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The relationship between the level of physical activity, independence in daily activities, and life quality and satisfaction in women over 80 living in rural areas - a pilot study

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Background: Better medicine and health care steadily increases the human life expectancy. Growing number of elderly people and the imbalance of population structure will affect many fields of life, including social security system, joborientation and culture. Therefore it is crucial that the elderly maintain not only good physical health but keep the ability to self-care as long as possible, stay functionally fit and express satisfaction of life in all domains. Objective: This study aims to analyse the factors that affect the quality of life in different domains (physical, psychological, social and environmental), like the independence in performing everyday life activities and the level of physical activity of women above 80 years old, living in own households. Materials and methods: The study was performed from March to August 2015 in Opole, Lower Silesia and Silesia voivodeship, mosty in rural areas, on 67 women, age above 80 (average 82.9), who filled the standarized questionnaires of life quality (WHOQOL-BREF), physical activity (IPAQ), and self-maintenance in daily living (IADL, Lawton scale). Results: The results show that the life satisfaction of women above 80 years old living in own households in rural areas is highest in the social and environmental domains, while is the lowest in physical health domain. There is a strong positive correlation between the level of physical activity, the level of self-maintenance and the life quality in four of its domains. Conclusions: Self-maintenance and higher level of physical fitness, which are the components of functional fitness, positively correlate with self-assesed life-satisfaction in all domains. It is crucial to stress the importance of physical activity in seniors, preferably in way of dedicated exercising of moderate and high intensity, that will bring benefits not only in domain of physical health but in overall well-being and higher life-satisfaction, the significant factors in healthy ageing.
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http://wydawnictwa.pzh.gov.pl/roczniki_pzh/
© Copyright by the National Institute of Public Health - National Institute of Hygiene
Corresponding author: Magdalena Golachowska,PhD., Państwowa Medyczna Wyższa Szkoła Zawodowa w Opolu, Wydział Nauk
o Zdrowiu, ul. Katowicka 68, Opole, tel. +48 511 868 421, e-mail: golachowskam@wsm.opole.pl
https://doi.org/10.32394/rpzh.2020.0112
Rocz Panstw Zakl Hig 2020;71(2):171-180
ORIGINAL ARTICLE
THE RELATIONSHIP BETWEEN THE LEVEL OF PHYSICAL ACTIVITY,
INDEPENDENCE IN DAILY ACTIVITIES, AND LIFE QUALITY
AND SATISFACTION IN WOMEN OVER 80 LIVING IN RURAL AREAS
– A PILOT STUDY
Grzegorz Żurek1, Ewelina Lepsy2, Alina Żurek3, Alina Radajewska4,
Kuba Ptaszkowski5, Magdalena Golachowska6
1Department of Biostructure, University School of Physical Education, Wroclaw, Poland
2 Department of Physiotherapy, Opole Medical School, Opole, Poland
3Department of Clinical Psychology and Health, University of Wroclaw, Wroclaw, Poland
4Department of Physiotherapy, Krapkowice Health Centre, Krapkowice, Poland
5Department of Clinical Biomechanics and Physiotherapy in Motor System Disorders,
Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland
6Department of Health Sciences, Opole Medical School, Opole, Poland
ABST RACT
Background. Better medicine and health care steadily increases the human life expectancy. Growing number of elderly
people and the imbalance of population structure will aect many elds of life, including social security system, job-
orientation and culture. Therefore it is crucial that the elderly maintain not only good physical health but keep the ability
to self-care as long as possible, stay functionally t and express satisfaction of life in all domains.
Objective. This study aims to analyse the factors that aect the quality of life in dierent domains (physical, psychological,
social and environmental), like the independence in performing everyday life activities and the level of physical activity
of women above 80 years old, living in own households.
