Relative Contributions of Different Lifestyle Factors to Health-Related Quality of Life in the Elderly
Abstract
:1. Introduction
2. Materials and Methods
2.1. Subjects and Data Collection
2.2. Instruments
2.2.1. Health-Related Quality of Life Measures
2.2.2. Socio-Demographic and Lifestyle Questionnaires
2.3. Statistical Analysis
3. Results
3.1. Characteristics of Participants
3.2. Distributions of Health-Related Behaviors and Lifestyle
3.3. Health-Related Quality of Life Scores
3.4. Relative Contributions of Different Lifestyle Factors to the HRQOL
4. Discussion
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Overall (n = 1369) | Urban (n = 542) | Rural (n = 561) | Institutionalized (n = 266) | p | |
---|---|---|---|---|---|
Gender n (%) | 0.1803 | ||||
Male | 547(40.0) | 206(38.0) | 222(39.6) | 119(44.7) | |
Female | 822(60.0) | 336(62.0) | 339(60.4) | 147(55.3) | |
Age (years) | <0.0001 | ||||
Mean ± SD | 73.32 ± 6.32 | 73.88 ± 6.23 | 70.27 ± 4.99 | 78.59 ± 6.80 | |
Education level n (%) | <0.0001 | ||||
No schooling | 238(17.4) | 79(14.6) | 113(20.1) | 46(17.4) | |
Primary school | 444(32.5) | 95(17.5) | 282(50.3) | 67(25.3) | |
Middle school | 297(21.7) | 113(20.8) | 131(23.4) | 53(20.0) | |
High school | 217(15.9) | 138(25.5) | 31(5.5) | 48(18.1) | |
College or higher | 172(12.6) | 117(21.6) | 4(0.7) | 51(19.2) | |
Personal monthly income n (CNY, %) | <0.0001 | ||||
<500 | 552(40.5) | 60(11.1) | 459(81.8) | 33(12.6) | |
500–2999 | 433(31.7) | 230(42.4) | 85(15.2) | 118(45.2) | |
≥3000 | 379(27.8) | 252(46.5) | 17(3.0) | 110(42.1) | |
Smoking status n (%) | <0.0001 | ||||
Non-smokers | 963(70.3) | 394(72.7) | 386(68.8) | 183(68.8) | |
Ex-smokers | 162(11.8) | 83(15.3) | 29(5.2) | 50(18.8) | |
Current smokers | 244(17.8) | 65(12.0) | 146(26.0) | 33(12.4) | |
Drinking status n (%) | 0.0004 | ||||
Nondrinkers | 1047(76.5) | 412(76.0) | 430(76.6) | 205(77.1) | |
Abstainers | 129(9.4) | 38(7.0) | 52(9.3) | 39(14.7) | |
Drinkers | 193(14.1) | 92(17.0) | 79(14.1) | 22(8.3) | |
Fresh fruit consumption frequency n (%) | <0.0001 | ||||
Frequently | 590(43.1) | 339(62.5) | 136(24.2) | 115(43.2) | |
Sometimes | 420(30.7) | 102(18.8) | 243(43.3) | 75(28.2) | |
Seldom | 359(26.2) | 101(18.6) | 182(32.4) | 76(28.6) | |
Have meals on time n (%) | 0.0007 | ||||
Usually | 1308(95.5) | 517(95.4) | 525(93.6) | 266(100.0) | |
Sometimes | 44(3.2) | 16(3.0) | 28(5.0) | 0(0.0) | |
Seldom | 17(1.2) | 9(1.7) | 8(1.4) | 0(0.0) | |
Food control n (%) | 0.2330 | ||||
Usually | 1142(83.4) | 448(82.7) | 469(83.6) | 225(84.6) | |
Sometimes | 63(4.6) | 19(3.5) | 32(5.7) | 12(4.5) | |
