Journal of Shandong University (Health Sciences) ›› 2025, Vol. 63 ›› Issue (9): 57-64.doi: 10.6040/j.issn.1671-7554.0.2024.0780

• Special Issue on “Big DataEnabled, AI Foundation ModelDriven Multimodal Cohort Design and Analysis” • Previous Articles    

Health-related quality of life and its influencing factors of the elderly in Shandong Province based on multilevel models

FU Yu1,2, JIANG Wei3, ZHU Gaopei1,2, XUE Fuzhong1,2,4   

  1. 1. Department of Medical Dataology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China;
    2. National Institute of Health and Medical Big Data, Jinan 250003, Shandong, China;
    3. National Administration of Health Data, Jinan 250002, Shandong, China;
    4. Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
  • Published:2025-09-08

PDF (PC)

0

Abstract: Objective To examine the health-related quality of life of the elderly in Shandong Province, and to analyze its influencing factors on the basis of controlling for regional heterogeneity. Methods A total of 5,447 elderly people over 65 years old in 10 demonstration counties in Shandong Province were selected by Multicenter cluster random sampling. Face-to-face questionnaires were used to collect information. The European Five Dimensions of Health(EQ-5D-5L)scale was used to investigate the health-related quality of life of the subjects. The Mann-Whitney U test and Kruskal-Wallis test were used to compare health-related quality of life. Because of the nested structure of the data in this study, a multilevel Logistic regression model was used to analyze the factors influencing health-related quality of life and a comparison was made with a single-level Logistic regression model. Results Health utility value ［M(P25, P75)］ of elderly people over 65 years old in Shandong Province was 0.942(0.861, 1.000), and the EQ-VAS ［M(P25, P75)］ was 80(80, 90). Among the five dimensions of the EQ-5D-5L scale, the highest proportion of people without difficulties was "self-care"(91.33%), while the highest proportion of people with difficulties was "pain or discomfort"(45.4%). The results of univariate analysis showed that county, age, gender, smoking, alcohol consumption, physical exercise and accidental injury affect the health utility values, while age, alcohol consumption, physical exercise and accidental injury were also influential factors of the EQ-VAS scores(P<0.05). The results of multilevel Logistic regression analyses showed that age, gender, alcohol consumption, physical exercise, and accidental injury affected the health utility value, while alcohol consumption, physical exercise and accidental injury were also the influencing factors of EQ-VAS score(P<0.05). Conclusion The health-related quality of life of the elderly in Shandong Province is relatively high; Geographical differences affect health-related quality of life; On the basis of considering regional heterogeneity, attention should be given to proactive interventions in the areas of smoking, alcohol consumption, physical activity and accident prevention.

Key words: Elderly people, Health-related quality of life, EQ-5D-5L, Health utility value, Multilevel Logistic Regression

CLC Number: 