Materials and methods. The study was performed from March to August 2015 in Opole, Lower Silesia and Silesia
voivodeship, mosty in rural areas, on 67 women, age above 80 (average 82.9), who lled the standarized questionnaires
of life quality (WHOQOL-BREF), physical activity (IPAQ), and self-maintenance in daily living (IADL, Lawton scale).
Results. The results show that the life satisfaction of women above 80 years old living in own households in rural areas is
highest in the social and environmental domains, while is the lowest in physical health domain. There is a strong positive
correlation between the level of physical activity, the level of self-maintenance and the life quality in four of its domains.
Conclusions. Self-maintenance and higher level of physical tness, which are the components of functional tness, positively
correlate with self-assesed life-satisfaction in all domains. It is crucial to stress the importance of physical activity in seniors,
preferably in way of dedicated exercising of moderate and high intensity, that will bring benets not only in domain of
physical health but in overall well-being and higher life-satisfaction, the signicant factors in healthy ageing.
Key words: senior physical activity, functional tness, senior self-maintenance, quality of life of elderly
STRESZCZENIE
Wprowadzenie. Rosnący poziom opieki zdrowotnej stale zwiększa długość życia ludzi. Rosnąca liczba osób starszych
i zaburzenie równowagi w strukturze populacji wpłynie na wiele dziedzin życia, w tym na system ubezpieczeń spo-
łecznych, orientację zawodową osób pracujących czy kulturę. Dlatego bardzo ważne jest, aby osoby starsze zachowały
nie tylko dobre zdrowie zyczne, ale także utrzymywały zdolność do samoopieki tak długo, jak to możliwe, pozostały
sprawne funkcjonalnie i wyrażały zadowolenie z życia we wszystkich dziedzinach.
Cel. Niniejsze badanie ma na celu analizę czynników wpływających na jakość życia w różnych dziedzinach (zyczna,
psychologiczna, społeczna i środowiskowa), takich jak niezależność w wykonywaniu codziennych czynności oraz po-
ziom aktywności zycznej u kobiet w wieku powyżej 80 lat, mieszkających we własnych gospodarstwach domowych.
Materiał i metody. Badanie przeprowadzono od marca do sierpnia 2015 r. w województwach opolskim, dolnośląskim
i śląskim, głównie na wsi, na 67 kobietach w wieku powyżej 80 lat (średnia 82,9), które wypełniły standaryzowane kwe-
stionariusze dotyczące jakości życia (WHOQOL-BREF), aktywności zycznej (IPAQ) i samowystarczalności w życiu
codziennym (IADL, skala Lawtona).
172 No 2
Wyniki. Wyniki naszego badania pokazują, że zadowolenie z życia kobiet w wieku powyżej 80 lat mieszkających we
własnych domach na obszarach wiejskich jest najwyższe w domenie społecznej i środowiskowej, a najniższe w dziedzinie
zdrowia zycznego. Istnieje silna dodatnia korelacja między poziomem aktywności zycznej, poziomem samodzielności
a jakością życia w czterech jej dziedzinach.
Wnioski. Samodzielność i wyższy poziom sprawności zycznej, które są składnikami sprawności funkcjonalnej, pozy-
tywnie korelują z ocenianą satysfakcją życiową we wszystkich jej dziedzinach. Bardzo ważne jest podkreślenie znaczenia
aktywności zycznej u seniorów, zwłaszcza w formie dedykowanych ćwiczeń o umiarkowanej i wysokiej intensywności,
co może mieć korzyści nie tylko w dziedzinie zdrowia zycznego, ale także w ogólnym lepszym samopoczuciu i więk-
szym zadowoleniu z życia, które są podstawami zdrowego starzenia się.
Słowa k luczowe: aktywność zyczna seniorów, sprawność funkcjonalna, samodzielność seniorów, jakość życia seniorów
INTRODUCTION
Growing number of studies published in recent
decades show the increase in human life expectancy.
The developments in medicine, better nutrition
and more available health care have led to decrease
in mortality rate from injuries, infections and
noncommunicable diseases [44].
