Published: 2022-07-27

Evaluation of health-related quality of life in a physically active senior population

Ana Paula Fontes, Natércia Joaquim, Tânia Pereira


Background: Physical activity (PA) is a strong determinant of health and one of the most important predictors of healthy aging and health-related quality of life (HRQoL). The aim of the study was to understand the HRQoL of a senior population practicing PA and its association with some socio-demographic characteristics, the levels of PA, and functional independence.

Methods: This is a correlational study with a sample of 376 individuals of both sexes. The data collection instruments were a socio-demographic and health questionnaire, the international PA questionnaire (IPAQ)-short version, the Katz index, the Lawton and Brody index, and the WHOQOL-OLD and WHOQOL-BREF questionnaires.

Results: The sample revealed a good perception of HRQoL, especially in the “psychological” and “social relations” domains. Sex showed a greater association with quality of life (QoL) than age. Multiple linear regression revealed that the variables with the most significant influence on the individuals’ QoL were related to health (“Presence of chronic disease” and “habitual use of medication”). The QoL related to "social relationships" is the domain with more predictors, with a markedly socio-demographic focus.

Conclusions: Practicing PA proved to be a HRQoL predictor, where “sensory function” and HRQoL related to “social relations” are included. Despite PA practice and socio-demographic characteristics being able to predict some HRQoL domains, health-related variables showed a more robust presence in this prediction.


QoL, HRQoL, PA, Exercise, Elderly

Full Text:



Urzua, MA. Calidad de vida relacionada con la salud: Elementos conceptuales. Revista Medica de Chile 2010;138(3):358-65.

Romero M, Vivas-Consuelo D, Alvis-Guzman N. Is Health Related Quality of Life (HRQoL) a valid indicator for health systems evaluation? Springerplus. 2013;2(1):664.

WHO Regional Office for Europe 1. Policies and Priority Interventions for Healthy Ageing, 2012. Available at /pdf_file/0006/161637/WHD-Policies-and-Priority-Interventions-for-Healthy-Ageing.pdf. Accessed 1 april 2022.

American College of Sports Medicine. Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory, Musculoskeletal, and Neuromotor Fitness in Apparently Healthy Adults: Guidance for Prescribing Exercise. Position Stand. 2013.

Puciato D, Borysiuk Z, Rozpara M. Quality of life and physical activity in an older working-age population. Clin Interv Aging. 2017;12:1627-34.

Koolhaas CM, Dhana K, van Rooij FJA, Schoufour JD, Hofman A, Franco OH. Physical Activity Types and Health-Related Quality of Life among Middle-Aged and Elderly Adults: The Rotterdam Study. J Nutr Health Aging. 2018;22(2):246-53.

Dasso NA. How is exercise different from physical activity? A concept analysis. Nurs Forum. 2019;54(1):45-52.

Martin BW, Kahlmeier S, Racioppi F, Berggren F, Miettinen M, Oppert JM et al. Evidence-based physical activity promotion - HEPA Europe, the European Network for the Promotion of Health-Enhancing Physical Activity. J Public Health. 2006;14:53-7.

Arrospide A, Machón M, Ramos-Goñi JM, Ibarrondo O, Mar J. Inequalities in health-related quality of life according to age, gender, educational level, social class, body mass index and chronic diseases using the Spanish value set for Euroquol 5D-5L questionnaire. Health Qual Life Outcomes. 2019;;17(1):69.

Maniscalco L, Miceli S, Bono F, Matranga D. Self-Perceived Health, Objective Health, and Quality of Life among People Aged 50 and Over: Interrelationship among Health Indicators in Italy, Spain, and Greece. Int J Environ Res Public Health. 2020;17(7):2414.

Pereira-de-Sousa AM, López-Rodríguez JA. Self-perceived health in Spanish and Portuguese young seniors after the great recession according to the European Health Survey: A cross-sectional study. Aten Primaria. 2021;53(7):102064.

Wrosch C, Scheier MF. Personality and quality of life: the importance of optimism and goal adjustment. Qual Life Res. 2003;12(1):59-72.

Netuveli G, Blane D. Quality of life in older ages. Br Med Bull. 2008;85:113-2.

Lee KH, Xu H, Wu B. Gender differences in quality of life among community-dwelling older adults in low- and middle-income countries: results from the Study on global AGEing and adult health (SAGE). BMC Public Health. 2020;20(1):114.

Manzoli L, Villari PM, Pirone G, Boccia A. Marital status and mortality in the elderly: a systematic review and meta-analysis. Soc Sci Med. 2007;64:77-94.

Luanaigh CO, Lawlor BA. Loneliness and the health of older people. Int J Geriatr Psychiatry. 2008;23(12):1213-21.

Meyer OL, Castro-Schilo L, Aguilar-Gaxiola S. Determinants of mental health and self-rated health: a model of socioeconomic status, neighborhood safety, and physical activity. Am J Public Health. 2014;104(9):1734-41.

Morgan KJ, Eastwood JG. Social determinants of maternal self-rated health in South Western Sydney, Australia. BMC Res Notes. 2014;7:51.

Ross NA, Garner R, Bernier J, Feeny DH, Kaplan MS, McFarland B, Orpana HM, Oderkirk J. Trajectories of health-related quality of life by socio-economic status in a nationally representative Canadian cohort. J Epidemiol Community Health. 2012;66(7):593-8.

Pappa E, Kontodimopoulos N, Papadopoulos AA, Niakas D. Assessing the socio-economic and demographic impact on health-related quality of life: evidence from Greece. Int J Public Health. 2009;54(4):241-9.

