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Lifestyle Practices, Functional Capacity, and Life Satisfaction of Elderly Above 65 Years
* Corresponding author: Dr. Mathias T, Department of Mental Health Nursing, Laxmi Memorial College of Nursing, Mangalore, Karnataka, India. tresavinay@yahoo.com
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Received: ,
Accepted: ,
How to cite this article: Rasheedu T, Mathias T, Jayanna S. Lifestyle Practices, Functional Capacity, and Life Satisfaction of Elderly Above 65 Years. J Health Allied Sci NU. doi: 10.25259/JHASNU_58_2025
Abstract
Objectives
Ageing is a universal and inevitable phenomenon of life. It refers to the multidimensional process of physical, psychological, and social changes. While some dimensions grow and expand over time, others decline. This study aimed to assess the lifestyle practices, functional capacity, and life satisfaction among elderly individuals above 65 years in a selected community in Mangaluru, India.
Material and Methods
A non-experimental survey approach with a cross-sectional design was adopted. The purposive sampling technique was adopted to select 300 individuals above the age of 65 years residing in their homes. The interview technique was adopted to collect information through a demographic proforma, the fantastic lifestyle checklist, the Katz index of independence in activities of daily living, and the satisfaction with life scale. Descriptive and inferential statistics were used for analysis.
Results
More than half (56.7%) of the individuals above 65 years adopted a good lifestyle. Alcohol was the highest in the lifestyle practice, and the least was activity. The majority (44.3%) had high levels of independent functional capacity. The mean functional capacity was 5.18, indicating a level close to high independence. Half (56.5%) of the participants were slightly satisfied with their lives.
Conclusion
The study concludes that the elderly are at high risk of developing chronic illness due to unhealthy lifestyle practices, inability to perform activities of daily living to maintain optimal functional capacity, and lower levels of life satisfaction.
Keywords
Elderly
Functional capacity
Lifestyle practices
Life satisfaction
Rural community
INTRODUCTION
Ageing is a natural and biological process of growth and development that every individual goes through in their life. “Old age is an incurable disease,” says Seneca. We cannot heal old age, but we can protect, promote, and extend it.[1]
India is moving towards a demographic transition. According to the 2011 census, nearly 8% of the population was recorded to be 60 years and above. This group is expected to increase to 12.5% by 2026 and 20% by 2050.[2] Furthermore, the distribution of ageing revealed that a vast majority (67%) of India’s older population resides in rural areas.[3]
Owing to ageing, older people have diminished physical and mental capacities in daily life and are prone to suffer from chronic disease and comorbidities.[2] Old age is often associated with functional decline and physical dependence.
The greying of the population has significant consequences on the health, social, and economic development of a country. Therefore, it is a matter of grave concern to promote healthy ageing, particularly in developing countries like India.[4]
The adoption of a faulty lifestyle affects the elderly throughout their life, increasing their risk of morbidity and mortality and hindering their prospects for healthy ageing.[5] A recent study has shown evidence that a healthy lifestyle with different dimensions like healthy nutrition, sleep hygiene, regular physical exercise, stress-free life, regular medical checkups, not smoking, and participation in social activities by the elderly promotes functional capacity and thereby improves their life satisfaction.[6] Inequitable health resource distribution and inadequate social support systems must be addressed to improve the quality of life of the older population, especially in rural areas.[7]
When the younger population leaves homes for fresh pastures, the elderly are left behind to fend for themselves. As the strength and functional capacity decrease due to physical changes, the elderly face psychological problems. Very few studies have been conducted to assess these three variables, even though they have a strong bearing on the morbidity, living status, and satisfaction with life among the elderly.
MATERIAL AND METHODS
Study design, setting, and participants
A non-experimental survey approach with a cross-sectional design was adopted to assess the lifestyle, functional capacity, and life satisfaction among older individuals above 65 years. The study was conducted between January and February 2020 at a selected rural community area of Benjanapadavu situated 23 km from Mangaluru in Karnataka state, India. The rural centre with three villages was selected as it is the attached community centre for the college. Permission was obtained from the District Health Office to conduct the study. Eligibility criteria: Older individuals, both male and female, age more than 65 years, residing in a specific community in their own home either alone or with family members, cooperative, willing to participate, and able to speak English or Kannada were included in the study.
