Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
PLoS One. 2022 Feb 8;17(2):e0263751. doi: 10.1371/journal.pone.0263751. eCollection 2022.
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.
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.
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).
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.
在全球范围内，较低的收入与较差的健康状况和较低的生活质量（QOL）有关。然而，需要更多的研究来了解随着年龄的增长，较低收入家庭的 QOL 会如何受到影响，特别是因为随着年龄的增长，患慢性病和需要护理的风险会增加。为此，本研究试图确定与健康相关的生活质量（HRQOL）在 60 岁及以上的低收入家庭与 60 岁以下的低收入成年人之间的差异。
参与者是从马来西亚统计局的抽样框架中确定的。通过自我管理的问卷对 18 岁及以上的个人家庭进行了调查。收集了人口统计学、家庭收入、就业状况、疾病数量以及使用 EuroQol 5-Dimension 5-Level（EQ-5D-5L）工具评估的 HRQOL 信息。
在总共 1899 名参与者中，有 620 名（32.6%）是女性，有 328 名（17.3%）年龄在 60 岁及以上。平均（SD）年龄为 45.2（14.1），平均（SD）家庭收入为 RM2124（1356）。与年轻的参与者相比，年龄较大的受访者更有可能在移动性（32.1%对 9.7%，p<0.001）、自我护理（11.6%对 3.8%，p<0.001）、日常活动（24.5%对 9.1%，p<0.001）、疼痛/不适（38.8%对 16.5%，p<0.001）和焦虑/抑郁（21.4%对 13.5%，p<0.001）方面存在更多困难。年龄较大的受访者的平均（SD）EQ-5D 指数得分较低，分别为 0.89（0.16）和 0.95（0.13），p=0.001。在校正了协变量后，年龄是移动性（OR=2.038，95%CI：1.439-2.885）、日常活动（OR=1.957，95%CI：1.353-2.832）和疼痛或不适（OR=2.241，95%CI：1.690-2.972）的显著影响因素（p=0.001）。
与年轻的低收入成年人相比，低收入的老年人的 HRQOL 更差。这对涉及将积极老龄化概念纳入个人和政策制定层面的干预策略具有重要意义，特别是在较年长的低收入人群中，以提高生活质量和幸福感。
