained by differences in performance-based functional capacity and chronic conditions, using the conceptual model of health outcomes as proposed by Wilson and Cleary. Data are from a cross-sectional home survey of 872 surviving individuals from an elderly cohort representative of Barcelona's general population. Complete valid data for these analyses were obtained from 62% of the subjects (n = 544). The evaluation included the Nottingham Health Profile (NHP), a generic measure of HRQL; three performance-based functional capacity tests (balance, chair-stand, and walking tests); and a standardized list of self-reported chronic conditions. A series of multiple linear regression models were built with the total NHP score as the dependent variable, with gender, socio-demographic information, performance-based functional capacity and chronic conditions included sequentially, as independent variables. Women (65.4%) showed worse results than men on HRQL (mean of NHP total score 28.3 vs 16.7, p < 0.001) and functional capacity (mean of summary score 7.1 vs 8.3, p < 0.001). Functional capacity, arthritis, back pain, diabetes, and depression were significantly associated to the NHP total score in the final regression model, which explained 42% of the variance. Raw differences by gender in the total NHP score were 11.5 points (p < 0.001), but decreased to a non-significant 3.2 points (p = 0.18) after adjusting for all the other variables. In conclusion, our data suggest that worse reported HRQL in elderly women is mainly due to a higher prevalence of disability and chronic conditions.

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Author and article information

Journal

Journal ID (nlm-ta): Prim Health Care Res Dev

Journal ID (iso-abbrev): Prim Health Care Res Dev

Journal ID (publisher-id): PHC

Title: Primary Health Care Research & Development

Publisher: Cambridge University Press (Cambridge, UK )

ISSN (Print): 1463-4236

ISSN (Electronic): 1477-1128

Publication date Collection: 2019

Publication date (Electronic): 13 September 2018

Volume: 20

Electronic Location Identifier: e54

Affiliations

[1 ] Saint Joseph of Cluny Higher School of Nursing , Funchal, Portugal

[2 ] Health Administration Institute, IP-RAM, Secretary of Health of the Autonomous Region of Madeira, Funchal, Portugal

[3 ] Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva , Geneva, Switzerland

[4 ] Madeira Interactive Technologies Institute, University of Madeira , Funchal, Portugal

[5 ] Department of Psychology, University of Geneva , Geneva, Switzerland

[6 ] Department of Physical Education and Sport, University of Madeira , Funchal, Portugal

[7 ] Department of Mathematical Sciences, University of Essex , Colchester, UK

Author notes

Author for correspondence: Bruna R. Gouveia, Escola Superior de Enfermagem São José de Cluny, Rampa da Quinta de Sant’Ana, 22; 9050-535 Funchal, Portugal. E-mail: bgouveia@ 123456esesjcluny.pt

Article

Publisher Item ID: S1463423618000233 Publisher ID: 00023

DOI: 10.1017/S1463423618000233

PMC ID: 7008396

PubMed ID: 30208982

SO-VID: fa7b83af-10f4-4f86-9cbb-d49015639540

License:

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 28 April 2017

Date revision received : 14 January 2018

Date accepted : 25 February 2018

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Most cited references 17

Depression and Quality of Life in Older Persons: A Review

Critical perspectives on successful aging: does it "appeal more than it illuminates"?

Gender differences in health-related quality of life among the elderly: the role of objective functional capacity and chronic conditions.

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