Journal List > Korean J Community Nutr > v.17(6) > 1038396

Korean J Community Nutr. 2012 Dec;17(6):772-781. Korean.
Published online December 31, 2012.
Copyright © 2012 The Korean Society of Community Nutrition
Health-Related Factors Influencing the Quality of Life of Rural Elderly Subjects - Activities of Daily Living, Cognitive Functions, Prevalence of Chronic Diseases and Nutritional Assessment
Mee Sook Lee
Department of Food and Nutrition, Hannam University, Daejeon, Korea.

Corresponding author: Mee Sook Lee, Department of Food and Nutrition, Hannam University, #461-6 Jeonmin-dong, Yuseong-gu, Daejeon 305-811, Korea. Tel: (042) 629-8794, Fax: (042) 629-8789, Email:
Received December 08, 2012; Revised December 24, 2012; Accepted December 24, 2012.

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


In order to supply the reference data to define the quality of life of the rural agricultural elderly population in the simplified steps, the data were collected by personal visits to 232 elder people over 65 (89 males and 143 females) in Sunchang area. The survey was conducted with written questionnaires concerning the quality of life, health-related habits, basic physical functions and cognitive behavior. The prevalence of the degenerative diseases were assessed by anthropometric and biochemical determinations. The averaged overall quality of life represented by EQ-5D index with Nam's model was calculated to be 0.865 ± 0.1509, and the percentages of people below the average were 38% (low QOL group) and 62% (high QOL group) were found to be the above the average. Generally, the subjects with male gender, higher educational background, higher self-rated health status, higher social activities were belonged to the high QOL group. The high QOL group had higher scores of daily living activities KADL and IADL, and lower risks in cognitive functions K-MMSE and depression scale GDS. There was no statistically significant correlation between biochemical indexes of blood and cognitive function and EQ-5D scores when the results were adjusted for age and gender. There were significant differences in nutritional assessment determined by the MNA between the high and low QOL groups. The low QOL group showed inferior nutritional status. The rapidly measurable factors of the quality of life of rural elderly were turned out to be physical activity scores and the simplified nutritional status measurement.

Keywords: quality of life; EQ-5D index; ADL; MNA; elderly


Table 1
General characteristics of EQ-5D groups of subject
Click for larger image

Table 2
Comparison of health related habits in EQ-5D groups of subject
Click for larger image

Table 3
Comparison of MNA(mini-nutritional assessment) in EQ-5D groups of subject
Click for larger image

Table 4
States of activities of daily living, cognitive function, and depression by EQ-5D groups of subject
Click for larger image

Table 5
Prevalence of disease in EQ-5D groups of subject
Click for larger image

Table 6
Correlation coefficient among EQ-5D index, biochemical indices and nutritional assessment adjusted by age and sex
Click for larger image

