健康教育研究与发展杂志

Quality of Life among Persons Aged 60-84 Years in Europe: The Role of Psychological Abuse and Socio-Demographic, Social and Health Factors

Abstract

Joaquim JF Soares, Örjan Sundin, Eija Viitasara, Maria Gabriella Melchiorre, Mindaugas Stankunas, Jutta Lindert, Francisco Torres- Gonzales, Henrique Barros and Elisabeth Ioannidi- Kapolou

Background: Elder abuse and its effects are a serious public health issue. However, little is known about the relation between psychological abuse, other factors (e.g. social support) and quality of life (QoL) by domain. This study addressed differences in QoL by domain between psychologically abused and non-abused. While considering other factors such as social support.

Methods: The respondents were 4,467 (2,559 women) randomly selected persons aged 60-84 years living in 7 European cities. The mean response across countries was 45.2%. The cross-sectional data were analyzed with bivariate/multivariate methods.

Results: Abused respondents contrasted to non-abused scored lower in QoL (autonomy, 67.42 ± 21.26 vs. 72.39 ± 19.58; intimacy, 55.31 ± 31.15 vs. 67.21 ± 28.55; past/present/future activities, 62.79 ± 19.62 vs. 68.05 ± 18.09; social participation, 65.03 ± 19.84 vs. 68.21 ± 19.77). Regressions showed that abuse was negatively associated with autonomy, intimacy and past/present/future activities, and positively with the social participation. All QoL dimensions were negatively associated with country and depressive/anxiety symptoms, and positively with social support. Further, variables such as age, sex and somatic symptoms were negatively associated with some of the QoL dimensions and others such as family structure, education, health care use and drinking positively. The regression model “explained” 32.8% of the variation in autonomy, 45.6% in intimacy, 44.8% in past/present/future activities and 41.5% in social participation.

Conclusions: Abuse was linked to lower QoL in most domains, but other factors such as depressive symptoms also carried a negative impact. Social support and to some extent family structure had a “protective” effect on QoL. Abuse, health indicators (e.g. depressive symptoms) and social support should be considered in addressing the QoL of older persons. However, QoL was influenced by many factors, which could not be firmly disentangled due to the crosssectional approach, calling for longitudinal research to address causality.