These facts, together with decrease in number
of births, lead to the process of doubling the aging
population, which involves an increase in the total
segment of seniors as well as the subpopulation of very
elderly persons (aged 80 and more). Demographers
predict that by 2060 the number of people aged 80 and
over will double in European countries. In Germany,
Slovakia, Spain, Portugal and Greece, the proportion of
these people will be 13.4-16.1% of the total population,
and in Poland will be 12.3%.
The process of ageing depends mostly on decrease
in eectiveness of metabolic processes over time,
accumulation of errors (eg. more DNA damage,
more dysfunctional proteins’ deposits) and worse
regeneration, which inuence the functionality of
each cell, tissues and organs, leading to organ failure
and eventually death [22]. Better health care and better
medicines may help to extend life in terms of physical
health. However it is important to take into account
other domains of health as well as overall wellbeing
and life satisfaction of elderly [11, 18, 43].
According to the World Health Organization
(WHO), quality of life is dened as “the individual’s
perception of their position in life in the context of the
culture and value systems in which they live and in
relation to their goals” [19]. To assess the life quality
of late age seniors the state of not only physical, but
also emotional and social health has to be taken into
account. These factors are reected in the feeling of
happiness, cognitive functions, self-vision, coping
with environment changes and growing limitations of
the body [23, 38].
According to many studies [7, 29, 30, 39] the
quality of life correlates, beside the type of disorder,
disease length, treatment and its side eects, also with
gender, education, relations with family and friends,
place of residence (own household or senior houses). It
also includes maintaining functional tness, which is
the independence from others in satisfying basic life
needs or the ability to self-care, like mobility, nutrition,
personal hygiene and control over physiological urges.
In many studies it is indicated that functional tness is
one of the most important factors inuencing the life
satisfaction. However with age, activities of elderly
shift from regular and intensive to low impact activities
like walking and housekeeping duties, leading to more
sedentary life style [32, 34].
Nowadays, studying the components that aect the
overall sense of life satisfaction in growing population
of elderly is very important. It is worth stressing that
seniors who score higher at self-assessed life quality
are more independent, need less care from others
(family members and health care sta), recover faster
and have less age-related diseases [21].
Our research focuses on several domains related
to life satisfaction in women over the age of 80, such
as physical, psychological, social and environmental
health. We also tried to nd important components
that are associated with it, i.e. independence in the
performance of daily duties and level of physical
activity.
MATERIALS AND METHODS
The study was conducted on 67 women from three
voivodships in Poland (Opole, Lower Silesia, Silesia),
from March to August 2015. The including criteria
were:
age over 80 years old on the day of the study
ability to logically and independently answer the
questions,
living alone or with family in own household
informed consent to participate in the research.
Participants were asked to answer three validated
questionnaires, translated to Polish language:
WHOQOL-BREF (World Health Organisation
Quality of Life questionnaire)
IPAQ (International Physical Activity
Questionnaire) – short version
The relationship between the physical activity and life quality in women over 80
173No 2
Lawton Scale (The Lawton Instrumental Activities
of Daily Living, IADL)
WHOQOL-BREF (World Health Organisation
Quality of Life Questionnaire) is often used in national
and international studies to assess the psychometric
quality of life. It consists of four sections related to
four domains of live and two questions on individual
perception of the quality of life (global quality of life)
and individual, overall perception of one’s own health
(self-assessment of one’s health) [16].
The aspects measured in four domains related to
quality of life are:
in the physical domain: limitations related to pain,
level of energy, dependence on medical treatment,
satisfaction with sleep, eciency in everyday life,
readiness to work;
in the psychological domain: meaning and joy
of life, concentration, self-esteem, negative and
positive feelings;
in the social domain: relations with the environment
and social support, intimate life;
in the environmental domain: a sense of security,
access to health care, material and housing
conditions, access to information and pursuit of
interests, access to public transportation
Scoring in each domain has a positive direction, so
the higher the number of points, the better the quality
of life [16].
