Risk Factors and Number of Falls as Determinants of Quality of Life of Community-Dwelling Older Adults

Background and Purpose: In older adults, the psychological impact and effects related to the loss of functional capacity are directly related to perceived quality of life (QOL). The predictors of better QOL are increased physical activity, lower prevalence of overweight, lower cases of depression, and lower rate of reported alcohol abuse. On the contrary, the predictors of decreased QOL are female gender, comorbidity, deficient nutritional condition, polypharmacy, loss of mobility, depression and dependency, poor economic conditions, and social isolation and loneliness. Furthermore, QOL in older adults is more dependent on the number of falls than comorbidity. The objective was to investigate the determinants of perceived QOL among independent community-dwelling older adults and to quantify the influence of number of falls and number of risk factors on QOL. Methods: This is a cross-sectional study of 572 older adults (>70 years of age) seen in 10 primary care centers in La Ribera, Valencia, Spain. Comprehensive geriatric assessment was done by 4 nurses in primary care centers. Functional status and sociodemographic and clinical variables were collected. Quality of life was assessed with the EQ-5D scale. Results: Females predominated (63.3%). Mean age (standard deviation) was 76.1 (3.9) years. The male gender (beta = .09; 95% confidence interval [CI]: 0.05-0.13) was found to be predictive of better QOL, together with physical activity (beta = .04; 95% CI: 0.02-0.06), while the use of drugs affecting the central nervous system (beta = -.08; 95% CI: -0.12 to -0.03), overweight (beta = -.06; 95% CI: 0.1 to - 0.02), comorbidity (beta = -.09; 95% CI: -0.13 to -0.05), the presence of fall risk factors (beta = -.02; 95% CI: -0.03 to 0.01), and the number of previous falls (beta = -.03; 95% CI: -0.06 to 0.01) had a negative impact upon the EQ-5D Index score. Conclusions: If perceived QOL is used as an indicator of the success of intervention programs, certain factors accompanying the adoption of measures for the prevention of falls may mask the results (failure or success) of the intervention. Because most determinants of QOL are modifiable and physical activity has the potential to improve QOL, this research suggests that physical activity programs should be a component of health care for older adults.