  • R195
[1] 国家统计局. 中国统计年鉴2024 [M/OL]. 北京:中国统计出版社, 2024: 2-4.(2024-10-15)[2025-04-22]. https://www.stats.gov.cn/sj/ndsj/2024/indexch.htm
[2] 朱亚鑫, 成思桦, 吴炜, 等. 老年人生命质量现状及其影响因素[J]. 中国医科大学学报, 2022, 51(8): 734-737. ZHU Yaxin, CHENG Sihua, WU Wei, et al. Research progress on the quality of life of the elderly and its influencing factors [J]. Journal of China Medical University, 2022, 51(8): 734-737.
[3] van Hout BA, Shaw JW. Mapping EQ-5D-3L to EQ-5D-5L[J]. Value Health, 2021, 24(9): 1285-1293.
[4] Wang P, Gao JY, Zhou HJ, et al. Health-related quality of life of Chinese AIDS patients: a multi-region study[J]. Qual Life Res, 2023, 32(4): 1005-1014.
[5] Huang HY, Wang H, Shi JF, et al. Health-related quality of life of patients with colorectal neoplasms in China: a multicenter cross-sectional survey[J]. J Gastroenterol Hepatol, 2021, 36(5): 1197-1207.
[6] 邓清文, 刘文彬. 心血管疾病患者健康相关生命质量及其影响因素的多水平模型分析[J]. 山东大学学报(医学版), 2020, 58(7): 115-121. DENG Qingwen, LIU Wenbin. Multilevel analysis of health related quality of life of patients with cardiovascular disease and its determinants[J]. Journal of Shandong University(Health Sciences), 2020, 58(7):115-121.
[7] Freitas JLGDS, Silva JMM, Nóbrega JCL, et al. Health-related quality of life and associated factors: regional differences among oldest-old in Brazil[J]. Inquiry, 2022, 59: 469580221086922. doi:10.1177/00469580221086922
[8] Luo N, Liu G, Li MH, et al. Estimating an EQ-5D-5L value set for China[J]. Value Health, 2017, 20(4): 662-669.
[9] Su MZ, Yao NL, Shang MM, et al. Frailty and its association with health-related quality of life among older cancer patients: an evidence-based study from China[J]. Health Qual Life Outcomes, 2022, 20(1): 124. doi:10.1186/S12955-022-02032-7
[10] Kim MJ, Park S, Jung YI, et al. Exploring health-related quality of life and frailty in older adults based on the Korean Frailty and Aging Cohort Study[J]. Qual Life Res, 2020, 29(11): 2911-2919.
[11] Masel MC, Graham JE, Reistetter TA, et al. Frailty and health related quality of life in older Mexican Americans[J]. Health Qual Life Outcomes, 2009, 7: 70. doi:10.1186/1477-7525-7-70
[12] Du YG, Yang LQ, An Y, et al. Health-related quality of life and associated factors in elderly individuals with dyslipidemia in rural Northern China[J]. Qual Life Res, 2023, 32(12): 3547-3555.
[13] 程诺, 李林, 李伊然, 等. 东北地区中老年居民的健康相关生命质量及其影响因素[J]. 中国卫生统计, 2023, 40(2): 239-241.
[14] 梁琼, 张晓波, 宋雪茜. 中国老年人口健康水平空间分布及影响因素[J]. 中国老年学杂志, 2022, 42(8): 1994-2000.
[15] 丁小婷, 杨晓珊, 王文杰, 等. 武汉市社区老年人生命质量及影响因素分析[J]. 中华疾病控制杂志, 2017, 21(10): 1014-1017. DING Xiaoting, YANG Xiaoshan, WANG Wenjie, et al. Health-related quality of life and its risk factors among community-dwelling older adults in Wuhan[J]. Chinese Journal of Disease Control & Prevention, 2017, 21(10):1014-1017.
[16] 赵珊, 汤敏, 徐淑涛, 等. 潍坊市居民健康相关生命质量评价[J]. 医学与社会, 2017, 30(5): 38-40. ZHAO Shan, TANG Min, XU Shutao, et al. Evaluation of health-related life quality of residents in Weifang City[J]. Medicine and Society, 2017, 30(5): 38-40.
[17] 李心怡, 李忠, 许张娣, 等. 苏北农村地区老年人生命质量及影响因素分析[J]. 南京医科大学学报(社会科学版), 2017, 17(1): 7-11. LI Xinyi, LI Zhong, XU Zhangdi, et al. Analysis of elderly peoples health quality and its influencing factors in the northern rural areas of Jiangsu Province[J]. Journal of Nanjing Medical University(Social Sciences), 2017, 17(1): 7-11.
[18] 王晓辉, 胡文品, 吕萌, 等. 基于EQ-5D-5L量表的兰州市居民健康相关生命质量及影响因素研究[J]. 中国农村卫生事业管理, 2021, 41(6): 435-440. WANG Xiaohui, HU Wenpin, LYU Meng, et al. Health-related quality of life and impact factors of Lanzhou residents based on EQ-5D-5L[J]. Chinese Rural Health Service Administration, 2021, 41(6): 435-440.
[19] 田艳梅, 肖文文, 乔慧. 宁夏5县农村老年人生命质量及影响因素分析[J]. 中国公共卫生, 2021, 37(1): 1-4. TIAN Yanmei, XIAO Wenwen, QIAO Hui. Quality of life and its influencing factors among rural elderly in five counties of Ningxia Hui Autonomous Region[J]. Chin J Public Health, 2021, 37(1):1-4.
[20] 王静贤, 张爱莲, 董小燕. 山西省城乡老年人生命质量影响因素[J]. 中国老年学杂志, 2019, 39(5): 1217-1220.
[21] Chen C, Liu GG, Shi QL, et al. Health-related quality of life and associated factors among oldest-old in China[J]. J Nutr Health Aging, 2020, 24(3): 330-338.
[22] Hwang HA, Jeong H, Yim HW. Health-related quality of life of Korean older adults according to age, sex, and living arrangements: a cross-sectional study[J]. Front Public Health, 2023, 11: 1281457. doi:10.3389/fpubh.2023.1281457
[23] Liao W, Liu XT, Kang N, et al. Associations between healthy lifestyle score and health-related quality of life among Chinese rural adults: variations in age, sex, education level, and income[J]. Qual Life Res, 2023, 32(1): 81-92.
