Changes in the health status and health-related quality of life of community-dwelling older adults living alone: one-year follow-up from a cohort study

Front Public Health. 2023 Dec 21:11:1278008. doi: 10.3389/fpubh.2023.1278008. eCollection 2023.

Abstract

Background: The percentage of older adults living alone is rapidly increasing, improving the health status and health-related quality of life (HRQoL) in this group is becoming a more significant public health issue. This study aimed to examine the changes in the HRQoL of older South Korean adults living alone and identify the factors that affect their HRQoL.

Methods: A longitudinal study design was followed. Data were collected at baseline and 1-year follow-up. Participants consisting of 789 older adults living alone in S*City aged>65 years completed a cohort survey regarding health status and HRQoL from August 2018 to August 2019. Trained interviewers conducted face-to-face interviews with the participants using a validated questionnaire (physical health, mental health, social health, and HRQoL). Generalized estimating equations were used to assess the change in health status and the interaction effect of time and gender. Then, a stepwise multiple logistic regression analysis was performed to identify factors related to HRQoL.

Results: Time differences were observed in the subjective evaluation of health status (SEH), IPAQ scores, frailty, nutritional status, and depression. Gender differences were observed in the SEH, IPAQ, frailty, loneliness, depression, and social support. The interaction between time and gender was observed in the IPAQ and HRQoL. At baseline, SEH, depressive symptoms, gender, frailty, and age were associated with HRQoL. After one year, HRQoL was associated with SEH, frailty, depressive symptoms, cost of living, suicidal thoughts, gender, social support, loneliness, and suicide attempts.

Conclusion: Our results highlight that HRQoL is associated with physical health, mental health, and social support. Future detailed studies are needed to determine whether governments and communities can prevent depression, loneliness, and suicidal thoughts through psychological support and provide economic support to improve the quality of life of older adults living alone.

Keywords: aged; cohort; health outcomes; health-related quality of life; living arrangements.

MeSH terms

  • Aged
  • Cohort Studies
  • Follow-Up Studies
  • Frailty*
  • Health Status
  • Home Environment
  • Humans
  • Independent Living
  • Longitudinal Studies
  • Quality of Life*

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This research was supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHDI), funded by the Ministry of Health and Welfare, Republic of Korea (grant number: HI18C1284).