Seldom | 164(12.0) | 75(13.8) | 60(10.7) | 29(10.9) | |
Sleep on time n (%) | 0.0006 | ||||
Usually | 1206(88.1) | 473(87.3) | 481(85.7) | 252(94.7) | |
Sometimes | 101(7.4) | 40(7.4) | 56(10.0) | 5(1.9) | |
Seldom | 62(4.5) | 29(5.4) | 24(4.3) | 9(3.4) | |
Suffer from sleep disorders n (%) | 0.0507 | ||||
Frequently | 304(22.2) | 112(20.7) | 116(20.7) | 76(28.6) | |
Sometimes | 351(25.6) | 140(25.8) | 155(27.6) | 56(21.1) | |
Seldom | 714(52.2) | 290(53.5) | 290(51.7) | 134(50.4) | |
Take sleeping pills n (%) | 0.0007 | ||||
Frequently | 40(2.9) | 18(3.3) | 8(1.4) | 14(5.3) | |
Sometimes | 75(5.5) | 35(6.5) | 19(3.4) | 21(7.9) | |
Seldom | 1254(91.6) | 489(90.2) | 534(95.2) | 231(86.8) | |
Do physical exercise n (%) | <0.0001 | ||||
Regularly | 954(69.7) | 410(75.6) | 348(62.0) | 196(73.7) | |
Sometimes | 133(9.7) | 32(5.9) | 78(13.9) | 23(8.6) | |
Seldom | 282(20.6) | 100(18.5) | 135(24.1) | 47(17.7) | |
Do housework n (%) | <0.0001 | ||||
Usually | 895(65.4) | 402(74.2) | 448(79.9) | 45(16.9) | |
Sometimes | 115(8.4) | 48(8.9) | 48(8.6) | 19(7.1) | |
Seldom | 359(26.2) | 92(17.0) | 65(11.6) | 202(75.9) | |
Physical labor participation n (%) | <0.0001 | ||||
Usually | 273(19.9) | 13(2.4) | 256(45.6) | 4(1.5) | |
Sometimes | 142(10.4) | 23(4.2) | 110(19.6) | 9(3.4) | |
Seldom | 954(69.7) | 506(93.4) | 195(34.8) | 253(95.1) | |
Individual sedentary pastime score n (%) | <0.0001 | ||||
0 | 203(14.8) | 26(4.8) | 137(24.4) | 40(15.0) | |
1 | 740(54.1) | 238(43.9) | 357(63.6) | 145(54.5) | |
2 | 426(31.1) | 278(51.3) | 67(11.9) | 81(30.5) | |
Individual outdoor activities score n (%) | <0.0001 | ||||
0 | 366(26.7) | 99(18.3) | 188(33.5) | 79(29.7) | |
1 | 1003(73.3) | 443(81.7) | 373(66.5) | 187(70.3) | |
Individual non-developmental interest score n (%) | <0.0001 | ||||
0 | 763(55.7) | 213(39.3) | 331(59.0) | 219(82.3) | |
1 | 479(35.0) | 254(46.9) | 187(33.3) | 38(14.3) | |
2 | 127(9.3) | 75(13.8) | 43(7.7) | 9(3.4) | |
Developmental interest score n (%) | <0.0001 | ||||
0 | 1136(83.0) | 434(80.1) | 507(90.4) | 195(73.3) | |
1 | 207(15.1) | 92(17.0) | 51(9.1) | 64(24.1) | |
2 | 26(1.9) | 16(3.0) | 3(0.5) | 7(2.6) | |
Interactive entertainment score n (%) | 0.0061 | ||||
0 | 279(20.4) | 116(21.4) | 94(16.8) | 69(25.9) | |
1 | 749(54.7) | 291(53.7) | 312(55.6) | 146(54.9) | |
2 | 314(22.9) | 124(22.9) | 139(24.8) | 51(19.2) | |
3 | 27(2.0) | 11(2.0) | 16(2.9) | 69(25.9) | |
Travel n (%) | <0.0001 | ||||
0 | 1054(77.0) | 325(60.0) | 494(88.1) | 235(88.3) | |
1 | 315(23.0) | 217(40.0) | 67(11.9) | 31(11.7) |
