Raggi Alberto, Corso Barbara, Minicuci Nadia, Quintas Rui, Sattin Davide, De Torres Laura, Chatterji Somnath, Frisoni Giovanni Battista, Haro Josep Maria, Koskinen Seppo, Martinuzzi Andrea, Miret Marta, Tobiasz-Adamczyk Beata, Leonardi Matilde
Neurological Institute C. Besta IRCCS Foundation, Neurology, Public Health and Disability Unit, Milan, Italy.
National Council Research, Neuroscience Institute, Padova, Italy.
PLoS One. 2016 Jul 19;11(7):e0159293. doi: 10.1371/journal.pone.0159293. eCollection 2016.
To comprehensively identify the determinants of quality of life (QoL) in a population study sample of persons aged 18-50 and 50+.
In this observational, cross-sectional study, QoL was measured with the WHOQOL-AGE, a brief instrument designed to measure QoL in older adults. Eight hierarchical regression models were performed to identify determinants of QoL. Variables were entered in the following order: Sociodemographic; Health Habits; Chronic Conditions; Health State description; Vision and Hearing; Social Networks; Built Environment. In the final model, significant variables were retained. The final model was re-run using data from the three countries separately.
Complete data were available for 5639 participants, mean age 46.3 (SD 18.4). The final model accounted for 45% of QoL variation and the most relevant contribution was given by sociodemographic data (particularly age, education level and living in Finland: 17.9% explained QoL variation), chronic conditions (particularly depression: 4.6%) and a wide and rich social network (4.6%). Other determinants were presence of disabling pain, learning difficulties and visual problems, and living in usable house that is perceived as non-risky. Some variables were specifically associated to QoL in single countries: age in Poland, alcohol consumption in Spain, angina in Finland, depression in Spain, and self-reported sadness both in Finland and Poland, but not in Spain. Other were commonly associated to QoL: smoking status, bodily aches, being emotionally affected by health problems, good social network and home characteristics.
Our results highlight the importance of modifiable determinants of QoL, and provide public health indications that could support concrete actions at country level. In particular, smoking cessation, increasing the level of physical activity, improving social network ties and applying universal design approach to houses and environmental infrastructures could potentially increase QoL of ageing population.
在一项针对18 - 50岁及50岁以上人群的研究样本中，全面识别生活质量（QoL）的决定因素。
在这项观察性横断面研究中，使用世界卫生组织生活质量年龄量表（WHOQOL-AGE）来测量生活质量，该量表是一种旨在测量老年人生活质量的简短工具。进行了八个层次回归模型以识别生活质量的决定因素。变量按以下顺序输入：社会人口统计学因素；健康习惯；慢性病；健康状况描述；视力和听力；社会网络；建成环境。在最终模型中，保留显著变量。使用来自三个国家的数据分别重新运行最终模型。
共有5639名参与者提供了完整数据，平均年龄46.3岁（标准差18.4）。最终模型解释了生活质量变异的45%，其中社会人口统计学数据（特别是年龄、教育水平以及居住在芬兰：解释了17.9%的生活质量变异）、慢性病（特别是抑郁症：4.6%）以及广泛而丰富的社会网络（4.6%）的贡献最为显著。其他决定因素包括存在致残性疼痛、学习困难和视觉问题，以及居住在被认为无风险的适用房屋中。一些变量在单个国家中与生活质量有特定关联：波兰的年龄、西班牙的酒精消费、芬兰的心绞痛、西班牙的抑郁症，以及芬兰和波兰的自我报告悲伤情绪，但在西班牙不存在这种关联。其他因素则普遍与生活质量相关：吸烟状况、身体疼痛、受到健康问题的情绪影响、良好的社会网络和家庭特征。
我们的结果突出了生活质量可改变决定因素的重要性，并提供了公共卫生指标，可支持国家层面的具体行动。特别是，戒烟、增加身体活动水平、改善社会网络联系以及对房屋和环境基础设施应用通用设计方法可能会提高老年人口的生活质量。
