Plain-language summary
Growing numbers of people are living into older age, while many are also managing long-term health conditions. For older adults, health is not only about whether a disease is present. It also includes how comfortably a person can move around, manage everyday activities, maintain emotional wellbeing, sustain relationships and live in a safe and supportive environment. This study examined these different aspects of health-related quality of life among people aged 65 years and above in Calabar Metropolis, Cross River State, Nigeria.
The study involved 743 older adults selected through a multistage sampling process. Information was collected using an interviewer-administered questionnaire based on the WHOQOL-BREF, which assesses quality of life across four areas: physical health, psychological wellbeing, social relationships and the environment. The responses were analysed using descriptive statistics, chi-square tests and logistic regression to describe quality of life and examine which characteristics were associated with it.
Overall, three out of every four participants were classified as having good health-related quality of life under the study’s scoring approach. The average scores across the four domains were in the moderate range. The environmental domain had the highest mean score (55.93 out of 100), followed by social relationships (55.62), psychological wellbeing (54.09) and physical health (52.91). The overall composite mean score was 54.64. These results suggest that quality of life was not experienced in exactly the same way across all areas of daily living, and physical health had the lowest average domain score.
The analyses identified several factors associated with quality of life. At the initial, unadjusted stage, age was the only socio-demographic factor significantly associated with the outcome. Chronic illness, hospitalisation, self-rated health, physical activity, balanced meal consumption, sleep quality and social participation were also associated with health-related quality of life. After adjustment for other factors in the model, age, sex, chronic illness, self-rated health, physical activity and sleep quality remained significant independent predictors.
In practical terms, the findings highlight the importance of looking beyond illness alone when supporting older people. Preventive healthcare, effective management of chronic conditions, opportunities for safe physical activity, adequate sleep and supportive everyday environments may all form part of a broader approach to healthy ageing. The findings also point to the value of paying attention to how older people rate their own health and to the social and practical circumstances in which they live. Because this was a cross-sectional study, the results identify associations and predictors within the analysis; they do not establish that any one factor caused a change in quality of life.
The study therefore provides local evidence that can help inform discussions about health and wellbeing among older adults in Calabar Metropolis and comparable settings. It supports an approach to healthy ageing that combines preventive care and chronic disease management with attention to daily functioning, lifestyle and social wellbeing.
Abstract
Population ageing and the rising burden of chronic diseases have increased concern about the health-related quality of life (HRQoL) of elderly persons, particularly in low- and middle-income countries. This study assessed the HRQoL of elderly persons and its associated factors in Calabar Metropolis, Cross River State, Nigeria. An analytical community-based cross-sectional study was conducted among 743 elderly persons aged 65 years and above selected through a multistage sampling technique. Data were collected using an interviewer-administered questionnaire based on the WHOQOL-BREF. Data were analysed using descriptive and inferential statistics, such as Chi-square tests and logistic regression at a 5% level of significance. Moderate levels of HRQoL were observed across the physical (52.91 ± 9.21), psychological (54.09 ± 12.73), social relationships (55.62 ± 18.86), and environmental (55.93 ± 18.08) domains, with an overall composite score of 54.64 ± 13.41. Overall, 75.0% of the respondents had good HRQoL. Age was the only socio-demographic factor significantly associated with HRQoL at the bivariate level. Chronic illness, hospitalisation, self-rated health, physical activity, balanced meal consumption, sleep quality, and social participation were significantly associated with HRQoL. After adjustment for potential confounding variables, age, sex, chronic illness, self-rated health, physical activity, and sleep quality remained significant independent predictors of HRQoL. Health-related quality of life among elderly persons is influenced by multiple interacting demographic, health-related, and lifestyle factors. Comprehensive interventions that promote healthy ageing through preventive healthcare, effective chronic disease management, and healthy lifestyle practices are essential for improving the well-being of elderly persons in Calabar Metropolis and similar settings.
Keywords: Quality of Life; Aged; Chronic Disease; Exercise; Sleep; Social Participation; Health Status.