IPAQ (International Physical Activity
Questionnaire) was used to measure the level of
physical tness in form of the energy expenditure for
activity per week (MET-min/week) [3]. In this study
we used the shortened version cosisting of 7 questions
relating to all variants of physical activity associated
with everyday life, work and leisure. The respondent
provides answers about the time spent sitting, walking
and the time spent on moderate and intense physical
eort. The type of physical activity was expressed
using the Metabolic Equivalent of work, MET. It is
calculated as the ratio of the coecient assigned to
a given physical activity (intensive, moderate and low),
the number of days it is performed per week and the
duration in minutes per day. In this way, the average
value of physical activity expressed in MET units [min
/ week] is obtained for each of three levels of physical
activities [3].
Lawton Scale (The Lawton Instrumental Activities
of Daily Living, IADL) was used to assess the self-
maintenance in daily living and independence in
complex everyday activities [13,24].
It consists of 8 questions assessing the performance
of household chores such as cleaning, cooking,
washing; ability to shop and use the available means
of transport, use of the telephone, ability to manage
money, proper use of medicines. Being completely
independent of the others, the respondent received
a maximum of 8 points.
Statistics
The collected test results were subjected to
statistical analysis with Statistica 12 (StatSoft,
Inc., USA). The normality of variable distribution
was assessed using the Shapiro-Wilk test. For the
parameters for which there were no grounds to reject
the hypothesis of normal distribution, mean values
(x), standard deviation (s) were calculated. In turn,
for parameters where the hypothesis with normal
distribution was rejected, the median, quartiles (lower
and upper), minimum and maximum were calculated.
The signicance of dierences between the average
values was assessed by the Student’s t test. The Mann-
Whitney U test was used to show signicant dierences
between groups. The Pearson’s correlation coecient
(for normal distribution) and Spearman’s rank
correlation coecient (for distribution that deviates
from normal) were used to assess relationships.
The level α = 0.05 was assumed as statisticaly
signicant for all analyzes and the obtained values of
“p” were rounded to 4 decimal places.
The study was approved by the Bioethics Commitee
of Opole Medical School (nr 3/2015).
RESULTS
The study was completed by 67 women, aged 80-90
(median age 82.9). Most of participants were widows
(78%), living independently in their own households
in rural areas (73%), who used to perform physical
work in the past (78%). Detailed description of the
group is depicted in Table 1.
Table 1. Detailed characteristics of tested group
Women (n = 67)
average standard
deviation
Age [years] 82.94 2.67
Body height [cm] 157.9 5.53
Body weight [kg] 68.49 9.94
BMI [kg/m2]27.46 3.85
Type of work performed in
the past
physical – 78%
intelectual – 22%
Marital status
unmarried – 7%
married – 15%
widow – 78%
Place of residence rural area – 73%
town or city – 27%
G. Żurek, E. Lepsy, A. Żurek et al.
174 No 2
WHOQOL-Bref
The results of life-quality questionnaire in each of
four domains and self-assessed overall life-quality are
shown in Table 2. The highest scores were obtained
in social and environmental domains, then the
psychological domain, while the physical domain had
the lowest score.
The respondents scores, represented as the average
percentage of the total sum in each of four domains,
are depicted in Figure 1.
