Exploring the effect of the structural model of active aging on the self-assessment of quality of life among older people: a cross-sectional and analytical study
Keywords:
Aged, Quality of life, Models, statistical, Older adults, Quality of life of older people, Active aging, Statistical modelAbstract
BACKGROUND: Although studies have examined the relationship between variables associated with active aging and quality of life (QoL), no studies have been identified to have investigated the effect of a structural model of active aging on QoL in a representative sample of older people in the community.
OBJECTIVE: To measure the domains and facets of QoL in older people and identify the effect of the structural model of active aging on the self-assessment of QoL.
DESIGN AND SETTING: This cross-sectional analytical study included 957 older people living in urban areas. Data were collected from households using validated instruments between March and June 2018. Descriptive, confirmatory factor, and structural equation modeling analyses were performed.
RESULTS: Most older people self-rated their QoL as good (58.7%), and the highest mean scores were for the social relationships domain (70.12 ± 15.4) and the death and dying facet (75.43 ± 26.7). In contrast, the lowest mean scores were for the physical domains (64.41 ± 17.1) and social participation (67.20 ± 16.2) facets. It was found that active aging explained 50% of the variation in self-assessed QoL and directly and positively affected this outcome (λ = 0.70; P < 0.001).
CONCLUSION: Active aging had a direct and positive effect on the self-assessment of QoL, indicating that the more individuals actively aged, the better the self-assessment of QoL.
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References
World Health Organization. Active ageing: a policy framework. Geneva: WHO; 2002. Available from: https://apps.who.int/iris/ handle/10665/67215. Accessed in 2023 (April 13).
The World Health Organization Quality of Life assessment (WHOQOL): position paper from the World Health Organization. Soc Sci Med. 1995;41(10):1403-9. PMID: 8560308; https://doi.org/10.1016/02779536(95)00112-k.
Fleck MP, Louzada S, Xavier M, et al. Aplicação da versão em português do instrumento abreviado de avaliação da qualidade de vida “WHOQOL-bref” [Application of the Portuguese version of the abbreviated instrument of quality life WHOQOL-bref]. Rev Saude Publica. 2000;34(2):178-83. PMID: 10881154; https://doi.org/10.1590/S003489102000000200012.
Ferreira LK, Meireles JFF, Ferreira MEC. Evaluation of lifestyle and quality of life in the elderly: a literature review. Rev Bras Geriatr Gerontol. 2018;21(5):616-27. https://doi.org/10.1590/1981-22562018021.180028.
Lima GS, Souza IMO, Storti LB, et al. Resilience, quality of life and symptoms of depression among elderlies receiving outpatient care.
Rev Lat Am Enfermagem. 2019;27:e3212. PMID: 31664416; https://doi. org/10.1590/1518-8345.3133.3212.
Sousa AAD, Martins AMEBL, Silveira MF et al. Quality of life and functional disability among elderly enrolled in the family health strategy. ABCS Health Sci. 2018;43(1):14-24. https://doi.org/10.7322/abcshs.v43i1.986.
Tiraphat S, Peltzer K, Thamma-Aphiphol K, Suthisukon K. The role of age-friendly environments on quality of life among Thai older adults.
Int J Environ Res Public Health. 2017;14(3):282. PMID: 28282942; https:// doi.org/10.3390/ijerph14030282.
Talarska D, Tobis S, Kotkowiak M, et al. Determinants of quality of life and the need for support for the elderly with good physical and mental functioning. Med Sci Monit. 2018;24:1604-13. PMID: 29551764; https:// doi.org/10.12659/msm.907032.
Toselli S, Campa F, Spiga F, et al. The association between body composition and quality of life among elderly Italians. Endocrine. 2020;68(2):279-86. PMID: 31893349; https://doi.org/10.1007/s12020019-02174-7.
Marôco J. Análise de equações estruturais: Fundamentos teóricos, software e aplicações. Lisboa: ReportNumber; 2014.
Duarte LSS, Dutra CDT, Pires CAA, et al. Análise da capacidade funcional de idosos atendidos pela estratégia de saúde da família. Rev Para Med. 2012;26(4):1-7. Available from: https://pesquisa.bvsalud.org/portal/ resource/pt/lil-670719. Accessed in 2023 (May 31).
Bertolucci PH, Brucki SM, Campacci SR, Juliano Y. O Mini-Exame do Estado Mental em uma população geral. Impacto da escolaridade [The Mini-Mental State Examination in a general population: impact of educational status]. Arq Neuropsiquiatr. 1994;52(1):1-7. PMID: 8002795; https://doi.org/10.1590/S0004-282X1994000100001.
