College of Nursing, Gachon University, Incheon, Republic of Korea.
Department of Family Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea.
Front Public Health. 2023 Dec 21;11:1278008. doi: 10.3389/fpubh.2023.1278008. eCollection 2023.
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.
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.
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.
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.
独居的老年人比例正在迅速增加，改善这一群体的健康状况和健康相关生活质量（HRQoL）正成为一个更重要的公共卫生问题。本研究旨在探讨独居韩国老年人 HRQoL 的变化，并确定影响其 HRQoL 的因素。
采用纵向研究设计。数据在基线和 1 年随访时收集。由 S*市 789 名年龄>65 岁的独居老年人组成的研究对象完成了一项关于健康状况和 HRQoL 的队列调查，调查时间为 2018 年 8 月至 2019 年 8 月。经过培训的访谈员使用经过验证的问卷（身体健康、心理健康、社会健康和 HRQoL）对参与者进行面对面访谈。使用广义估计方程评估健康状况的变化以及时间和性别之间的交互作用。然后，进行逐步多元逻辑回归分析，以确定与 HRQoL 相关的因素。
健康状况主观评估（SEH）、IPAQ 评分、虚弱、营养状况和抑郁在时间上存在差异。SEH、IPAQ、虚弱、孤独、抑郁和社会支持在性别上存在差异。时间和性别之间存在交互作用IPAQ 和 HRQoL。在基线时，SEH、抑郁症状、性别、虚弱和年龄与 HRQoL 相关。一年后，HRQoL 与 SEH、虚弱、抑郁症状、生活成本、自杀念头、性别、社会支持、孤独和自杀企图有关。
我们的研究结果表明，HRQoL 与身体健康、心理健康和社会支持有关。未来需要进行详细研究，以确定政府和社区是否可以通过心理支持预防抑郁、孤独和自杀念头，并提供经济支持来提高独居老年人的生活质量。