1. Acree LS, Longfors J, Fjeldstad AS, Fjeldstad C, Schank B, Nickel KJ, Montgomery PS, Gardner AW. Physical activity is related to quality of life in older adults. Health Qual Life Outcomes 2006;4:37.
2. Ahn MH, Kim KU. A study of quality of life and depression for the elderly in senior welfare center. J Korea Acad Ind Coop Soc 2012;13(8):3544–3551.
3. Bize R, Johnson JA, Plotnikoff RC. Physical activity level and health-related quality of life in the general adult population: A systematic review. Prev Med 2007;45:401–415.
4. Brown JE. Mini nutritional assessment. In: Brown JE, editor. Nutrition through the life cycle. 4th ed. Wadsworth: 2011. pp. 466.
5. Choe JS, Kwon SO, Paik HY. Health-related quality of life by socioeconomic factors and health-related behaviors of the elderly in rural area. Korean J Rural Med 2004;29(1):29–41.
6. Chung JY, Lee MY, Kim MJ. A study on the prevalence of chronic disease, health-related habits and nutrient intakes according to the quality of life in Korean adults. Korean J Community Nutr 2010;15(4):445–459.
7. Han MA, Ryu SY, Park J, Kang MG, Park JK, Kim KS. Health-related quality of life assessment by the EuroQol-5D in some rural adults. J Prev Med Public Health 2008;41(3):173–180.
8. Hagstrom B, Mattsson B, Wimo A, Gunnarsson RK. More illness and less disease? A 20-year perspective on chronic disease and medication. Scand J Public Health 2006;34:584–588.
9. Jang YR, Chiriboga DA, Kim GY. Acculturation and manifestation of depressive symptoms among Korean American older adults. Korean J Res Gerontol 2006;15(1):51–73.
10. Janssen MF, Birnie E, Haagsma JA, Bonsel GJ. Comparing the standard EQ-5D three-level system with a five-level version. Value Health 2008;11(2):275–284.
11. Jhoo JH, Kim KW, Lee DY, Youn JC, Lee TJ, Choo IH, Ko HJ, Seo EH, Woo JI. Comparison of the performance in two different Korean versions of Mini-Mental State Examination: MMSE-KC and K-MMSE. J Korean Neuropsychiatr Assoc 2005;44(1):98–104.
12. Kang E, Shin H, Park H, Jo M, Kim N. A valuation of health status using EQ-5D. Korean J Health Econ Policy 2006;12(2):19–43.
13. Kim JH, Koo BK, Kim KJ, Baek JW, Lee YK, Lee SK, Lee HS. Characteristics of eating behaviors of the long-lived elderly people in Kyungpook Sung-Ju. Korean J Community Nutr 1999;4(2):219–230.
14. Kim JY, Lee SG, Lee SK. The relationship between health behaviors, health status, activities of daily living and health-related quality of life in the elderly. J Korean Gerontol Soc 2010;30(2):471–484.
15. Kim SY, Yun JE, Kimm H, Jee SH. The relation of physical activity by the IPAQ to health-related quality of life - Korea National Health and Nutrition Examination Survey (KHANES) IV 2007-2008. J Korean Soc Health Educ Promot 2011;28(2):15–25.
16. Kim WK. Subjective and objective social support in the association between physical disability and depression in older adults. Korean J Res Gerontol 2001;10(1):55–74.
17. Kwon YC, Park JH. Korean Version of Mini-Mental State Examination (MMSE-K) Part I: Development of the Test for the Elderly. J Korean Neuropsychiatr Assoc 1989;28(1):125–135.
18. Lee MS. Nutritional status of the nonagenarian population in longevity belt in Korea. Korean J Community Nutr 2005;10(3):290–302.
19. Lee JW, Lee MS, Kim JH, Son SM, Lee BS. In: Nutritional assessment. Paju: Kyomunsa; 2012. pp. 169-238.
20. Lee SI. Validity and reliability evaluation for EQ-5D in Korea. Korea Centers for Disease Control & Prevention (KCDC); 2012 [cited 2012 Nov. 21].
21. Lee YH, Choi JS, Rhee JA, Ryu SY, Shin Mh, Kim JH. A study on the application of the Korean valuation weights for EuroQoL-5 dimension. J Korean Soc Health Educ Promot 2009;26(1):1–13.
22. McNaughton SA, Crawford D, Ball K, Salmon J. Understanding determinants of nutrition, physical activity and quality of life among older adults: the Wellbeing, Eating and Exercise for a Long Life (WELL) study. Health Qual Life Outcomes 2012;10:109.
23. Ministry of Health & WelfareIn-depth analyses of the third Korea National Health and Nutrition Examination Survey (KHANES III) 2005: The health interview and health behavior survey part. 2007 [cited 2012 Nov. 21].
Available from
24. Ministry of Health & WelfareThe Korea National Health and Nutrition Examination Survey (KHANES IV) 2007: The health interview and health behavior survey part. Seoul: 2008 [cited 2012 Nov. 21].
Available from
25. Nam HS, Kim KY, Kwon IS, Koh KW. EQ-5D Korean valuation study using time trade-off method. Seoul: Korea Centers for Disease Control and Prevention (KCDC); 2007 [cited 2012 Nov. 21].
26. Park MJ. The cognition, balance, and quality of life in the elderly. J Korean Biol Nurs Sci 2011;13(2):185–192.
27. Phelan EA, Anderson LA, LaCroix AZ, Larson EB. Older adults' views of "successful aging"- how do they compare with researchers' definitions? J Am Geriatr Soc 2004;52:211–216.
28. Schünemann HJ, Sperati F, Barba M, Santesso N, Melegari C, Akl EA, Guyatt G, Muti P. An instrument to assess quality of life in relation to nutrition: item generation, item reduction and initial validation. Health Qual Life Outcomes 2010;8:26.
29. Seong SS, Choi CB, Sung YK, Park YW, Lee HS, Uhm WS, Kim TW, Jun JB, Yoo DH, Lee OY, Bae SC. Health-Related Quality of Life using EQ-5D in Koreans. J Korean Rheum Assoc 2004;11(3):254–262.
30. So H, Kim H, Ju K. Prediction model of quality of life in elderly based ICF model. J Korean Acad Nurs 2011;41(4):481–490.
31. Sohn S. A comparison study on the life quality of the elderly and its affecting factors between rural and urban areas. J Korean Gerontol Soc 2006;26(3):601–615.
32. Sohn S. Factors related to the health related quality of life in elderly women. Korean J Women Health Nurs 2009;15(2):99–107.
33. Sohn A, Hong IO, Kim J. Health-related quality of life assessment by health behavior and BMI among Seoul citizens. Korean Public Health Res 2010;36(2):19–25.
34. Spilker B, Revicki DA. Taxonomy of quality of life. In: Spilker B, editor. Quality of life and phamacoeconomics in clinical trials. 2nd ed. Philadelphia: Lippincott-Raven Publisher; 1996. pp. 25-31.
35. Statistics KoreaPopulation projections 2010-2060. 2012a [cited 2012 Nov. 21].
Available from
36. Statistics Korea2010 Life tables for Korea. 2012b [cited 2012 Nov. 21].
Available from
37. Statistics Korea2010 Census: Population and housing. 2012c [cited 2012 Nov. 21].
Available from
38. The EuroQoL group. EuroQoL - a new facility for the measurement of health-related quality of life. Health Policy 1990;16(3):199–208.
39. Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992;30:473–483.
40. WHOQOL Group. The World Health Organization Quality of Life Assessment (WHOQOL): Position paper from the World Health Organization. Soc Sci Med 1995;41(10):1403–1409.
41. Won CW, Yang KY, Rho YG, Kim SY, Lee EJ, Yoon JL. the development of Korean activities of daily living (K-ADL) and Korean instrumental activities of daily living (K-IADL) scale. J Korean Geriatr Soc 2002;6(2):107–120.
42. Yun JH, Kang JM, Kim KS, Kim SH, Kim TH, Park YW, Sung YK, Sohn JH, Song BJ, Uhm WS, Yoon HJ, Lee OY, Lee JH, Lee CB, Lee CH, Jung WT, Choe JY, Choi HS, Han DS, Bae SC. Health-Related Quality of Life in Korean Patients with Chronic Diseases. J Korean Rheum Assoc 2004;11(3):263–274.