Quality of life and associated factors among older adults of central Nepal: A cross-sectional study using WHOQOL-OLD tool

Abstract

Background The world population is ageing increasingly. The quality of life (QOL) of older people is an important global issue and is indicative of the health and well-being of this demographic. As the population ages, ensuring people's QOL has become increasingly challenging. This study aims to investigate the QOL among older people and factors associated with it in an urban setting of central Nepal using the WHOQOL-OLD tool. Methods A cross-sectional study was conducted in Central Nepal. Quality of life was measured using the WHOQOL-OLD questionnaire. The individual and overall mean scores of the six domains of QOL were presented along with their standard deviations (SDs). The association between QOL and independent variables were first examined using t-test or analysis of variance followed by multiple linear regression. Regression coefficient (β) and respective 95% confidence intervals were presented to show the association of independent variables with QOL. Results The mean age of the 366 participants was 70 years (SD: 8.2 years). Of which, 56.3% were aged 70 years and above and 55.2% were females. The mean score was higher in the domains of past, present and future activities (14.96, SD: 2.32), social participation (14.29, SD: 2.17) and intimacy (14.69, SD: 2.36) compared to other domains of QOL. Older people who had an annual household income of 40,000 (Nepalese Rupees) or more (β: 1.909: 95% CI: 0.337, 3.480), who reported health services as accessible (β: 4.019; 95% CI: 0.666, 7.371), and affordable (β: 3.176; 95% CI: 1.327, 5.025), and who reported being involved in physical activity (β: 2.107; 95% CI: 0.607, 3.606) had higher QOL scores compared to their respective counterparts. Conversely, those who were illiterate (β: -0.415; 95% CI: -5.556, -1.986) reported a lower QOL score compared to the literate group. There were considerable variations among the factors associated with the six individual domains of QOL, with a more consistent association observed with literacy status, household income and access to health services. Conclusions This study demonstrated that participants’ literacy, having a better household income, accessible and affordable health services and being involved in physical activity were crucial factors for quality of life. The current biomedical model of health service is unlikely to improve the QOL of older people. Therefore, a holistic model of service using the social determinants of health framework is essential to improve the well-being of older people in Nepal.