Overall (n = 1369) | Urban (n = 542) | Rural (n = 561) | Institutionalized (n = 266) | p | |
---|---|---|---|---|---|
SF-36v2 | |||||
Physical functioning (PF) | 48.06 ± 9.93 | 48.92 ± 8.54 | 49.97 ± 8.91 | 42.31 ± 12.25 | <0.0001 |
Role-physical (RP) | 48.41 ± 10.86 | 51.40 ± 9.04 | 46.61 ± 11.61 | 46.12 ± 11.25 | <0.0001 |
Bodily pain (BP) | 50.66 ± 12.17 | 51.40 ± 11.71 | 50.38 ± 12.52 | 49.75 ± 12.31 | 0.1490 |
General health (GH) | 45.76 ± 11.86 | 45.47 ± 12.03 | 45.85 ± 11.70 | 46.13 ± 11.85 | 0.7354 |
Vitality (VT) | 56.37 ± 11.10 | 56.82 ± 10.51 | 56.83 ± 11.24 | 54.46 ± 11.76 | <0.0077 |
Social functioning (SF) | 50.95 ± 10.27 | 53.10 ± 8.88 | 50.12 ± 10.49 | 48.31 ± 11.53 | <0.0001 |
Role-emotional (RE) | 50.23 ± 9.61 | 52.70 ± 7.42 | 48.33 ± 10.56 | 49.22 ± 10.37 | <0.0001 |
Mental health (MH) | 53.88 ± 10.33 | 55.14 ± 9.41 | 52.88 ± 11.29 | 53.43 ± 9.77 | <0.0010 |
Physical component summary (PCS) | 47.05 ± 9.95 | 47.87 ± 9.27 | 47.76 ± 9.79 | 43.87 ± 11.00 | <0.0001 |
Mental component summary (MCS) | 54.38 ± 9.92 | 56.12 ± 8.40 | 52.77 ± 10.90 | 54.25 ± 10.10 | <0.0001 |
WHOQOL-OLD | |||||
Sensory abilities (SAB) | 74.74 ± 22.30 | 77.72 ± 20.55 | 72.17 ± 22.99 | 74.06 ± 23.58 | 0.0002 |
Autonomy (AUT) | 71.23 ± 19.93 | 73.99 ± 20.32 | 70.10 ± 18.55 | 68.00 ± 21.27 | 0.0001 |
Past, present and future activities (PPF) | 72.10 ± 14.94 | 71.83 ± 14.99 | 74.52 ± 14.10 | 67.53 ± 15.47 | <0.0001 |
Social participation (SOP) | 68.29 ± 16.45 | 66.90 ± 16.20 | 70.58 ± 15.51 | 66.31 ± 18.26 | 0.0001 |
Death and dying (DAD) | 88.31 ± 18.32 | 87.00 ± 18.85 | 89.45 ± 18.36 | 88.56 ± 16.99 | 0.0831 |
Intimacy (INT) | 63.42 ± 23.99 | 68.23 ± 22.01 | 60.90 ± 25.24 | 58.93 ± 23.56 | <0.0001 |
WHOQOL-OLD total | 73.01 ± 11.99 | 74.28 ± 12.08 | 72.95 ± 11.46 | 70.56 ± 12.54 | 0.0002 |
Model 1 | Model 2 | Model 3 | Model 4 | Model 5 | Model 6 | |
---|---|---|---|---|---|---|
Gender (female vs. male) | −3.220 ** | –3.426 ** | −3.713 ** | −2.899 ** | −3.242 ** | −3.345 ** |
Age | −0.243 ** | −0.224 ** | −0.213 ** | −0.209 ** | −0.037 | −0.012 |
Education level | 0.171 | 0.153 | 0.365 | 0.462 | 0.442 | 0.641 * |
Personal monthly income | 0.466 | 0.397 | −0.074 | 0.242 | 0.899 * | 0.538 |
Smoking status (vs. non-smokers) | ||||||
Ex-smokers | −2.113 * | −1.988 * | −1.554 | −0.912 | −1.138 | |
Current smokers | −0.998 | −0.700 | −0.624 | −0.330 | −0.482 | |
Drinking status (vs. nondrinkers) | ||||||
Abstainers | −1.024 | −0.701 | −1.056 | −1.267 | −1.204 | |
Drinkers | 3.922 ** | 3.869 ** | 3.574 ** | 2.579 ** | 2.033 ** | |
Fresh fruit consumption frequency (vs. frequently) | ||||||