Table 2. Results of the WHOQOL-BREF questionnaire
WHOQOL-BREF
questionnaire questions and domains
questions rate
(points)
Respondends score (n = 67)
average SD
global quality of life 1-5 3.81 0.94
self-assessment of one’s health 1-5 3.42 1.02
physical domain 7-35 24.27 5.62
psychological domain 6-30 22.84 4.55
social domain 3-15 11.67 1.85
environmental domain 8- 40 31.08 4.81
69%
76%
78% 78%
physical domian psychological
domian
social domian environmental
domian
women
Figure 1. Percentage characteristics of assessments in four domains
of the WHOQOL-BREF questionnaire
Table 3. Statistical characteristics and comparison of means between a group of younger (up to 85 years old) and older
women (85 years old or more) (p values <0.05 are marked in bold)
WHOQOL-BREF
questions
rate
(points)
Women
up to 85 years
(n = 54)
Women 85
or more years
(n = 13)
t-Student’s test
average SD average SD t p
global quality of life 1-5 3.91 0.93 3.38 0.87 1.83 0.0719
self-assessment of one’s health 1-5 3.55 1.00 2.84 0.90 2.33 0.0228
physical domain 7-35 25.17 5.36 20.53 5.28 2,.9 0.0067
psychological domain 6-30 23.48 4.46 20.15 3.99 2.6 0.0166
social domain 3-15 11.87 1.77 10.84 2.03 1.82 0.0734
environmental domain 8-40 31.46 4.98 29.46 368 1.36 0.1796
For further analysis, the studied women were
divided into two age groups: younger (up to 85
years old) and older (85 years old and over). It was
established that younger women assess higher scores
on their quality of life in all the domains studied,
their global quality of life and self-assessment of
their health. In addition, the analysis showed the
signicance of dierences between the age groups in
physical, psychological domains and self-assessment
of one’s health (Table 3, Figure 2 and Figure 3).
The relationship between the physical activity and life quality in women over 80
175No 2
field of global quality of life self-assessment of health status
up to 85 years 85 or more years
WHOQOL-BREF
WOMEN
2,2
2,4
2,6
2,8
3,0
3,2
3,4
3,6
3,8
4,0
4,2
4,4
Figure 2. Statistical characteristics of assessments in the
eld of global quality of life and self-assessment of health
status of two age groups of women surveyed
Physical domain
Psychological domain
Social domain
Environmental domain
up to 85 years 85 or more years
WHOQOL-BREF
WOMEN
8
1
0
1
2
1
4
1
6
1
8
2
0
2
2
2
4
2
6
2
8
3
0
3
2
34
Figure 3. Statistical characteristics of assessments in the
four domains of quality of life of two age groups of women
surveyed
IPAQ – physical activity level
IPAQ was used to measure the level of physical
tness in form of the energy expenditure for activity
per week (MET-min/week) [3]. The results of IPAQ
were analysed with non-parametric statistical tests
because the variables do not meet the assumption of
normal distribution.
Less than 25% of surveyed women showed
intensive physical activity over the past 7 days.
Intensive activity means a kind of eort that
signicantly increases breathing and accelerates heart
rate, but it should be noted that in this questionnaire
the intensity of the eort was self assesed by the
respondents, and therefore is subjective. The averge
physical activity, which requires average eort with
slightly increased breathing and increased heart rate,
was indicated by 50% of the senior women. Almost all
respondents declared low activity (walking that lasted
at least 10 minutes at a time) (Table 4). Additionally, it
was observed that an older group of women (above 85
y.o.) showed lower levels of moderate and low physical
activity (Figure 4).
IADL (Lawton Scale)
The self-maintenance (independence) in daily
living was assesed with the Lawton Scale (The Lawton
Instrumental Activities of Daily Living, IADL) [13,
24]. The scale rates 0-8 points. The results of IADL
were analysed with non-parametric statistical tests
because the variables do not meet the assumption of
normal distribution.
In the examined group of women 50% scored 7
points or less, the other half obtained the maximum
number of 8 points. The results indicate that most
of the surveyed seniors are independent and do not
require help in everyday activities (Table 4). Analysis
of Lawton’s Scale results due to the age of the women
surveyed showed that younger women (up to 85 years
old) are more independent then older ones (85 years
and older) (Figure 5).
