DOI QR코드

DOI QR Code

The Association of Social Participation and Depressive Symptoms with Health-Related Quality of Life among Older Adults Living in Urban and Rural Areas Using the Korea Community Health Survey 2019

도시와 농촌지역 거주 노인의 사회활동, 우울 및 건강관련 삶의 질 간의 관계: 2019년 지역사회건강조사 자료활용

  • 김선희 (중앙대학교 적십자간호대학) ;
  • 손연정 (중앙대학교 적십자간호대학)
  • Received : 2022.10.28
  • Accepted : 2022.11.11
  • Published : 2022.12.31

Abstract

Purpose: This study aimed to investigate the association of social participation and depressive symptoms with health-related quality of life (HRQoL) among older adults living in urban and rural areas. Methods: This secondary, cross-sectional study was conducted with a total of 66,765 adults aged ≥65 years (urban-26,485 and rural-40,280) who participated in the household and individual surveys of the Korea Community Health Survey 2019. Data on the main study variables including social participation, depressive symptoms, and HRQoL were collected from August 16 to October 31, 2019. Multiple linear regression was used to identify the factors affecting HRQoL in urban and rural older adults. Results: The proportion of social participation (χ2=354.69, p<.001) and the level of HRQoL (χ2=12.06, p<.001) were significantly higher in older adults living in urban area than those in rural area. However, there was no significant difference in depressive symptoms between older adults living in urban and rural areas. Multiple linear regression analysis showed that social participation and depressive symptoms were significant predictors of HRQoL in both urban and rural older adults. Conclusion: Our main finding highlights that active participation in social activities and management of depressive symptoms in older adults regardless of living arrangements are crucial to improve HRQoL in later life. Interventions to increase social participation include early assessment of depressive symptoms in the community to promote HRQoL. More longitudinal studies are needed to identify the factors associated with HRQoL between older adults living in urban and rural areas while considering neighborhood environment and living arrangements.

