What factors can provide better conditions for older people? Is it possible to change the quality of life (QoL) for older people? While some perceive this time as the end stage, others point out that age itself is almost irrelevant for QoL. In our study we aimed to investigate the association of changes in social relations, such as family arrangements, paid work, use of the Internet, participation in social groups, and physical activity on QoL among older adults living in the city of Florianópolis, Santa Catarina State, Brazil, between 2009/2010 and 2013/2014.

This cross-sectional study is part of a population and home based study, called EpiFloripa Elderly Cohort Study. It was conducted with residents aged over 60 years, living in Florianópolis/SC, Southern of Brazil. The analysis consisted of multiple linear regression adjusting each variable of change in social relations and physical activity (from both waves), by demographic, socioeconomic and probable cognitive deficit, in order to estimate their effect on QoL score. The QoL was measured with CASP-16 Brazil at the second wave of data collection.

In the sample as a whole (N=1,131) the mean QoL score was 37.6 (95%CI: 37.2; 38.1), from a possible range of 0 to 48 (with 48 being the highest QoL). Older adults who remained living with their family had a lower QoL score compared to those who continued living alone. The perception of age as being related to fragility means that the older adults can still be excluded from certain activities, which contribute to their autonomy or control and are therefore important for their QoL. This may explain the lower QoL score for those who are living with family, while those who live alone may have more autonomy. Another factor can be the role often played by the family at times of illness or need, which can be stressful and provide a sense of dependence, reducing self-esteem and consequently have a negative effect on QoL.

Those older adults who started working between the waves of the study demonstrated a greater improvement in their QoL scores compared to those who remained without work. Retirement can be faced in different ways, and is a heterogeneous process. Historically, it has been associated with financial and physical decline. More recently however it has been seen as an opportunity to engage in other activities that older adults enjoy. Returning to the labor market may be consistent with the desire to remain active and feel socially important. The study shows that improved QoL can be attained through the domains of control, self-realization and pleasure. In additional, unpublished analysis revealed there was no predominance of low income among those who started working.

Regarding the use of technology, the study indicated participants who kept using the Internet showed a significant increase in their QoL score. The use of computer and Internet can contribute to well-being and generate a greater sense of capability and self-realization. It positively affects interpersonal relationships, stimulates cognitive function and contributes to the elderly’s independence.

In the EpiFloripa Study, those who had begun to participate in religious or lifestyle groups between the waves, showed improvements in their QoL scores. At this age, informal activity groups, such as education, art, music and physical activity groups, significantly contribute to better QoL. This membership may be related to socio-emotional selectivity, whereby they develop a strategy to engage primarily in activities that give them pleasure and satisfaction.

The study also reaffirms the importance of physical activity. As expected those who remained active had higher QoL scores. However, even those who were no longer active had a significantly higher QoL compared to those who remained insufficiently active.

Many important events affect the trajectory QoL in later life, and this study pointed out some changes that can improve QoL at this time of life. For this aged group QoL relates to the ability to adapt to difficulties that may arise. Some of the factors that contribute were: to encourage participation in social activities; to return to work; to use the Internet and to practice physical activity. The use of CASP-16 is recent, and further studies are required to evaluate its structural properties. It is, nonetheless, an excellent tool for population surveys, it has good psychometric properties and comparability with other countries.

 Reference

Marques, Larissa Pruner, Schneider, Ione Jayce Ceola, & d’Orsi, Eleonora. (2016). Quality of life and its association with work, the Internet, participation in groups and physical activity among the elderly from the EpiFloripa survey, Florianópolis, Santa Catarina State, Brazil. Cadernos de Saúde Pública, 32(12), e00143615.https://dx.doi.org/10.1590/0102-311×00143615

Guest blogger: PhD Student Larissa Pruner Marques, Federal University of Santa Catarina