The association between living arrangements and health-related quality of life in Korean older people a nationwide repeated cross-sectional study

Objectives: This study investigated the association between living arrangements and healthrelated quality of life (HRQoL) in older people. Methods: A secondary analysis was conducted of 6,153 participants (aged >= 60 years) from the seventh Korean National Health and Nutrition Examination Survey (2016 to 2018). HRQoL was measured using the 3-level version of the EuroQol 5-dimensional questionnaire. The chi-square test, t-test, and multiple regression were used, applying sampling weights for the analysis. Results: The proportion of respondents living alone was 18.0%, with a higher prevalence among women and older age groups (p < 0.001). The overall HRQoL was lower in groups living alone than in groups living with others (p < 0.001). Older people living alone showed higher impairments in all dimensions of the 3-level version of the European Quality of Life 5-Dimensional Questionnaire (EQ-5D-3L) than those living with others, including mobility (p < 0.001), self-care (p < 0.001), usual activities (p < 0.001), pain/discomfort (p < 0.001), and depression/anxiety (p < 0.001). Problems with mobility were most prevalent (42.8%), followed by pain/ discomfort (41.9%) in respondents living alone. Living alone was significantly associated with a lower HRQoL index score (b = -0.048, p < 0.001) after adjusting for age, gender, education, exercise, perceived stress, and perceived health status. Conclusion: Living alone was negatively associated with HRQoL. Based on this study, future care planning for older people should consider their living arrangements. The need to strengthen and expand care programs targeting those living alone should also be addressed.