Cognitive Functioning, Dependency, and Quality of Life Among Older Adults

ABSTRACT

The determinants of QoL need serious deliberation in national as well as international healthcare guidelines as few studies have assessed the QoL of older individuals across cultures and countries. The current cross-sectional study aimed to examine the relationships between cognitive functioning and level of dependency with quality of life (QoL) and the moderating effects of gender and housing type on these relationships among older adults in Pakistan. A total of 274 respondents (own homes = 153; care homes = 121; Mage = 68.75 years, SD = 5.78 years) participated in this study. Cognitive functioning was assessed through Montreal Cognitive Assessment (MoCA), while level of dependency was assessed through Incapacity Status Scale (ISS). As for the measurement of QoL, World Health Organization Quality of Life (WHOQOL-BREF) instrument (Urdu version) was adopted. The results of Pearson product-moment correlation revealed the significant relationships of the constructs of interest. Cognitive functioning significantly predicted social QoL for males only but did not significantly predict the overall QoL and its four domains (i.e. physical, psychological, social relationship, and environmental health domains), regardless of housing type (i.e. own homes versus care homes). Meanwhile, the results of regression analysis demonstrated the significance of level of dependency in predicting the overall QoL and its four domains for both male and female respondents. As for those living in their own homes, the level of dependency significantly predicted their overall QoL, as well as physical and environmental QoL. For the older adults living in care homes, cognitive functioning predicted only the social QoL for males, but did not predict the overall QoL or its domains for older individuals in care homes or own homes. Based on these findings, this study demonstrated the significance of cognitive functioning, level of dependency, gender, and housing-type care homes as determinants of QoL among older adults. The study findings have implications for policymakers, practitioners, and public health specialists to cautiously create content that will enhance the older individuals’ QoL. Findings can contribute to designing interventions to motivate and preserve functional mobility in older individuals, and the generate community-based programs to enhance or uphold physical activity in the older individuals.

KEYWORDS:

• Cognitive functioning
• level of dependency
• quality of life
• older adults
• care homes
• Pakistan

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available from the corresponding author, [KM], upon reasonable request.

Notes

1. To recruit participants from various care homes, central personnel were asked to make a pre-selection of participants based on the inclusion criteria. Upon initial screening, each participant was informed individually of the objectives of the study and of the assessment to be carried out, so he/she could give informed consent.

2. Upper threshold.

3. Upper threshold.