Table 4. Results of the IPAQ and Lawton Scale questionnaires
Questionnaires
Respondends score (n = 67)
Median lower
quartile
top
quartile
IPAQ – high activity [MET-min] 0.0 0.0 5760
IPAQ – moderate activity [MET-min] 240 0.0 3360
IPAQ – low activity (walking) [MET-min] 693.0 0.0 8316
IADL (Lawtons Scale) [scores 0-8] 7.0 0.0 8.0
G. Żurek, E. Lepsy, A. Żurek et al.
176 No 2
The cross-analysis of assessment of quality of life
in all four domains (WHOQOL-BREF) and physical
activity level (IPAQ) and independence (Lawton
Scale) showed signicantly moderate relationships
between these variables.
The greater the weekly physical activity level
(intensive and moderate), the better the quality of
life in all four domains was assesed (Table 5). Also
the higher scores on Lawton Scale of independence
the higher quality of life in all four domains was
noted. The strongest relationship was demonstrated
for the physical domain which means that the more
independent women, the more satised they are with
their quality of life and especially with their life
energy, readiness to work and rest (physical domain)
(Table 5).
DISCUSSION
The aging process cannot be stopped, but it is
possible to slow down its progression. For elderly
population the emphasis should be placed not only on
the physical health (disease diagnosis and treatment,
symptoms relief), but also on the quality of life, self-
maintenance and mobility [25,28].
An important element of functioning and healthy
aging is the functional tness [35] which is the
independence from others in satisfying basic life
needs, and the ability to self-care. It includes: mobility,
nutrition, controlling physiological functions and
personal hygiene [2]. The level of independence in
everyday activities and self-care of elderly depends on
mental and physical condition [37].
IPAQ - high (MET) IPAQ - moderate (MET)
IPAQ - low (walking) (MET)
up to 85 years 85 or more years
IPAQ
WOMEN
-1000
0
1000
2000
3000
4000
5000
6000
Figure 4. Statistical characteristics of the level of physical
activity for two age groups of women surveyed
Mediana
25%-75% Min-Maks
up to 85 years 85 or more years
WOMEN
LAWTON'S SCALE
2
3
4
5
6
7
8
9
Figure 5. Statistical characteristics of independence in
everyday life activities (Lawton Scae) for the two age
groups of women surveyed)
Table 5. Relationships between the quality of life in four domains (WHOQOL-BREF) and the independence (Lawton
Scale) and physical activity level (IPAQ). The correlation coecients highlighted in bold are statistically signicant with
p <0.05.
WHOQOL-BREF Lawton’s Scale IPAQ
high activity
IPAQ
moderate activity
IPAQ
low activity
physical domain 0.59 0.44 0.57 0.36
psychological domain 0.52 0.36 0.48 0.27
social domain 0.40 0.34 0.49 0.18
environmental domain 0.40 0.28 0.28 0.16
The relationship between the physical activity and life quality in women over 80
177No 2
Our results show that women aged 80 and more
living in the countryside are mostly independent.
Living in own household in the rural area reinforces
staying mobile because of i.e. the diculty in
access to shops or all kinds of institutions and the
lack or inecient public transportation. Bień et al.
[1] emphasizes that the main reason that causes
dependence on other people in daily care results from
the mobility limitations. In the studies of Fidecki et al.
[8] seniors from the rural environment showed better
eciency in everyday activities than people from the
urban environment.
Based on our results, it can be concluded that
the studied population of women over 80 showed no
deciencies in self-care abilities and required no help
from others in daily activities. Also we found the
relationship between eciency in complex everyday
activities and the assessment of the quality of life by
the respondents. The more independent people were,
the more they were satised with their own lives.
In this study, the physical activity was assessed
with the IPAQ questionnaire as the activities from the
last week preceding the day of the study. The results
showed that 50% women declared moderate activity
level and only 25% high activity level. The energy
expenditure, which generated moderate physical
activity, was related to work at home and around the
house, mosty on typical housekeeping work in the
home and in the garden. Similar results were obtained
by Skotnicka and Pieszko [36] in a study of people
over 80 years old, where the majority of respondents
also showed moderate levels of physical activity.
