Ageism and Its Impact on Quality of Life Among Older Persons Experiencing Difficulties with Activities of Daily Living

Abstract

Background: As the number of older persons increases globally, so does ageism, or being discriminated against because of their age. The overlap between ageism and ableism, which is discrimination based on impairments or disability may put persons having difficulties with their basic (ADL) or instrumental activities of daily living (IADL) at a higher risk of discrimination. Discrimination leads to poorer quality of life. However, ageism remains understudied, particularly in the UK. Methods: Data from the English Longitudinal Study of Ageing (ELSA) collected in the 2010-2011 period (Wave 5) was used to assess ageism, ADL/IADL status, and quality of life (CASP-19) at baseline. Multivariable linear regression was used to estimate the changes in the quality of life while adjusting for covariates and their baseline values in two following periods: 2016-2017 (Wave 7) and 2018-2019 (Wave 9). Results: At baseline, quality-of-life scores were significantly lower among individuals dealing with difficulties (33.6 points) compared to those without them (41.5 points), with a difference of 7.9 points (p < .001). In the following waves, age discrimination was found to have a negative effect on the quality of life of all the participants regardless of ADL/IADL difficulties (B: -1.106, p=<0.001), and also among those without difficulties (B=-1.401, p=<0.001). However, among those with difficulties, no such association was found in any of the analyses. Conclusions: Discrimination has a detrimental effect on quality of life, but this effect may be mediated by characteristics of the older persons suffering from loss of independence, such as coping mechanisms, resilience, social support, personality, and other latent characteristics that may be associated with ADL/IADL difficulties not included in this study. These findings underscore the importance of understanding the driving elements of quality of life among older persons to effectively inform future intervention strategies, especially for those at risk of ageism.