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Psychosocial Determinants of Quality of Life and Active Aging. A Structural Equation Model.

ABSTRACT: Population aging is the 21st century's predominant demographic event. The old-age dependency ratio is projected to rise sharply in the next decades. Variables of health-related quality of life can be useful in designing interventions for promoting active aging to prevent dependency and save governments' budgets. This study aims to find a model capable of explaining how psychosocial variables are related to improved quality of life during active aging, and if this relationship varies with age. Structural equation modelling (SEM) was used to examine the relationships among the availability of social resources, memory, depression, and perception of quality of life from three community senior centers in Madrid (Spain) in a sample of 128 older adult volunteers. The results suggest a psychosocial model where the availability of social support improves quality of life and explicit memory, reduces depression in active older adults, and where there are two main elements for understanding quality of life: perception of health and satisfaction. Importantly, age does not modify the interactions between variables, suggesting that their behavior is constant across aging. We concluded that the availability of social resources, understood not only as the people we interact with daily but also other family members, close friends, or institutions that could help in case of an emergency, allows people to avoid isolation and loneliness, increasing satisfaction and well-being in older adults. Professionals and policymakers should promote well-being by incorporating psychosocial variables related to personal satisfaction in the existential project, not only health, functional activity, or a friendly environment. Older adults need to feel that they are not alone, and in this sense, the availability of social resources is key.

SUBMITTER: Leon LP

PROVIDER: S-EPMC7503318 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Psychosocial Determinants of Quality of Life and Active Aging. A Structural Equation Model.

León Laura Ponce de LP Mangin Jean Pierre Lévy JPL Ballesteros Soledad S

International journal of environmental research and public health 20200819 17

Population aging is the 21st century's predominant demographic event. The old-age dependency ratio is projected to rise sharply in the next decades. Variables of health-related quality of life can be useful in designing interventions for promoting active aging to prevent dependency and save governments' budgets. This study aims to find a model capable of explaining how psychosocial variables are related to improved quality of life during active aging, and if this relationship varies with age. St ...[more]

PMID: 32824975

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Project description:BackgroundPsychosocial factors and dentist-patient relationships (DPR) have been suggested to be associated with oral health outcomes. This study aimed to test a conceptual model which hypothesised relationships among psychosocial factors, DPR variables, and oral health-related quality of life (OHRQoL) in the 'distal-to-proximal' framework.MethodsA total of 12,245 adults aged 18 years or over living in South Australia were randomly sampled for the study. Data were collected from self-complete questionnaires in 2015-2016. The outcome variable of Oral Health Impact Profile was used to measure OHRQoL. Psychosocial domain consisted of psychological well-being, social support, and health self-efficacy. DPR domain included trust in dentists, satisfaction with dental care, and dental fear. The hypothesised model was tested using the two-step approach in structural equation modelling.ResultsData were analysed from 3767 respondents after the screening/preparing process (adjusted valid response rate 37.4%). In the first step of the analysis, confirmatory factor analyses produced acceptable measurement models for each of the six latent variables (GFI = 0.95, CFI = 0.98, RMSEA = 0.04). The final structural model indicated that better well-being, higher self-efficacy, and more satisfaction were associated with lower oral health impact (β = - 0.12, - 0.07, - 0.14, respectively) whereas fear was positively associated (β = 0.19). Among intermediates, support was positively associated with satisfaction within a small effect size (β = 0.06) as compared to self-efficacy with trust (β = 0.22). The invariance of the final model was also confirmed on participants' SES and dental service characteristics except the variable of 'last dental visit'.ConclusionsPsychosocial factors and DPR variables were associated with oral health impact in both direct and indirect paths. The framework of 'distal-to-proximal' actions is empirically supported from psychosocial factors via DPR variables to OHRQoL.

Project description:IntroductionPopulation demography across the globe shows an increasing trend in the aging population due to better healthcare, improved nutrition, advanced health-related technology, and decreased fertility rate. Despite these advancements, there remains a knowledge gap in understanding the association between active aging determinants and quality of life (QoL) among older adults, particularly within diverse cultural contexts, which has not been adequately explored in previous research. Therefore, understanding the association between active aging determinants and QoL can help policymakers plan early interventions or programs to assist future older adults in both aging actively and optimizing their quality of life (QoL), as these two factors have a bidirectional relationship.ObjectiveThis study aimed to review evidence regarding the association between active aging and quality of life (QoL) among older adults and to determine the most widely used study designs and measurement instruments in studies conducted between 2000 and 2020.MethodsRelevant studies were identified by a systematic search of four electronic databases and cross-reference lists. Original studies examining the association between active aging and QoL in individuals aged 60 years or older were considered. The quality of the included studies and the direction and consistency of the association between active aging and QoL were assessed.ResultsA total of 26 studies met the inclusion criteria and were included in this systematic review. Most studies reported a positive association between active aging and QoL among older adults. Active aging had a consistent association with various QoL domains including physical environment, health and social services, social environment, economic, personal, and behavioral determinants.ConclusionActive aging had a positive and consistent association with several QoL domains among older adults, backing the notion that the better the active aging determinants, the better the QoL among older adults. Considering the broader literature, it is necessary to facilitate and encourage the active participation of older adults in physical, social, and economic activities for the maintenance and/or improvement of QoL. Identifying other possible determinants and enhancing the methods to improve those determinants may help improve the QoL among older adults.

