Health-related quality of life of younger and older lower-income households in Malaysia

Hussein Rizal; Mas Ayu Said; Hazreen Abdul Majid; Tin Tin Su; Tan Maw Pin; Rozmi Ismail; Mohd Azlan Shah Zaidi

doi:10.1371/journal.pone.0263751

Health-related quality of life of younger and older lower-income households in Malaysia

PLoS One. 2022 Feb 8;17(2):e0263751. doi: 10.1371/journal.pone.0263751. eCollection 2022.

Authors

Hussein Rizal^{1

2}, Mas Ayu Said^{1

3}, Hazreen Abdul Majid^{1

2

4}, Tin Tin Su⁵, Tan Maw Pin⁶, Rozmi Ismail⁷, Mohd Azlan Shah Zaidi⁸

Affiliations

¹ Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
² Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
³ Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
⁴ Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Jawa Timur, Indonesia.
⁵ South East Asia Community Observatory (SEACO) and Global Public Health, Jeffrey Cheah School of Medicine & Health Sciences, Monash University, Bandar Sunway, Subang Jaya, Malaysia.
⁶ Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
⁷ Faculty of Social Sciences and Humanity, National University of Malaysia, Bangi, Selangor.
⁸ Faculty of Economics and Management, National University of Malaysia, Bangi, Selangor.

Abstract

Background: Globally, a lower income is associated with poorer health status and reduced quality of life (QOL). However, more research is needed on how being older may influence QOL in lower-income households, particularly as older age is associated with an increased risk of chronic diseases and care needs. To this end, the current study attempts to determine the health-related QOL (HRQOL) among individuals from lower-income households aged 60 years and over compared to lower-income adults aged less than 60 years.

Methods: Participants were identified from the Department of Statistics Malaysia sampling frame. Surveys were carried out with individual households aged 18 years and older through self-administered questionnaires. Information was collected on demographics, household income, employment status, number of diseases, and HRQOL assessed using the EuroQol 5-Dimension 5-Level (EQ-5D-5L) tool.

Results: Out of a total of 1899 participants, 620 (32.6%) were female and 328 (17.3%) were aged 60 years and above. The mean (SD) age was 45.2 (14.1) and mean (SD) household income was RM2124 (1356). Compared with younger individuals, older respondents were more likely to experience difficulties in mobility (32.1% vs 9.7%, p<0.001), self-care (11.6% vs 3.8%, p<0.001), usual activities (24.5% vs 9.1%, p<0.001), pain/discomfort (38.8% vs 16.5%, p<0.001) and anxiety/depression (21.4% vs 13.5%, p<0.001). The mean (SD) EQ-5D index scores were lower among older respondents, 0.89 (0.16) vs 0.95 (0.13), p = 0.001. After adjusting for covariates, age was a significant influencing factor (p = 0.001) for mobility (OR = 2.038, 95% CI:1.439-2.885), usual activities (OR = 1.957, 95% CI:1.353-2.832) and pain or discomfort (OR = 2.241, 95% CI:1.690-2.972).

Conclusion: Lower-income older adults had poorer HRQOL compared to their younger counterparts. This has important implications concerning intervention strategies that incorporate active ageing concepts on an individual and policy-making level to enhance the QOL and wellbeing, particularly among the older lower-income population.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Age Factors*
Aged
Aged, 80 and over
Cross-Sectional Studies
Developing Countries / economics
Female
Health Status
Humans
Income
Malaysia / ethnology
Male
Middle Aged
Quality of Life / psychology*
Self Care
Sociodemographic Factors
Socioeconomic Factors
Surveys and Questionnaires

Grants and funding

This research was funded by the Ministry of Higher Education via the Long Term Research Grant (LRGS) awarded to the Malaysia Research University Network (MRUN) with the grant code of LRGS/1/2016/UKM/02/1/2 (LGRS MRUN/F1/01/2019). The funder played no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.