Brasil. Ministério da Saúde. Envelhecimento e saúde da pessoa idosa. Brasília, DF: Cadernos de Atenção Básica; 2006. Available from: https:// bvsms.saude.gov.br/bvs/publicacoes/evelhecimento_saude_pessoa_ idosa.pdf. Accessed in 2023 (May 31).
Fleck MP, Chachamovich E, Trentini C. Development and validation of the Portuguese version of the WHOQOL-OLD module. Rev Saude Publica. 2006;40(5):785-91. PMID: 17301899; https://doi.org/10.1590/ s0034-89102006000600007.
Oliveira NGN, Tavares DMDS. Active ageing among elderly community members: structural equation modeling analysis. Rev Bras Enferm. 2020;73(suppl 3):e20200110. PMID: 33111807; https:// doi.org/10.1590/0034-7167-2020-0110.
American Dietetic Association, American Academy of Family Physicians, National Council on the Aging. Nutrition interventions manual for professionals caring for older Americans. Washington (US): Nutrition Screening Initiative; 1992.
World Health Organization. Obesity: preventing and managing the global epidemic: report of a WHO consultation. Geneva: WHO; 2000. Available from: https://apps.who.int/iris/handle/10665/42330. Accessed in 2023 (May 31).
Pagotto V, Santos KFD, Malaquias SG, Bachion MM, Silveira EA. Calf circumference: clinical validation for evaluation of muscle mass in the elderly. Rev Bras Enferm. 2018;71(2):322-8. PMID: 29412289; https://doi. org/10.1590/0034-7167-2017-0121.
Burr ML, Phillips KM. Anthropometric norms in the elderly. Br J Nutr. 1984;51(2):165-9. PMID: 6704367; https://doi.org/10.1079/bjn19840020.
Frisancho AR. Anthropometric standards for the assessment of growth and nutritional status. Ann Arbor: Michigam Press; 1990.
Benedetti TB, Mazo GZ, Barros MVG. Aplicação do questionário internacional de atividades físicas (IPAQ) para avaliação do nível de atividades físicas de mulheres idosas: validade concorrente e reprodutibilidade teste-reteste. Rev Bras Ciên Mov. 2004;12(1):25-33. Available from: https://pesquisa.bvsalud.org/portal/resource/pt/lil524649. Accessed in 2023 (May 31).
Strelec MA, Pierin AM, Mion D Jr. The influence of patient’s consciousness regarding high blood pressure and patient’s attitude in face of disease controlling medicine intake. Arq Bras Cardiol. 2003;81(4):349-54, 343-8. PMID: 14666277; https://doi.org/10.1590/s0066-782x2003001200002.
Brasil. Ministério da Saúde. Calendário Nacional de Vacinação 2017. Brasília, DF: Ministério da Saúde; 2017. Available from: https://saude. rs.gov.br/upload/arquivos/carga20170803/22180312-16111737calendario-nacional-de-vacinacao-2.pdf. Accessed in 2023 (May 31).
Connor KM, Davidson JR. Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety. 2003,18(2):76-82. PMID: 12964174; https://doi.org/10.1002/da.10113.
Solano JP, Bracher ES, Faisal-Cury A, et al. Factor structure and psychometric properties of the Connor-Davidson resilience scale among Brazilian adult patients. São Paulo Med J. 2016;134(5):400-6. PMID: 27191249; https://doi.org/10.1590/1516-3180.2015.02290512.
Almeida OP, Almeida SA. Confiabilidade da versão brasileira da escala de depressão em geriatria (GDS) versão reduzida [Reliability of the Brazilian version of the ++abbreviated form of Geriatric Depression
Scale (GDS) short form]. Arq Neuropsiquiatr. 1999;57(2B):421-6. PMID: 10450349; https://doi.org/10.1590/s0004-282x1999000300013.
Ramos LR, Perracini M, Rosa TE, Kalache A. Significance and management of disability among urban elderly residents in Brazil. J Cross Cult Gerontol. 1993;8(4):313-23. PMID: 24389964; https://doi.org/10.1007/bf00972560.
Griep RH, Chor D, Faerstein E, Werneck GL, Lopes CS. Validade de constructo de escala de apoio social do Medical Outcomes Study adaptada para o português no Estudo Pró-Saúde [Construct validity of the Medical Outcomes Study’s social support scale adapted to
Portuguese in the Pró-Saúde Study]. Cad Saude Publica. 2005;21(3):70314. PMID: 15868028; https://doi.org/10.1590/s0102-311x2005000300004.
Dias EN, da Silva JV, Pais-Ribeiro JL, Martins T. Validation of the advanced activities of daily living scale. Geriatr Nurs. 2019;40(1):7-12. PMID: 29909023; https://doi.org/10.1016/j.gerinurse.2018.05.008.