Sometimes | −1.794 ** | −1.696 ** | −1.482 * | −1.008 | ||
Seldom | −3.905 ** | −3.551 ** | −2.364 ** | −1.856 ** | ||
Have meals on time (vs. usually) | ||||||
Sometimes | 0.296 | 1.350 | −0.112 | 0.559 | ||
Seldom | −2.418 | −1.006 | −1.145 | −0.049 | ||
Food control (vs. usually) | ||||||
Sometimes | −0.902 | −0.835 | −0.963 | −0.525 | ||
Seldom | 1.518 | 1.507 | 1.035 | 1.334 | ||
Sleep on time (vs. usually) | ||||||
Sometimes | 0.068 | 0.310 | −0.004 | |||
Seldom | −1.413 | −0.859 | −0.683 | |||
Suffer from sleep disorders (vs. seldom) | ||||||
Sometimes | −2.291 ** | −2.309 ** | −2.151 ** | |||
Frequently | −4.429 ** | −3.632 ** | −3.254 ** | |||
Take sleeping pills (vs. seldom) | ||||||
Sometimes | −3.965 ** | −2.985 ** | −2.821 ** | |||
Frequently | −4.331 ** | −3.792 * | −3.794 ** | |||
Do physical exercise (vs. regularly) | ||||||
Sometimes | −0.823 | −0.025 | ||||
Seldom | −5.117 ** | −4.021 ** | ||||
Do housework (vs. usually) | ||||||
Sometimes | −2.326 ** | −2.218 * | ||||
Seldom | −5.604 ** | −5.134 ** | ||||
Physical labor participation (vs. usually) | ||||||
Sometimes | −2.655 ** | −2.311 * | ||||
Seldom | −3.703 ** | −3.835 ** | ||||
Individual sedentary pastime | 0.534 | |||||
Individual outdoor activities | 0.975 | |||||
Individual non-developmental interest | −0.219 | |||||
Developmental interest | 1.716 ** | |||||
Interactive entertainment | 0.961 ** | |||||
Travel | 2.743 ** | |||||
Constant | 69.609 ** | 68.615 ** | 71.093 ** | 70.953 ** | 62.753 ** | 58.376 ** |
F value | 16.036 ** | 12.311 ** | 9.993 ** | 11.999 ** | 18.846 ** | 17.713 ** |
R2 (adjusted) | 0.045 (0.042) | 0.068 (0.062) | 0.094 (0.085) | 0.152 (0.139) | 0.268 (0.254) | 0.299 (0.282) |
R2 change | 0.045 | 0.023 | 0.026 | 0.058 | 0.116 | 0.031 |
Model 1 | Model 2 | Model 3 | Model 4 | Model 5 | Model 6 | |
---|---|---|---|---|---|---|
Gender (female vs. male) | −0.654 | −0.481 | −0.619 | 0.179 | −0.347 | −0.510 |
Age | 0.193 ** | 0.198 ** | 0.182 ** | 0.182 ** | 0.183 ** | 0.196 ** |
Education level | 0.624 * | 0.615 * | 0.819 ** | 0.893 ** | 0.880 ** | 1.082 ** |
Personal monthly income | 1.455 ** | 1.388 ** | 0.945 * | 1.124* | 0.731 | 0.398 |
Smoking status (vs. non-smokers) | ||||||
Ex-smokers | 0.137 | 0.429 | 0.785 | 0.852 | 0.517 | |
Current smokers | −0.195 | 0.300 | 0.288 | 0.574 | 0.086 | |
Drinking status (vs. nondrinkers) | ||||||
Abstainers | −0.574 | −0.209 | −0.347 | −0.402 | −0.057 | |
Drinkers | 1.513 | 1.528 | 1.368 | 1.207 | 0.625 | |
Fresh fruit consumption frequency (vs. frequently) | ||||||
Sometimes | −2.597 ** | −2.456 ** | −1.895 ** | −1.214 | ||