Exclusion criteria: Elderly individuals who had an altered level of consciousness and were at home, unable to hear, speak, and write, and not willing to participate were excluded from the study.
Sampling technique, sample size, and sample estimation
The purposive sampling technique was used to select 300 elderly males and females, keeping the inclusion criteria in view. Sample size calculation was done on the basis of a previously published study[8] with a precision/absolute error of 5% and a type 1 error of 5%. The sample size calculated was 300 elderly people staying in their own homes.
Tools and methods of data collection
The structured interview technique was adopted to collect information from older people. The sociodemographic proforma consisted of 10 items to obtain the baseline information of older people. Five experts validated this sociodemographic tool. All the experts had 100% agreement on all the items:
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The Fantastic lifestyle checklist is a 4-point scale with five responses: almost never (0), seldom (1), some of the time (2), fairly often (3), and almost always (4). It consists of 25 items to assess the lifestyle of older people. A score of 85 to 100 indicates excellent lifestyle; a score of 70 to 84 is considered very good; a score of 55 to 69 is considered good, and a score of 35 to 54 is considered fair.
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The Katz index of independence in activities of daily living (ADL) consists of six items such as bathing, dressing, toileting, transferring, continence, and feeding with two options of either yes or no. Each independent ADL has a score of 1, and each dependent ADL has a score of 0. The highest possible score of 6 indicates older people are independent, and a score of 0 indicates dependency.
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The satisfaction with lifestyle (SWL) is a 7-point rating scale with five items: strongly agree (7), agree (6), slightly agree (5), neither agree nor disagree (4), slightly disagree (3), disagree (2), and strongly disagree (1). The interpretation of the scores is as follows: extremely satisfied, 31 to 35; satisfied, 26 to 30; slightly satisfied, 21 to 25; neutral, 20; slightly satisfied, 15 to 19; dissatisfied, 10 to 14; and extremely dissatisfied, 5 to 9.
All the tools were standardised. Permission was obtained from the authors to use the standardised tools. The tools were translated into the local language, Kannada, and back-translated to English by a language expert. Reliability of the tools was established by administering the tool to ten elderly above 65 years residing in their home at a selected rural community, Benjanapadavu, to know the language difficulty and ambiguity in the data collection instruments. The Cronbach alpha method was used to check the reliability of all the scales. The reliability scores obtained were 0.8 for lifestyle practices, 0.9 for functional capacity, and 0.85 for satisfaction with life. Pretesting of the tool helped the investigator to know the comprehension level of older people. The tools used for the study would collect the necessary information with limited items, making them easy to understand for the elderly during the interview. There was a 100% response from all the participants. Since the structured interview technique was adopted, there has been no inconsistency in data collection. The investigator introduced themself to the participants and explained the purpose of the study. Consent was obtained from all study sample. The investigator collected all the information through face to face interview technique. No difficulties were faced by the investigator during data collection.
RESULTS
Description of demographic characteristics among the elderly above 65 years
The elderly, 34.7%, were in the age group of 65 to 69 years, and 20.0% were older than 80 years. The majority, 52.7%, were males, whereas 47.3% were females. In addition, 44.7% belonged to a joint family. With regard to education, 22% were illiterate, and only 9.7% had studied up to middle school. In total, 46.3% had a monthly income of Rs. 15,000, and only 1.0% had a monthly income of more than Rs. 30,000. The source of income included pension for 39.7%, and only 0.3% received help from self-help, local organisations, or government schemes. The majority of individuals, 58.0%, were married, and 5.7% were divorced. In all, 31.7% of the elderly did not have children. Forty-three per cent of the participants had been living with chronic illness for the past 2 years, and 7.75% had a history of chronic illness for the past 4 years. With regard to chronic illness, 24.3% of the participants had a history of high cholesterol, and 0.3% had chronic obstructive pulmonary disease and filariasis.
Description of lifestyle scores among the elderly above 65 years
With regard to lifestyle, the study shows that more than half (56.7%) of the individuals above 65 years adopted a good lifestyle in terms of practices such as friends, family, activity, nutrition, intake of alcohol, tobacco, and other toxics, sleep, seatbelt, safe sex, stress, type of behaviour insight, and career.
