FACTORS RELATED TO HEALTH-RELATED QUALITY OF LIFE AND SUBJECTIVE WELL-BEING IN OLDER ADULTS WHO REQUIRE LONG-TERM CARE

Background: Older adults who require long-term care have difficulty maintaining good quality of life (QOL). These adults require care for their activities of daily living, and have reduced physical, mental, and social function compared with the general older adults. It is recommended that both health-related quality of life (HR-QOL) and subjective well-being (SWB) be measured when evaluating QOL in older adults. However, HR-QOL and SWB are different concepts, which makes it difficult to interpret the results. This is because despite QOL being affected by factors such as physical function, mental state, and the social environment, it is easily reflected in HRQOL Only physical function and therapeutic effect, and it is difficult to reflect factors related to lifestyle, such as the social environment. Furthermore, SWB is only weakly correlated with physical function, so it is unsuitable as a QOL index for people with reduced physical function. When either HRQOL or SWB alone is used to measure QOL, the results may only represent one aspect of QOL. 

Purpose: We assessed QOL in older adults using HR-QOL and SWB as a single construct, and clarified related physical, mental, and social factors.

Methods: A questionnaire survey and physical function measurements were conducted on 123 users of day care rehabilitation services. Survey and measurement items were the physical and mental component summaries of the 8-item Short-Form Health Survey, Life Satisfaction Index K, 30-Second Chair-Stand Test, 5-meter walking time maximum, pain, Geriatric Depression Scale-15, K-I Scale, Japanese version of the abbreviated Lubben Social Network Scale, age, gender, nursing care level, living arrangements, residence history, educational level, and hobbies. Canonical correlation analysis was used to clarify factors related to QOL. Prior to conducting CCA, single correlation coefficients were confirmed between all the variables to confirm multicollinearity in advance. The statistical analysis software programs R2.8.1 (CRAN, freeware) and SPSS Statistics version 22 (IBM Corp., Armonk, NY) were used, and level of significance was set as 5%.

Results: Items with a canonical correlation coefficient of ≥0.4 were first and second canonical variates. As First canonical variates (canonical correlation coefficient, r=.692; p<.05), Geriatric Depression Scale-15 (canonical loading [CL] =.884) was strongly affected mental component summary (CL =-.574), Life Satisfaction Index K (CL =-.950). As second canonical variates (canonical correlation coefficient, r=.522; p=.062), 30-Second Chair-Stand Test (CL =.473), pain (CL =-.681) were strongly affected by physical component summary (CL =.979).

Conclusion(s): This study clarified that low level of depression, low level of pain, and strong leg muscle strength correlates with high QOL in older adults who require long-term care when evaluating QOL combining HRQOL and SWB as a single construct.

Implications: The results of this study will help us to consider what kind of rehabilitation services should be used to improve the quality of life of older adults who require long-term care.

Funding, acknowledgements: We would like to express sincere gratitude to the staff and patients for their understanding and cooperation in this study.

Keywords: health-related quality of life, subjective well-being, long-term care

Topic: Health promotion & wellbeing/healthy ageing/physical activity

Did this work require ethics approval? Yes

Institution: Hirosaki University School of Medicine Health Sciences

Committee: Ethics Review Committee of Hirosaki University School of Medicine Health Sciences

Ethics number: 2018-055