Seldom | −3.233 ** | −2.875 ** | −2.304 ** | −1.567 * | ||
Have meals on time (vs. usually) | ||||||
Sometimes | −3.916 ** | −2.771 | −2.173 | −0.980 | ||
Seldom | −6.739 ** | −5.127 * | −5.876 * | −4.523 * | ||
Food control (vs. usually) | ||||||
Sometimes | −3.756 ** | −3.650 ** | −2.904* | −1.878 | ||
Seldom | −0.072 | −0.141 | −0.143 | 0.268 | ||
Sleep on time (vs. usually) | ||||||
Sometimes | −0.029 | 0.292 | −0.183 | |||
Seldom | −1.134 | −0.998 | −0.940 | |||
Suffer from sleep disorders (vs. seldom) | ||||||
Sometimes | −2.352 ** | −2.283 ** | −1.982 ** | |||
Frequently | −5.161 ** | −4.980 ** | −4.417 ** | |||
Take sleeping pills (vs. seldom) | ||||||
Sometimes | −3.459 ** | −3.305 ** | −3.110 ** | |||
Frequently | 1.036 | 1.060 | 0.981 | |||
Do physical exercise (vs. regularly) | ||||||
Sometimes | −3.784 ** | −2.576 ** | ||||
Seldom | −3.152 ** | −1.384* | ||||
Do housework (vs. usually) | ||||||
Sometimes | −1.250 | −0.854 | ||||
Seldom | −1.569 * | −0.642 | ||||
Physical labor participation (vs. usually) | ||||||
Sometimes | −0.446 | −0.006 | ||||
Seldom | 1.583 * | 1.332 | ||||
Individual sedentary pastime | 1.252 ** | |||||
Individual outdoor activities | 2.362 ** | |||||
Individual non-developmental interest | 0.154 | |||||
Developmental interest | 0.444 | |||||
Interactive entertainment | 1.847 ** | |||||
Travel | 2.293 ** | |||||
Constant | 40.257 ** | 39.586 ** | 44.251 ** | 44.592 ** | 45.991 ** | 39.466 ** |
F value | 13.740 ** | 7.416 ** | 8.399 ** | 10.371 ** | 10.170 ** | 11.603 ** |
R2 (adjusted) | 0.039 (0.036) | 0.042 (0.036) | 0.080 (0.071) | 0.134 (0.121) | 0.165 (0.149) | 0.218 (0.199) |
R2 change | 0.039 | 0.003 | 0.038 | 0.054 | 0.031 | 0.053 |
Model 1 | Model 2 | Model 3 | Model 4 | Model 5 | Model 6 | |
---|---|---|---|---|---|---|
Gender (female vs. male) | 0.073 | 0.776 | 0.445 | 1.466 | 0.846 | 0.437 |
Age | −0.103 | −0.085 | −0.097 | −0.090 | 0.012 | 0.046 |
Education level | 0.096 | 0.050 | 0.375 | 0.504 | 0.479 | 1.032 ** |
Personal monthly income | 0.623 | 0.525 | −0.153 | 0.188 | 0.316 | −0.465 |
Smoking status (vs. non-smokers) | ||||||
Ex-smokers | −0.556 | −0.181 | 0.328 | 0.807 | 0.052 | |
Current smokers | 0.110 | 0.768 | 0.812 | 1.265 | 0.333 | |
Drinking status (vs. nondrinkers) | ||||||
Abstainers | 0.282 | 0.795 | 0.501 | 0.237 | 0.613 | |
Drinkers | 3.343 ** | 3.346 ** | 3.050 ** | 2.199 * | 1.203 | |
Fresh fruit consumption frequency (vs. frequently) | ||||||
Sometimes | −3.362 ** | −3.223 ** | −2.567 ** | −1.425 * | ||
Seldom | −5.462 ** | −4.963 ** | −3.677 ** | −2.324 ** | ||