The range of lifestyle practice scores among the elderly was between 36 and 81, and the mean lifestyle practice score was 64.90 ± 8.23, which showed that they adopted a good lifestyle.
A total of nine components of lifestyle practices among the elderly were determined. The data in Figure 1 shows that alcohol is the most commonly adopted lifestyle practice (79.81%), and the least practised (54.29%) lifestyle activities are exercises, yoga, walking, and deep breathing exercises.
- Bar diagram showing the mean percentage of components of lifestyle practices of the elderly individuals above 65 years.
Description of functional capacity scores of the elderly above 65 years
The functional capacity scores among the participants were in the range of 3 to 6. The mean functional capacity was 5.18 ± 0.85, which is nearer to a functional capacity score of 6, indicating high independence. This shows that the participants were able to perform their ADL independently.
Description of life satisfaction scores of the elderly above 65 years
The data in Table 1 shows that more than half (56.5%) of the individuals above 65 years are slightly satisfied with their life, and 3% had neutral life satisfaction. The life satisfaction scores among the elderly were between 11 and 30, and the mean life satisfaction score was 23.02 ± 3.51, that is, the participants were slightly satisfied with their life.
| Life satisfaction scores | Range | Frequency | Percentage |
|---|---|---|---|
| Extremely satisfied | 31–35 | – | – |
| Satisfied | 26–30 | 71 | 23.7 |
| Slightly satisfied | 21–25 | 170 | 56.5 |
| Neutral | 20 | 9 | 3.0 |
| Slightly satisfied | 15–19 | 45 | 15.0 |
| Dissatisfied | 10–14 | 5 | 1.7 |
| Extremely dissatisfied | 5–9 | – | – |
Association of lifestyle practices, functional capacity, and life satisfaction scores among the elderly with selected demographic variables
The chi-squared test was computed to determine the association of all three variables (lifestyle practices, function- al capacity, and life satisfaction scores) among the elderly with selected demographic variables at the significance level of 0.05.
Table 2 shows that demographic variables like gender (p < 0.006), educational status (p < 0.001), monthly family income (p < 0.006), and marital status (p < 0.002) had a significant association. Hence, the research hypothesis that there is a significant association between lifestyle practice scores of the elderly and selected demographic variables was accepted.
| Sl. no. | Demographic variable | Lifestyle (χ2 value) | Functional capacity (χ2 value) | Life satisfaction (χ2 value) | df | p-value |
| 1 | Age | 0.637 | 88.361a | 8.179b | 3 | 7.81 |
| 2 | Gender | 7.479b | 2.153 | 3.746 | 1 | 3.84 |
| 3 | Type of family | 0.995 | 2.635 | 1.718 | 2 | 5.99 |
| 4 | Educational status | 21.088b | 59.07a | 29.736a | 5 | 11.07 |
| 5 | Monthly family Income | 10.389b | 38.642b | 22.744a | 2 | 5.99 |
| 6 | Source of income after retirement | 3.204 | 48.52a | 18.855a | 4 | 9.49 |
| 7 | Marital status | 14.359b | 23.362a | 3.236 | 3 | 7.81 |
| 8 | No. of children | 2.261 | 10.595b | 5.876 | 3 | 7.81 |
| 9 | History of chronic illness | 5.912 | 2.830 | 5.281 | 4 | 9.49 |
| 10 | Duration of chronic illness | 7.714 | 3.292 | 4.672 | 3 | 7.81 |
aSignificant at 0.01.
bSignificant at 0.05.
χ2: Chi square statistic, df: Degrees of freedom.
DISCUSSION
Certainly, ageing cannot be prevented, but monitoring and preventing lifestyle problems and leading a satisfactory life are the key to ageing. Health contributes to general well-being and overall lifestyle. To enjoy life with quality, an individual needs to inculcate good habits that become their lifestyle. These habits determine the health of the individual.[9] The present study showed that more than half (56.7%) of the elderly people above 65 years adopted a good lifestyle in terms of practices such as friends, family, nutrition, intake of alcohol and tobacco, sleep, safe sex, insight, type of behaviour, and stress. Alcohol is the most commonly adopted lifestyle behaviour, whereas performing activities of daily living is the least adopted lifestyle practice. Further, the present study revealed that the range of the lifestyle practice scores among elderly individuals older than 65 years was 64.90 ± 8.22, which shows that the elderly adopted a good lifestyle.
