Lifestyle Behaviors and Quality of Life Among Older Adults After the First Wave of the COVID-19 Pandemic in Hubei China

Abstract

Background: Older adult quality of life (QoL) is facing huge challenges during the COVID-19 pandemic. New normal lifestyle behaviors, including getting adequate physical activity (PA), consuming sufficient fruits and vegetables (FV) and enacting individual preventive behaviors (frequent hand washing, facemask wearing, and social distancing), as a significant determinant for QoL, have not been adequately addressed in older adults during the pandemic. This study aimed to investigate the characteristics of QoL in Chinese older adults after the first wave of the COVID-19 pandemic in Hubei China. The objective of the study was to examine any associations of lifestyle behaviors with QoL, and to identify the moderating role of socioeconomic indicators in the associations identified.Methods: A cross-sectional study was conducted in Hubei, China, from June 15, 2020, to July 10, 2020. Five hundred sixteen older adults completed an online survey (mean age = 67.6 ± 6.6; 57.9% women). The questionnaire consisted of demographic information, covariates (chronic diseases and infected cases of acquaintances), lifestyle behaviors [PA stage, FV intake (FVI) stage and three preventive behaviors], and QoL. T-tests, ANOVA tests, multiple linear regression models with simple slope analyses were used to test the hypotheses.Results: QoL significantly differed in relation to economic situation, chronic diseases, marital status, education, living situation, age group, and professional status. Participants' economic situation (βaverage vs. below average = 0.17, p < 0.01; βabove average vs. below average = 0.15, p < 0.01), chronic diseases (βyes vs. no = 0.19, p < 0.001), FVI stage (β = 0.21, p < 0.001), and preventive behaviors (β = 0.10, p < 0.05) indicated a significant association with QoL. Education level and economic situation significantly interacted with preventive behaviors on QoL, respectively (βpreventive behaviors × educational level = −1.3, p < 0.01; βpreventive behaviors × economic situation = −0.97, p < 0.05).Conclusions: Findings emphasize the importance of enhancing FVI and preventive behaviors on QoL improvement in older adults during the COVID-19 pandemic. Older adults who are in a lower economic situation with lower education levels should be given priority when implementing interventions to improve preventive behaviors and QoL in older adults.

Factors Associated with Health-Related Quality of Life among Older Adults in Rural South Korea Based on Ecological Model

“…As found in previous studies [ 41 , 42 ], older adults living alone showed a lower quality of life than older adults living with their family. Close friends and family members who can provide positive support influence quality of life more than demographic factors [ 42 ].…”

Individual Preventive Behaviors of COVID-19 and Associated Psychological Factors Among Chinese Older Adults: A Cross-Sectional Online Survey

“…Compared to older people with lower or no education, highly educated old people are more likely to take preventive behaviors, which is consistent with previous studies ( Zhong et al, 2020 ). Older people who were pensioner/retired are more likely to take preventive behaviors than those who were unemployed, highlighting the stable income or a certain level of economic status facilitates preventive behaviors among older adults ( Duan et al, 2021 ). The findings above revealed that when authorities motivate older adults to enact COVID-19 preventive behaviors, they need to especially focus on elderly men and older adults who are at a lower economic status (e.g., without pension) and with lower education levels.…”

“…From a social policy aspect, local government can provide relief funding and epidemic prevention appliances (e.g., face masks, disinfection alcohol, and hand sanitizer) for older adults who have economic disadvantages to facilitate their preventive behaviors. In addition, community administrators can organize workshops for older adults who are at lower education levels to increase their health literacy about preventive behaviors ( Duan et al, 2021 ).…”

“…Three preventive behaviors before and during the COVID-19 pandemic (hand washing, mask wearing, and social distancing; Duan et al, 2021 ; Liang et al, 2021 ), motivational factors of preventive behaviors [risk perception ( Perloff and Fetzer, 1986 ; Duan et al, 2017 ), health knowledge ( Contzen and Mosler, 2015 ; Li et al, 2019 ), attitude ( O’Boyle et al, 2001 ; Rosen et al, 2009 ), subjective norm ( Ajzen, 2002 ; Chung et al, 2018 ), intention ( Lippke et al, 2009 ; Duan et al, 2018 ; Liang et al, 2019 ), motivational self-efficacy ( Zhou et al, 2016 ; Duan et al, 2018 ; Liang et al, 2019 )] and volitional factors of preventive behaviors [volitional self-efficacy ( Zhou et al, 2016 ; Duan et al, 2018 ; Liang et al, 2019 ), planning ( Luszczynska and Schwarzer, 2003 ; Duan et al, 2018 ; Liang et al, 2019 ; Zhang et al, 2020 ), action control ( Sniehotta et al, 2005 ; Zhang et al, 2020 )] were measured by questionnaires. The details of the measurement tools are outlined in Table 1 .…”

Association of Social-Cognitive Factors with Individual Preventive Behaviors of COVID-19 among a Mixed-Sample of Older Adults from China and Germany

“…To be eligible for inclusion, participants needed to meet the criteria, including: (1) aged 55 years or older; (2) have not been infected with the COVID-19; (3) have access to a mobile phone or laptop with internet connection; and (4) are able to read Chinese (for Chinese samples) or German (for German sample). Aiming to achieve a small-to-medium effect size (Cohen’s f 2 = 0.085) on the association of social-cognitive factors with health behaviors [ 34 ], with an alpha of 0.05, a statistical power of 80%, and a response rate of 60% [ 35 ], a total of 335 participants were required.…”