Have meals on time (vs. usually) | ||||||
Sometimes | −4.453 * | −3.166 | −3.321 | −1.152 | ||
Seldom | −9.486 ** | −7.792 ** | −8.424 ** | −5.498 * | ||
Food control (vs. usually) | ||||||
Sometimes | −3.426 * | −3.477 * | −2.896 | −1.466 | ||
Seldom | 1.362 | 1.297 | 0.920 | 1.776 * | ||
Sleep on time (vs. usually) | ||||||
Sometimes | 0.392 | 1.029 | 0.170 | |||
Seldom | −0.708 | −0.123 | −0.090 | |||
Suffer from sleep disorders (vs. seldom) | ||||||
Sometimes | −2.636 ** | −2.526 ** | −2.109 ** | |||
Frequently | −6.499 ** | −5.760 ** | −4.753 ** | |||
Take sleeping pills (vs. seldom) | ||||||
Sometimes | −4.240 ** | −3.590 ** | −3.413 ** | |||
Frequently | −3.032 | −2.798 | −3.224 | |||
Do physical exercise (vs. regularly) | ||||||
Sometimes | −4.924 ** | −2.748 ** | ||||
Seldom | −6.218 ** | −3.353 ** | ||||
Do housework (vs. usually) | ||||||
Sometimes | −4.706 ** | −3.937 ** | ||||
Seldom | −4.206 ** | −2.521 ** | ||||
Physical labor participation (vs. usually) | ||||||
Sometimes | −1.722 | −1.085 | ||||
Seldom | −1.336 | −1.550 | ||||
Individual sedentary pastime | 2.942 ** | |||||
Individual outdoor activities | 1.979 ** | |||||
Individual non-developmental interest | 0.804 | |||||
Developmental interest | 2.808 ** | |||||
Interactive entertainment | 3.756 ** | |||||
Travel | 2.872 ** | |||||
Constant | 79.513 ** | 76.719 ** | 82.757 ** | 82.534 ** | 79.282 ** | 67.828 ** |
F value | 0.978 | 1.970 * | 6.372 ** | 9.576 ** | 13.081 ** | 19.738 ** |
R2 (adjusted) | 0.003 (0.000) | 0.012 (0.006) | 0.062 (0.052) | 0.125 (0.112) | 0.203 (0.187) | 0.322 (0.306) |
R2 change | 0.003 | 0.009 | 0.051 | 0.063 | 0.078 | 0.119 |
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Share and Cite
Zhang, X.; Xia, R.; Wang, S.; Xue, W.; Yang, J.; Sun, S.; Zhuang, G. Relative Contributions of Different Lifestyle Factors to Health-Related Quality of Life in the Elderly. Int. J. Environ. Res. Public Health 2018, 15, 256. https://doi.org/10.3390/ijerph15020256
Zhang X, Xia R, Wang S, Xue W, Yang J, Sun S, Zhuang G. Relative Contributions of Different Lifestyle Factors to Health-Related Quality of Life in the Elderly. International Journal of Environmental Research and Public Health. 2018; 15(2):256. https://doi.org/10.3390/ijerph15020256
Chicago/Turabian StyleZhang, Xiaona, Ruyi Xia, Shu Wang, Wei Xue, Jian Yang, Shuliu Sun, and Guihua Zhuang. 2018. "Relative Contributions of Different Lifestyle Factors to Health-Related Quality of Life in the Elderly" International Journal of Environmental Research and Public Health 15, no. 2: 256. https://doi.org/10.3390/ijerph15020256