Szeles MR. Comparative Examination of Self-Perceived Health and Other Measures of the Quality of Life Across the EU-27. Soc Indic Res. 2018;137:391-411.

Delgado-Sanz MC, Prieto-Flores ME, Forjaz MJ, Ayala A, Rojo-Perez F, Fernandez-Mayoralas G et al. Influence of chronic health problems in dimensions of EQ-5D: study of institutionalized and non-institutionalized elderly. Rev Esp Salud Publica. 2011;85(6):555-68.

Van Wilder L, Devleesschauwer B, Clays E, De Buyser S, Van der Heyden J, Charafeddine R, Boeckxstaens P, De Bacquer D, Vandepitte S, De Smedt D. The impact of multimorbidity patterns on health-related quality of life in the general population: results of the Belgian Health Interview Survey. Qual Life Res. 2022;31(2):551-65.

Wang HM, Beyer M, Gensichen J, Gerlach FM. Health-related quality of life among general practice patients with differing chronic diseases in Germany: cross sectional survey. BMC Public Health. 2008;8:246.

Hunger M, Thorand B, Schunk M, Döring A, Menn P, Peters A, Holle R. Multimorbidity and health-related quality of life in the older population: results from the German KORA-age study. Health Qual Life Outcomes 2011;9:53.

Kuijpers MA, van Marum RJ, Egberts AC, Jansen PA; OLDY (OLd people Drugs and dYsregulations) Study Group. Relationship between polypharmacy and underprescribing. Br J Clin Pharmacol. 2008;65:130-3.

Montiel-Luque A, Núñez-Montenegro AJ, Martín-Aurioles E, Canca-Sánchez JC, Toro-Toro MC, González-Correa JA; Polipresact Research Group. Medication-related factors associated with health-related quality of life in patients older than 65 years with polypharmacy. PLoS One. 2017;12(2):e0171320.

Milton JC, Hill-Smith I, Jackson SHD. Prescribing for older people. BMJ. 2008;336(7644):606-9.

Alagiakrishnan K, Mah D, Padwal R. Classic challenges and emerging approaches to medication therapy in older adults. Discov Med. 2018;26(143):137-46.

Olsson IN, Runnamo R, Engfeldt P. Medication quality and quality of life in the elderly, a cohort study. Health Qual Life Outcomes.2011;9:95

Salahudeen MS. Deprescribing medications in older people: a narrative review. Drugs Today (Barc). 2018;54(8):489-98.

Balboa-Castillo T, León-Muñoz LM, Graciani A, Rodríguez-Artalejo F, Guallar-Castillón P. Longitudinal association of physical activity and sedentary behavior during leisure time with health-related quality of life in community-dwelling older adults. Health Qual Life Outcomes. 2011;9:47.

Sanchez-Villegas A, Ara I, Dierssen T, de la Fuente C, Ruano C, Martínez-González MA. Physical activity during leisure time and quality of life in a Spanish cohort: SUN (Seguimiento Universidad de Navarra) project. Br J Sports Med. 2012;46(6):443-8.

Niedermeier M, Herzog S, Kopp-Wilfling P, Burtscher M, Kopp M. Is the Effect of Physical Activity on Quality of Life in Older Adults Mediated by Social Support? Gerontology. 2019;65(4):375-82.

Wendel-Vos GC, Schuit AJ, Tijhuis MA, Kromhout D. Leisure time physical activity and health-related quality of life: cross-sectional and longitudinal associations. Qual Life Res. 2004;13(3):667-77.

An HY, Chen W, Wang CW, Yang HF, Huang WT, Fan SY. The Relationships between Physical Activity and Life Satisfaction and Happiness among Young, Middle-Aged, and Older Adults. Int J Environ Res Public Health. 2020;17(13):4817.

Gheysen F, Poppe L, DeSmet A, Swinnen S, Cardon G, De Bourdeaudhuij I et al. Physical activity to improve cognition in older adults: can physical activity programs enriched with cognitive challenges enhance the effects? A systematic review and meta-analysis. Int J Behav Nutr Phys Act. 2018;15(1):63.

Wanderley FA, Silva G, Marques E, Oliveira J, Mota J, Carvalho J. Associations between objectively assessed physical activity levels and fitness and self-reported health-related quality of life in community-dwelling older adults. Qual Life Res. 2011;20(9):1371-8.

Olivares PR, Gusi N, Prieto J, Hernandez-Mocholi MA. Fitness and health-related quality of life dimensions in community-dwelling middle aged and older adults. Health Qual Life Outcomes. 2011;9:117.

Acree LS, Longfors J, Fjeldstad AS, Fjeldstad C, Schank B, Nickel KJ et al. Physical activity is related to quality of life in older adults. Health Qual Life Outcomes. 2006;4:37.

Carmona-Torres JM, Rodríguez-Borrego MA, Laredo-Aguilera JA, López-Soto PJ, Santacruz-Salas E, Cobo-Cuenca AI. Disability for basic and instrumental activities of daily living in older individuals. PLoS One 2019;14(7):e0220157.

Naik AD, Concato J, Gill TM. Bathing disability in municipality-living older persons: Common, consequential, and complex. J Am Geriatr Soc. 2004;52(11):1805-10.

Portela D, Almada M, Midão L, Costa E. Instrumental Activities of Daily Living (iADL) Limitations in Europe: An Assessment of SHARE Data. Int J Environ Res Public Health. 2020;17(20):7387.

American College of Sports Medicine. Exercise and Physical Activity for Older adults. Position Stand. 2009.