Page 74 - IJPS-11-1

International Journal of
Population Studies Health-related quality of life and mortality

providing a more comprehensive understanding than that Our results indicate that HRQoL can serve as a
afforded by summary components alone. significant indicator of future adverse health outcomes,
Physical functioning exhibited the strongest association supporting clinical, social, and policy decisions. For
with mortality. A decline in physical functions can stem from instance, in Australia, the SF-12 has been integrated into
various health conditions, potentially explaining the increased the routine application of Patient Reported Outcome
risk of premature death. However, our study adjusted for the Measures as a strategic goal for the Australian health
number of chronic diseases at the beginning of the follow-up, system (Williams et al., 2016). As an abbreviated version
which mitigated this effect. Lower physical functioning of SF-36, SF-12 assesses health-related QoL across physical
at baseline may have contributed to increased sedentary and mental health dimensions. Improved prediction of
behavior, increased risk of falls, as well as diminished social premature death risk among older individuals facilitates
interactions, autonomy, and independence among older better clinical monitoring and targeted interventions
individuals. These combined factors can exacerbate health aimed at reducing this risk. Reducing the testing costs
issues and lead to premature mortality. This association can alleviate the economic burden linked to health issues,
reinforces Evans and Stoddart’s (1990) model, highlighting in the context of a rapidly aging population (Phyo et al.,
functionality as a critical component of health, influenced by 2021). These possibilities align with Evans and Stoddart’s
disease, behavioral, and biological aspects. (1990) model, which transcends traditional healthcare
boundaries to incorporate health status and functionality as
A prospective cohort study involving 30,043 key elements in understanding and delivering healthcare.
participants (Shishehbor et al., 2006) found that physical
functioning accounted for 47% of the relationship between Previous studies conducted across different countries
socioeconomic status and mortality. This underscores the have generally shown that healthy aging does not adversely
importance of analyzing HRQoL as a predictor of mortality affect HRQoL, suggesting that it is feasible to enjoy a high
in Brazil, where approximately 70% of older individuals QoL and well-being over extended periods (Tourani et al.,
had an individual monthly income of <420 United States 2018). Maintaining a healthy lifestyle in old age is essential
dollars in 2020 (Brazil, 2020). to prevent chronic diseases, improve physical functioning
and well-being, as well as support independence, autonomy,
In addition, our study identified associations between and active aging (Lima et al., 2011). Understanding which
mortality and social, emotional, and mental health aspects of QoL are most affected by comorbidities in the
domains. A systematic review conducted in Asia found that older population is crucial for developing strategies to
strong social support, having a spouse or partner, living minimize these impacts and promote dignified aging with
with family, maintaining a large social network, frequent good health and well-being.
contact with family and friends, emotional support, and
satisfaction with social connections were linked to fewer A high score in PC indicates minimal physical
depressive symptoms among non-institutionalized older limitations, high energy levels, and health rated as
adults (Mohd et al., 2019). Furthermore, a cohort study with “excellent.” Meanwhile, a high score in MC reflects frequent
a 20-year follow-up demonstrated a significant association positive feelings, absence of psychological distress, and no
between social isolation/loneliness and mortality (Beller & impairment in social activities due to emotional issues,
Wagner, 2018). Two systematic reviews and meta-analyses along with health rated as “excellent” (Ware & Gandek,
in low- and middle-income countries also revealed an 1998). Therefore, HRQoL serves as a measure of the
association between depression and premature death impact of diseases on individual lives, and lower HRQoL
among older adults (Brandão et al., 2019; Wei et al., 2019). scores indicate impaired well-being and predict all-
These findings highlight the importance of considering cause mortality. Consequently, clinical, social, and policy
social and emotional aspects when assessing the health of interventions are essential to manage CNCDs.
the elderly population. The strengths of this study include its retrospective cohort
In a large cohort study of women who initially reported design with a representative sample of the older population,
poor physical and mental health but improved during along with comprehensive information and variables that
follow-up, the risk of mortality was similar to that of women enabled adjustments for potential confounders. These
whose HRQoL remained consistently good (Kroenke et al., findings are unprecedented in Brazil and Latin America
2008). Positive lifestyle changes, particularly increased concerning various dimensions of health and QoL assessed
physical activity, were associated with improvements using a validated and widely employed standardized
in both PC and MC scores. Adopting healthier lifestyles instrument that serves as a predictor of mortality in older
and pursuing preventive measures can enhance health, adults. Although this study has limitations, they were
improve QoL, and reduce the risk of premature mortality. minimal and did not compromise the validity of the results.

Volume 11 Issue 1 (2025) 68 https://doi.org/10.36922/ijps.1928