Review of publications and the results of our
research conrm the phenomenon that physical
activity of the respondents decreases with age both
among women and men [15, 17, 36, 40] In addition,
Talbot et al. [41] noticed a change in the level of
intensity of exercise with age, from intensive and
moderate in adultery to low intensity exercise in the
elderly. In our study almost all participants declared
performing low level activities, mostly in the means of
walking at least 10 minutes in one time. However, this
type of activity might not enough to maintain good
physical tness. The World Health Organization and
the American College of Sports Medicine recommend
regular exercise more intensive than walking [4, 26,
45]. Maintaining high physical tness in old age is
one of the factors that predicts the length of life and
enables older people to maintain independence and
autonomy [17]. Any type of physical exercise is better
than hypokinesia, so older people who engage in any
form of physical activity will always have some health
benets [4, 33].
Analysis of the quality of life prole for each
domains of the WHOQOL-Bref questionnaire showed
that older women gave highest scores in the domains
of social relations and environment, while the physical
domain obtained the lowest scores. In the research by
Zboina et al. [46, 47] elderly women living in long-term
care units also scored the lowest in the physical domain.
Ćwirlej-Sozańska et al. [6] found a higher quality of life
in all domains of the WHOQOL-Bref questionnaire in
seniors living in rural areas, and the score was higher
for seniors physically and socially active.
The quality of life of older people depends, among
others, on the conditions and place of residence [9].
Participants in our study who stayed in their own
households rated their quality of life at a good level.
Also older women living in rural areas scored higher
in the health self-assesment and quality of life than
women living in cities. Similarly, in the research by
Tra czyk et al. [42], Grzegorczyk et al. [14], a higher
assessment of the quality of life in most domains were
found in seniors living independently than living in
daily-care units or senior houses. Chruściel et al. [5]
showed that seniors living in rural areas in their own
household together with family members scored higher
on life quality then seniors living independently but
alone. Comparable results were delivered in the study
of Garbaccio et al. [10] who showed high life quality
and satistaction, that correlated with living in rural
areas in own household with family members, and
with nancial independence and access to services
including medical support when needed.
On the other hand Karwat et al. [20] and dlich
[31], have dierent results, where the residents of
cities assessed their life satisfaction more positively
than rural residents. However it was correlated with
higher disabilities and lower health status of surveyed
seniors.
One of the most important predictors aecting
the quality of life is the age of surveyed seniors
[12,27,29]. In our research the age also turned out to be
a signicant factor inuencing the assessment in the
physical, psychological domain and self-assessment
of health, where women above 85 years old showed
decrease in physical performance, self-maintanance
and overall life quality.
The conductance of our research was associated
with certain limitations. The respondents assessed
their independence in everyday activities, physical
activity, quality of life in a subjective way, and, as
in all surveys assessing health-related behaviour and
lifestyle, the tendency to show oneself in a better light
may be important factor that inuences the results.
Despite the presented limitations, our results bring
new content into the area of issues related to the
quality of life of women in old age. In addition, our
research was conducted mostly in rural areas, among
the elderly women living in their households, which is
undoubtedly an important practical aspect in the eld
of seniors studies.
G. Żurek, E. Lepsy, A. Żurek et al.
178 No 2
CONCLUSIONS
Our study shows that women aged 80-84 assess
their quality of life higher, are more independent in
everyday activities and are more physically active than
women aged 85 and more. Age signicantly aects
the assessment of the quality of life in the eld of
physical, psychological and self-assessment of health.
The physical activity level has the strongest relation to
quality of life and ability to self-care. However most
women in old age showed moderate and low level of
physical activity (mosty walking and housekeeping)
which is not aimed at increasing physical tness per
se. It is recomended that more education and action
should be aimed to increase the physical tness of
elderly women.
Conict of interst
All authors claim no conict of interest.