Project description:Background/Study Context: Conceptual frameworks are analytic models at a high level of abstraction. Their operationalization can inform randomized trial design and sample size considerations.MethodsThe Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) conceptual framework was empirically tested using structural equation modeling (N=2,802). ACTIVE was guided by a conceptual framework for cognitive training in which proximal cognitive abilities (memory, inductive reasoning, speed of processing) mediate treatment-related improvement in primary outcomes (everyday problem-solving, difficulty with activities of daily living, everyday speed, driving difficulty), which in turn lead to improved secondary outcomes (health-related quality of life, health service utilization, mobility). Measurement models for each proximal, primary, and secondary outcome were developed and tested using baseline data. Each construct was then combined in one model to evaluate fit (RMSEA, CFI, normalized residuals of each indicator). To expand the conceptual model and potentially inform future trials, evidence of modification of structural model parameters was evaluated by age, years of education, sex, race, and self-rated health status.ResultsPreconceived measurement models for memory, reasoning, speed of processing, everyday problem-solving, instrumental activities of daily living (IADL) difficulty, everyday speed, driving difficulty, and health-related quality of life each fit well to the data (all RMSEA < .05; all CFI > .95). Fit of the full model was excellent (RMSEA = .038; CFI = .924). In contrast with previous findings from ACTIVE regarding who benefits from training, interaction testing revealed associations between proximal abilities and primary outcomes are stronger on average by nonwhite race, worse health, older age, and less education (p < .005).ConclusionsEmpirical data confirm the hypothesized ACTIVE conceptual model. Findings suggest that the types of people who show intervention effects on cognitive performance potentially may be different from those with the greatest chance of transfer to real-world activities.

Project description:Background Breast cancer care today involves state-of-the-art biomedical treatment but can fail to address the broader psychosocial and quality-of-life (QoL) issues associated with the transition to breast cancer survivorship. This scoping review examines the evidence on the influence of psychosocial determinants on QoL in breast cancer survivors. Methods Scoping review methodology was used to: (1) identify the research question(s); (2) identify relevant studies; (3) undertake study selection; (4) extract data; (5) collate, summarise and report the results. Results A total of 33 studies met the inclusion criteria. The majority of studies were conducted in the US (n?=?22, 67%) and were mainly cross-sectional (n?=?26, 79%). Sixteen psychosocial determinants of QoL were identified. Social support (n?=?14, 42%), depression (n?=?7, 21%) and future appraisal and perspective (n?=?7, 21%) were the most frequently investigated determinants. Twelve different QoL measures were used. A range of different measurement tools were also used per psychosocial determinant (weighted average?=?6). The 14 studies that measured the influence of social support on QoL employed 10 different measures of social support and 7 different measures of QoL. In general, across all 33 studies, a higher level of a positive influence and a lower level of a negative influence of a psychosocial determinant was associated with a better QoL e.g. higher social support and lower levels of depression were associated with a higher/better QoL. For some determinants such as spirituality and coping skills the influence on QoL varied, but these determinants were less commonly investigated. Conclusion Consensus around measures of QoL and psychological determinants would be valuable and would enable research to determine the influence of psychosocial determinants on QoL adequately. Research in other healthcare settings beyond the US is required, in order to understand the influence of organisation and follow-up clinical and supportive care on psychosocial determinants and QoL and to improve the quality of care in breast cancer survivors.

Project description:AimsLiving alone, a reality in an increasing number of older adults recently, is a risk factor for low quality of life. This study identified the predictors of quality of life in older adults living alone based on mental health and the International Classification of Functioning, Disability, and Health.MethodsThis secondary data analysis used information from the 2018 Assessing the Requirements of Customized Health Care and Daily Living Support Services survey (N = 1,022), collected from adults aged ≥ 65 living alone in Siheung City, South Korea, from August to October 2018. The exogenous variables were body functions (hand grip strength, timed "up and go" test score, and body mass index), daily living activities (Korean Instrumental Activities of the Daily Living Scale), social activity participation (social activity engagement, neighbor contacts, and family contacts), and participation in economic activity (frequency). The endogenous variables were mental health (Geriatric Depression Scale Short Form-Korean Version and UCLA Loneliness Scale) and quality of life (EuroQoL-5 Dimension-3 Level and EuroQoL-Visual Analog Scale).ResultsAfter modifying the hypothetical model, which had failed to satisfy the recommended fitness level, the (modified) model had good fitness indices Q (CMIN / df) 2.90, GFI 1, AGFI 1, RMSEA 0.04, CFI 0.90 and PCFI 0.53. Of the nine pathways of the modified model, five were statistically significant. Quality of life was affected by body functions, daily living activities, social activity participation, and mental health. These variables explained 68.2% of the factors affecting quality of life.ConclusionsBy highlighting the role of mental health, this model provides a useful framework for improving the quality of life of older adults who live alone and function at various levels in the community. Focusing on advancing mental health through body functions, daily living activities, and social activity participation can improve quality of life.

Dataset Information

Psychosocial Determinants of Quality of Life and Active Aging. A Structural Equation Model.

Publications

Psychosocial Determinants of Quality of Life and Active Aging. A Structural Equation Model.

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