Keywords

References

  1. Statistics Korea. Population of the aged [Internet]. Daejeon; Statistics Korea; 2021 [cited 2022 September 15]. Available from: http://kostat.go.kr/portal/eng/pressReleases/11/3/index.board 
  2. Marquez DX, Aguinaga S, Vasquez, PM, Conroy DE, Erickson KI, Hillman C, et al. A systematic review of physical activity and quality of life and well-being. Translational Behavioral Medicine. 2020;10(5):1098-1109. https://doi.org/10.1093/tbm/ibz198 
  3. Statistics Korea. 2020. Life tables for Korea [Internet]. Daejeon; Statistics Korea; 2021 [cited 2022 September 10] Available from: https://kostat.go.kr/portal/korea/kor_nw/1/6/9/index.board?bSeq=&pageNo=1&rowNum=10&amSeq=&s Target=&sTxt= 
  4. Rondon Garcia LM, Ramirez Navarrro JM. The impact of quality of life on the health of older people from a multidimensional perspective. Journal of Aging Research. 2018. https://doi.org/10.1155/2018/4086294 
  5. WHO Group. (1998). Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychological Medicine. 1998;28(3):551-558.  https://doi.org/10.1017/S0033291798006667
  6. An JS, Choi HY. Trend of influencing factors on health-related quality of life in Korean elderly. Journal of Korean Public Health Nursing. 2018;32(2):275-287. https://doi.org/10.5932/JKPHN.2018.32.2.275 
  7. Hidayati AR, Gondodiputro S, Rahmiati L. Elderly profile of quality of life using whoqol-bref Indonesian version: A community-dwelling. Althea Medical Journal. 2018;5(2): 105-110. DOI: https://doi.org/10.15850/amj.v5n2.1417 
  8. Blanco-Reina E, Valdellos J, Ocana-Riola R, Garcia-Merino MR, Aguilar-Cano L, Ariza-Zafra G, et al. Factors associated with health-related quality of life in community-dwelling older adults: A multinomial logistic analysis. Journal of Clinical Medicine. 2019;8(11):1810. https://doi.org/10.3390/jcm8111810. 
  9. Lee H, Choi MS. The age-friendly community environment factors contributing to life satisfaction of older adults living alone. Health and Social Welfare Review. 2022;42(2): 262-279. https://doi.org/10.15709/hswr.2022.42.2.262 
  10. Levasseur M, Routhier S, Clapperton I, Dore C, Gallagher F. Social participation needs of older adults living in a rural regional county municipality: Toward reducing situations of isolation and vulnerability. BMC Geriatrics. 2020;20(1):1-12. https://doi.org/10.21203/rs.2.19631/v1 
  11. Muhammad T, Srivastava S, Hossain B, Paul R, Sekher TV. Decomposing rural-urban differences in successful aging among older Indian adults. Scientific Reports. 2022;12(1):1-14. https://doi.org/10.1038/s41598-022-09958-4. 
  12. Zhou Z, Zhou Z, Gao J, Lai S, Chen G. Urban-rural difference in the associations between living arrangements and the health-related quality of life (HRQOL) of the elderly in China-evidence from Shaanxi province. PLoS One. 2018;13(9):e0204118. https://doi.org/10.1371/journal.pone.0204118. 
  13. Choi J, Yang K, Chu SH, Youm Y, Kim HC, Park YR, et al. Social activities and health-related quality of life in rural older adults in South Korea: A 4-year longitudinal analysis. International Journal of Environmental Research and Public Health. 2020;17(15):5553. https://doi.org/10.3390/ijerph17155553. 
  14. Liu D, Xi J, Hall BJ, Fu M, Zhang B, Guo J, et al. Attitudes toward aging, social support and depression among older adults: Difference by urban and rural areas in China. Journal of Affective Disorders. 2020;274:85-92. https://doi.org/10.1016/j.jad.2020.05.052. 
  15. Vogelsang, EM. Older adult social participation and its relationship with health: Rural-urban differences. Health Place. 2016;42:111-119. https://doi.org/10.1016/j.healthplace.2016.09.010 
  16. Sampaio PYS, Ito E, Sampaio RAC. The association of activity and participation with quality of life between Japanese older adults living in rural and urban areas. Journal of Clinical Gerontology and Geriatrics. 2013;4(2):51-56. https://doi.org/10.1016/j.jcgg.2012.11.004 
  17. Engel L, Chen G, Richardson J, Mihalopoulos C. The impact of depression on health-related quality of life and wellbeing: Identifying important dimensions and assessing their inclusion in multi-attribute utility instruments. Quality of Life Research. 2018;27(11): 2873-2884. https://doi.org/10.1007/s11136-018-1936-y 
  18. Kim YM, Cho SI. Regular exercise and depressive symptoms in Korean older adults. International Journal of Environmental Research and Public Health. 2021;18(1):303. https://doi.org/10.3390/ijerph18010303. 
  19. Kim GE, Jo MW, Shin YW. Increased prevalence of depression in South Korea from 2002 to 2013. Scientific Reports. 2020;10(1):1-9. https://doi.org/10.1038/s41598-020-74119-4 
  20. Purtle J, Nelson KL, Yang Y, Langellier B, Stankov I, Roux AVD. Urban-rural differences in older adult depression: A systematic review and meta-analysis of comparative studies. American Journal of Preventive Medicine. 2019;56(4): 603-613. https://doi.org/10.1016/j.amepre.2018.11.008 
  21. Jung M, Kim J. Influence of social capital on depression of older adults living in rural area: A cross-sectional study using the 2019 Korea community health survey. Journal of Korean Academy of Nursing. 2022;52(2):144-156. https://doi.org/10.1016/j.chb.2022.107480 
  22. dos Santos Tavares DM., Fernandes Bolina A, Aparecida Dias F, dos Santos Ferreira PC, Jose Haas V. Quality of life of elderly. Comparison between urban and rural areas. Investigacion Educacion en Enfermeria. 2014;32(3):401-413.  https://doi.org/10.17533/udea.iee.v32n3a05
  23. Guo Q, Bai X, Feng N. Social participation and depressive symptoms among Chinese older adults: A study on rural-urban differences. Journal of Affective Disorders. 2018;239: 124-130. https://doi.org/10.1016/j.jad.2018.06.036 
  24. Park SJ, Choi HR, Choi JH, Kim KW, Hong, JP. Reliability and validity of the Korean version of the Patient Health Questionnaire-9 (PHQ-9). Anxiety and Mood. 2010;6(2):119-124. 
  25. Han, C., Jo, S. A., Kwak, J. H., Pae, C. U., Steffens, D., Jo, I., & Park, M. H. (2008). Validation of the Patient Health Questionnaire-9 Korean version in the elderly population: the Ansan Geriatric study. Comprehensive psychiatry, 49(2), 218-223.  https://doi.org/10.1016/j.comppsych.2007.08.006
  26. EuroQol Group (2011). EQ-5D-3L[Internet]. Rotterdam; EuroQol office; 2021 [cited 2022 September 1]. Available from: http://www.euroqol.org/euroqol-group/about-us.Html, 
  27. Lee YK, Nam HS, Chuang LH, Kim KY, Yang HK, Kwon IS, et al. South Korean time trade-off values for EQ-5D health states: Modeling with observed values for 101 health states. Value in Health. 2009;12(8):1187-1193. https://doi.org/10.1111/j.1524-4733.2009.00579.x 
  28. Korea Centers for Disease Control and Prevention. Community health survey [Internet]. Cheongju: Korea Centers for Disease Control and Prevention; 2019 [cited 2022 October 01]. Available from: https://chs.kdca.go.kr/chs/examinCn/sampleSlctnMain.do 
  29. Carver LF, Beamish R, Phillips SP, Villeneuve M. A scoping review: Social participation as a cornerstone of successful aging in place among rural older adults. Geriatrics. 2018;3(4), 75. https://doi.org/10.3390/geriatrics3040075 
  30. Risal A, Manandhar S, Manandhar K, Manandhar N, Kunwar D, Holen A. Quality of life and its predictors among aging people in urban and rural Nepal. Quality of Life Research. 2020;29(12):3201-3212. https://doi.org/10.1007/s11136-020-02593-4