[24] 张乐, 赵延芳, 关素珍. 乌鲁木齐市某区老年人健康相关生命质量及影响因素[J]. 中国老年学杂志, 2017, 37(1): 200-202.
[25] 顾心月, 戴士媛, 徐爱军, 等. 江苏省老年人健康相关生命质量影响因素[J]. 中国公共卫生, 2020, 36(10): 1409-1412. GU Xinyue, DAI Shiyuan, XU Aijun, et al. Health-related life quality among the elderly in Jiangsu province: an empirical study[J]. Chinese Journal of Public Health, 2020, 36(10): 1409-1412.
[26] 张继萍, 秘玉清, 刘一鋆, 等. 山东省4地市社区老年人生命质量及影响因素[J]. 中国老年学杂志, 2019, 39(8): 1983-1987.
[27] 田诗音, 陈琪, 王睿, 等. 上海市老年人健康相关生命质量及其影响因素[J]. 中国公共卫生, 2018, 34(4): 505-509. TIAN Shiyin, CHEN Qi, WANG Rui, et al. Health-related quality of life and its influencing factors among elderly people in Shanghai city[J]. Chinese Journal of Public Health, 2018, 34(4): 505-509.
[28] Geigl C, Loss J, Leitzmann M, et al. Social factors of health-related quality of life in older adults: a multivariable analysis[J]. Qual Life Res, 2023, 32(11): 3257-3268.
[29] Kaplan MS, Huguet N, Feeny D, et al. Alcohol use patterns and trajectories of health-related quality of life in middle-aged and older adults: a 14-year population-based study[J]. J Stud Alcohol Drugs, 2012, 73(4): 581-590.
[30] Mutz J, Roscoe CJ, Lewis CM. Exploring health in the UK biobank: associations with sociodemographic characteristics, psychosocial factors, lifestyle and environmental exposures[J]. BMC Med, 2021, 19(1): 240. doi:10.1186/s12916-021-02097-z
[31] 刘冰, 秦康, 徐珏, 等. 杭州市居民健康相关生命质量评价及影响因素分析[J]. 中国慢性病预防与控制, 2023, 31(3): 231-236.
[32] 魏馨远, 程梓敉, 潘惊萍, 等. 四川省空巢老人生命质量及影响因素研究[J]. 现代预防医学, 2021, 48(11): 2032-2035. WEI Xinyuan, CHENG Zim, PAN Jingping, et al. Health-related quality of life and its risk factors among the empty-nest elderly, Sichuan[J]. Modern Preventive Medicine, 2021, 48(11): 2032-2035.
[33] Kaplan MS, Huguet N, Feeny D, et al. Alcohol use patterns and trajectories of health-related quality of life in middle-aged and older adults: a 14-year population-based study[J]. J Stud Alcohol Drugs, 2012, 73(4): 581-590.
[34] 刘梅, 李灵清. 云南省居民健康相关生命质量及影响因素研究[J]. 中国健康教育, 2021, 3(3): 199-204. LIU Mei, LI Lingqing. Study on health-related quality of life and its influencing factors among residents in Yunnan Province[J]. Chinese Journal of Health Education, 2021, 3(3): 199-204.
[35] Su Y, Liu MS, De Silva PV, et al. Health-related quality of life in Chinese workers: a systematic review and meta-analysis[J]. Glob Health Res Policy, 2021, 6(1): 29. doi:10.1186/s41256-021-00209-z
[36] 李佳萌. 多水平模型及其在卫生领域的应用[J]. 中国慢性病预防与控制, 2007, 15(5): 514-515.
[1] GUO Yantong, YU Yuanyuan, CHEN Yingying, FU Yu, ZHANG Botao, YUAN Ying, SUN Shuangshuang, ZHAO Yingqi, ZHU Gaopei, XUE Fuzhong. Current situation and influencing mechanism of knowledge, attitude and practice about chronic disease management among elderly people in Shandong Provinces proactive health demonstration area [J]. Journal of Shandong University (Health Sciences), 2024, 62(7): 98-105.
[2] DENG Qingwen, LIU Wenbin. Multilevel analysis of health related quality of life of patients with cardiovascular disease and its determinants [J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 115-121.
[3] XU Qiongqiong, GUO Xiaolei, CHU Jie, JING Zhengyue, ZHANG Xinyi, ZHOU Chengchao. Health-related quality of life and its influencing factors in type 2 diabetes patients in Shandong Province [J]. Journal of Shandong University (Health Sciences), 2019, 57(3): 96-103.
[4] WANG Meijian, HOU Xinguo, LIANG Kai, CHEN Li. Serum lipids and lipoproteins in middle-aged and elderly Chinese in Shandong Province [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(5): 70-75.
[5] LI Mi, SU Lina, XU Lingzhong. Health-related quality of life among vulnerable people in Shandong Province based on the EQ-5D utility value integral system [J]. Journal of Shandong University (Health Sciences), 2017, 55(12): 71-76.
[6] ZHANG Yang, LI Wanhu, SONG Weiyang, LIU Chunlei, ZHANG Quan. Distribution pattern of cerebrovascular reactivity in healthy middle-aged or elderly people: a breath holding functional magnetic resonance imaging study [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(5): 85-88.
[7] ZHANG Xiao-wen,CAI Xiao-lan,PAN Xin-liang,LEI Da-peng,LIU Da-yu. Health-related quality of life in patients with obstructive sleep apnea hypopnea syndrome [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2007, 45(1): 97-100.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright 2018 © Editorial office of Journal of Shandong University (Health Sciences)
Supported by Beijing Magtech Co.Ltd