A study reported similar results, which revealed that the overall lifestyle of most seniors was “excellent” (45.7%) or “very good” (41.3%). None of the respondents scored in the lowest category—”needs improvement.” 10] A study reported similar components of lifestyle practices such as activity, nutrition, insight, sleep, and stress, which need to be taken care of as age advances. Noncommunicable diseases are chronic in nature and are mainly the result of an improper daily lifestyle.[11]
A study supports the present findings that the samples had average lifestyle practices as indicated by the mean score and standard deviation (6.95 ± 1.879). The maximum score was 10, the minimum score obtained was 2, and the variance was 3.532.[10]
With regard to functional capacity, the majority (44.3%) of the elderly had a high level of independent functional capacity. The mean functional capacity was 5.18 ± 0.84, which is nearer to the highest possible functional capacity score of 6, indicating high independence to perform ADL. A study showed evidence of one-fourth (25.6%) of the study participants having a functional disability.[5] Similar findings were reported in a study among 100 elderly individuals, which found that the prevalence of dependence for ADL was 50.3%.[12] Both these study findings have a close range similar to the present study findings.
In the present study, 34.7% of the elderly included were in the age group of 65 to 69 years, which is just the beginning of old age. Probably, that may be one reason why the study sample has high independence. However, as age advances, the chance of dependency would probably increase, and the elderly may become dependent on others for their functional needs. Moreover, the present study also shows an association between functional capacities of the elderly and age, which implies that increasing age reduces functional capacity.
With regard to life satisfaction among the elderly, the present study revealed that more than half (56.5%) of the elderly older than 65 years were slightly satisfied with their life, and 3% had neutral life satisfaction. It also shows that the range of life satisfaction scores among the elderly was between 11 and 30, and the mean life satisfaction score was 23.02 ± 3.51, that is, the elderly above 65 years were slightly satisfied with their life.
Contrasting findings were reported by a study among 284 respondents, with 68% of the respondents being satisfied with their life. The results of the study demonstrated that the mean score of various dimensions was medium, which is in contrast to the findings of the present study.[13]
The results of the present study highlight the need for adopting healthy lifestyle practices. These practices keep the elderly active and can reduce the occurrence of chronic diseases. The study participants are already diagnosed with chronic illness (43%) for the past 1 to 2 years and are on medication. Hence, this study projects the need to educate the elderly about the importance of healthy lifestyle practices and the need to keep them fit so that they are satisfied with their life.
Limitations of the study
The study was limited to a single setting. The standardised structured tool restricts the amount of information collected from an older adult. Only subjective data provided by the elderly was taken into consideration. No other objective assessment was done.
CONCLUSION
The study concludes that lifestyle practices play an important role in the health of the elderly. Alcohol is the most commonly adopted lifestyle behaviour adopted by the elderly. The least practised lifestyle activities were exercises, yoga, walking, and deep breathing exercises. These two factors affect the elderly, leading to poor functional capacity. When the elderly do not perform ADL, their body movement and joint mobility are hampered. This affects their life satisfaction as they are not able to perform their activities and remain confined to the home environment. Hence, the family members should take a keen interest in the performance of healthy lifestyle practices among the elderly, which will help them to grow grey gracefully. Further studies may be conducted adopting various multimodal interventions to improve lifestyle practices, functional capacity, and life satisfaction among the elderly and their caregivers.
Acknowledgement
Gratitude is expressed to all the participants for their cooperation during the study. We are thankful to all the authors for giving us permission to use and translate the tools.
Ethical approval
The research/study approved by the Ethics Committee of A.J. Institute of Medical Sciences and Research Centre, Kuntikana, Mangaluru, Karnataka, DCGI Reg. No.: ECR/ 348/inst/KA/2013/RR-16, dated 19th March 2019.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
Use of artificial intelligence (AI)-assisted technology for manuscript preparation
The authors confirm that there was no use of artificial intelligence (AI)-assisted technology for assisting in the writing or editing of the manuscript and no images were manipulated using AI.
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