Laros JA. O uso da análise fatorial: Algumas diretrizes para pesquisadores. In: Pasquali L, editor. Análise Fatorial para pesquisadores. Brasília-DF: LabPAM Saber e Tecnologia; 2012. p. 141-60.
Molina NPFM, Tavares DMS, Haas VJ, Rodrigues LR. Religiousity, spirituality and quality of life of elderly according to structural equation modeling. Texto Contexto - Enferm. 2020;29:e20180468. http://dx.doi. org/10.1590/1980-265X-TCE-2018-0468.
Silva JG, Caldeira CG, Cruz GECP, Carvalho LED. Envelhecimento ativo, qualidade de vida e cognição de idosos: um estudo transversal em uma cidade de Minas Gerais. REAS. 2020;12(1):e1796. https://doi. org/10.25248/reas.e1796.2020.
Sao Paulo Med J. 2024;142(2):e2022609
Assari S, Smith J, Bazargan M. Health-related quality of life of economically disadvantaged African American older adults: age and gender differences. Int J Environ Res Public Health. 2019;16(9):1522. PMID: 31036795; https://doi.org/10.3390/ijerph16091522.
dos Santos Junior AG, Casais TR, Arantes WS, et al. Avaliação da qualidade de vida em idosos de um centro de convivência. R Enferm Cent O Min. 2019;9:e3053. https://doi.org/10.19175/recom.v9i0.3053,
Papathanasiou IV, Rammogianni A, Papagiannis D, et al. Frailty and Quality of Life Among Community-Dwelling Older Adults. Cureus. 2021;13(2):e13049. PMID: 33680593; https://doi.org/10.7759/cureus.13049.
Gobbens RJ, Remmen R. The effects of sociodemographic factors on quality of life among people aged 50 years or older are not unequivocal: comparing SF-12, WHOQOL-BREF, and WHOQOL-OLD. Clin Interv Aging. 2019;14:231-9. PMID: 30787599; https://doi.org/10.2147/CIA.S189560.
Brito TRP, Nunes DP, Duarte YAO, Lebrão ML. Redes sociais e funcionalidade em pessoas idosas: evidências do estudo Saúde, Bem-Estar e Envelhecimento (SABE). Rev Bras Epidemiol. 2018;21 (Suppl 02):e180003. https://doi.org/10.1590/1980-549720180003.supl.2.
Aragão EIS, Campos RM, Portugal FB, et al. Social Support patterns in Primary Health Care: differences between having physical diseases or mental disorders. Cien Saude Colet. 2018;23(7):2339-50. PMID: 30020386; https://doi.org/10.1590/1413-81232018237.21012016.
Bombardelli C, Rosa LHT, Keller KD, et al. Quality of life of elderly people living in a municipality with rural characteristics in the countryside of Rio Grande do Sul, Brazil. Rev Bras Geriatr Gerontol. 2017;20(1):85-90. https://dx.doi.org/10.1590/1981-22562017020.160082.
Costa IP, Bezerra VP, Pontes MLF, et al. Qualidade de vida de idosos e sua relação com o trabalho. Rev Gaúcha Enferm. 2018;39:e2017-0213. https://doi.org/10.1590/1983-1447.2018.2017-0213.
Bastos MAMSC, Monteiro JMMP, Faria CMGM, et al. Participation in community intervention programs and quality of life: findings from a multicenter study in Portugal. Rev Bras Geriatr Gerontol. 2020;23(6):e190017. https://doi.org/10.1590/1981-22562020023.190017.
Envelhecimento ativo: um marco político em resposta à revolução da longevidade. 1a ed. Rio de Janeiro: Centro Internacional de Longevidade Brasil; 2015. Available from: https://longevidade.ind.br/publicacao/ envelhecimento-ativo-um-marco-politico-em-resposta-a-revolucaoda-longevidade/. Accessed in 2023 (May 31).
Marsillas S, De Donder L, Kardol T, et al. Does active ageing contribute to life satisfaction for older people? Testing a new model of active ageing. Eur J Ageing. 2017;14(3);295-310. PMID: 28936139; https:// doi.org/10.1007/s10433-017-0413-8.
León LP, Mangin JPL, Ballesteros S. Psychosocial Determinants of Quality of Life and Active Aging. A structural equation model. Int J Environ Res Public Health. 2020;17(17):6023. PMID: 32824975; https://doi.org/10.3390/ijerph17176023.
World Health Organization. World Population Prospects 2019. Volume II: Demographic Profiles. New York: United Nations; 2019. Available from: https://www.un.org/development/desa/pd/news/world-populationprospects-2019-0. Accessed in 2023 (May 31).
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