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Received: 11.02.2020
Accepted: 15.04.2020
This article is available in Open Access model and licensed under a Creative Commons Attribution-Non Commercial 3.0.Poland License (CC-BY-NC)
available at: http://creativecommons.org/licenses/by-nc/3.0/pl/deed.en
The relationship between the physical activity and life quality in women over 80
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Purpose: In order to cope with the challenges that are the result of an aging population, policies and services promote keeping elders in the community and letting them age in place rather than sending them to specialized institutions. Aging in place refers to the option where people can stay in their homes as they age. This policy option, however, poses various challenges and may also threaten the quality of life of the aging. A literature review was performed on the quality of life of older people aging in place to determine whether the actual assessment of quality of life can be used within aging in place. Methods: Web of Science, PubMed, CINAHL, Sociological Abstracts and Social Science Research Network were searched for publications on "Ag(e)ing in place" AND "Quality of life." Results: Although assessment is crucial to a policy pursuing a good quality of life, literature reveals that it is seldom performed. Only a small part of the studies report on the assessment of quality of life, including the instruments used and the results. The findings also indicate that there is no consensus on the definition of quality of life or its domains structures. Conclusion: As no existing instrument assessing the quality of life of older people aging in place could be identified, such a tool should be developed, because any policy towards this growing group of people should be complemented by an evaluation.
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The terms health, health-related quality of life (HRQoL), and quality of life (QoL) used interchangeably. Given that these are three key terms in the literature, their appropriate and clear use is important. This paper reviews the history and definitions of the terms and considers how they have been used. It is argued that the definitions of HRQoL in the literature are problematic because some definitions fail to distinguish between HRQoL and health or between HRQoL and QoL. Many so-called HRQoL questionnaires actually measure self-perceived health status and the use of the phrase QoL is unjustified. It is concluded that the concept of HRQoL as used now is confusing. A potential solution is to define HRQoL as the way health is empirically estimated to affect QoL or use the term to only signify the utility associated with a health state.
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Given the biological complexity of the ageing process, there is no single, simple and reliable measure of how healthily someone is ageing. Intervention studies need a panel of measures which capture key features of healthy ageing. To help guide our research in this area, we have adopted the concept of the "Healthy Ageing Phenotype" (HAP) and this study aimed to (i) identify the most important features of the HAP and (ii) identify/develop tools for measurement of those features. After a comprehensive assessment of the literature we selected the following domains: physiological and metabolic health, physical capability, cognitive function, social wellbeing, and psychological wellbeing which we hoped would provide a reasonably holistic characterisation of the HAP. We reviewed the literature and identified systematic reviews and/or meta-analysis of cohort studies, and clinical guidelines on outcome measures of these domains relevant to the HAP. Selection criteria for these measures included: frequent use in longitudinal studies of ageing; expected to change with age; evidence for strong association with/prediction of ageing-related phenotypes such as morbidity, mortality and lifespan; whenever possible, focus on studies measuring these outcomes in populations rather than on individuals selected on the basis of a particular disease; (bio)markers that respond to (lifestyle-based) intervention. Proposed markers were exposed to critique in a Workshop held in Newcastle, UK in October 2012. We have selected a tentative panel of (bio)markers of physiological and metabolic health, physical capability, cognitive function, social wellbeing, and psychological wellbeing which we propose may be useful in characterising the HAP and which may have utility as outcome measures in intervention studies. In addition, we have identified a number of tools which could be applied in community-based intervention studies designed to enhance healthy ageing. We have proposed, tentatively, a panel of outcome measures which could be deployed in community-based, lifestyle intervention studies. The evidence base for selection of measurement domains is less well developed in some areas e.g. social wellbeing (where the definition of the concept itself remains elusive) and this has implications for the identification of appropriate tools. Although we have developed this panel as potential outcomes for intervention studies, we recognise that broader agreement on the concept of the HAP and on tools for its measurement could have wider utility and e.g. could facilitate comparisons of healthy ageing across diverse study designs and populations.
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