Participants and their characteristics
Twenty-two out of 408 elders were excluded due to Alzheimer’s disease and 386 (94.6%) were entered to the study. The mean age of participants was 68.12 ± 6.24 years. They consisted of 248 (64.2%) participants aged 60 - 69 years, 200 (51.8%) females, 272 (70.5%) married, and 350 (90.6%) who educated up to 12 years. The mean number of persons living with elders was 3 ± 1.5 (median = 3). The socioeconomic, demographic, anthropometric and medical backgrounds of interviewees are shown in the Table 1.
Total score of QOL, CCQOL, and MQOL
The mean total score of QOL was 83.67 ± 13.75 (out of 127); representing a moderate level of QOL among the elders. Accordingly, 12 (0.5%) participants had low QOL, while 281 (72.8%) and 84 (21.9%) had moderate and high levels of QOL, respectively. For 9 elders, QOL could not be categorized due to incomplete answers. Total score of CCQOL was 70.68 ± 9.42 (out of 93), with an interquartile range (IQR) from 66 - 77. Total score of MQOL was 20.94 ± 2.30 (out of 34) with an IQR from 19 - 22.
Correlates of QOL
Univariable analysis showed that being female, single life, level of education up to 12 years or being jobless (elders and their spouses) and not being the source of family income had a negative statistical association with the total score of QOL (Table 2). Moreover, the history of chronic diseases (vascular, skeletal, and neurological diseases, sleep-related disorders, and hyperlipidemia), chronic pain, facing to violence and not taking medical supplements found to have an inverse correlation with the total score of QOL (p < 0.2; Table 2). Other socioeconomic, demographic, anthropometric and medical characteristics of the elders were not correlated with the total score of QOL (p > 0.2). Multivariable analysis showed that sleep disorder (B = -0.15), osteoporosis (B = -0.14), female gender (B = -0.13), and not being the source of family income (B = - 0.13) had a significant and inverse association with the total score of QOL (p < 0.05) (Table 3).
Correlates of CCQOL
Figure 1 demonstrates the association of the total score of CCQOL with each of its seven components. Physical functioning had the most correlation (0.81) and sexual functioning (0.17) had the least correlation with the total score of CCQOL.
Univariable analysis showed that female gender, single life, being jobless of the elders, and not being the source of family income had a negative association with the total score of CCQOL (Table 2). Further, having history of chronic diseases (cardiovascular, hematological, renal, skeletal, neurological, rheumatic, and psychological diseases, sleep disorders, and hyperlipidemia), chronic pain , facing to violence and taking medical supplements found to have an inverse correlation with CCQOL (p < 0.2; Table 2). Other socioeconomic, demographic, anthropometric and medical characteristics of the elders were not correlated with QOL score (p > 0.2). Multivariable analysis showed that sleep disorder (B = -0.21), facing to violence (B = -0.21), female gender (B = -0.17), migraine (B = -0.14), psychological disease (B = -0.13), and not being the source of family income (B = -0.09) had a significant and inverse correlation with CCQOL (p < 0.05; Table 3).
CCQOL components
Physical functioning
The mean score of physical function was 11.3 ± 2.6 (out of 15). Sleep disorder (B = -0.20), chronic pain (B = -0.18), being female (B = -0.16), osteoporosis (B = -0.12), low age of marriage (B = -0.12), and migraine (B = -0.11) had a negative and significant association with physical function of the older adults.
Cognitive functioning
The mean score of cognitive function was 12.1 ± 2.5 (out of 15). Sleep disorder (B = -0.20), migraine (B = -0.17), and facing to violence (B = -0.14) had a significant association with decrease of cognitive functioning.
Depression and anxiety
The mean score of depression and anxiety was 9.4 ± 2.9 (out of 12). Migraine (B = 0.19), psychological disease (B = 0.17), being female (B = 0.16), sleep disorder (B = 0.14), and facing to violence (B = 0.11) had a significant and positive association with depression and anxiety scale in the elders.
Self-care
The mean score of self-care was 16.6 ± 2.3 (out of 18). Female gender (B = -0.19), older age (B = -0.19), osteoporosis (B = -0.15), facing to violence (B = -0.10), and hypertension (B = -0.10) significantly decreased the self-care of the elders.
Social Functioning
The mean score of social function was 6.6 ± 2.0 (out of 9). Facing to violence (B = -0.25), single life (B = -0.19), female gender (B = -0.13), and not being the source of family income (B = -0.13) had a significant and opposite association with social functioning of the elders.
Life satisfaction
The mean score of life satisfaction was 10.30 ± 2.36 (out of18). Facing to violence (B = -0.18), sexual problem (B = -0.15), sleep disorder (B = -0.12), and not being the source of family income (B = -0.15) decreased the life satisfaction among the elders.
Sexual functioning
The mean score of sexual function was 4.1 ± 1.6 (out of 6). Single life (B = -0.66), female gender (B = -0.18), sexual problem (B = -0.16) and older age (B = - 0.14) had a significant and inverse association with the sexual functioning of the elders.
MQOL Components and its Correlates
The mean score of perceived personality was 4.02 ± 1.22 (out of 8) and the mean score of anger was 9.20 ± 1.06 (out of 12). Moreover, social desirability had a mean score of 0.28 ± 0.55 (out of 3), compared to self-esteem that had mean of 6.42 ± 0.79 (out of 9), and trust in God with the mean of 1.0 ± 0.07 (out of 2). Among the five items of MQOL; perceived personality (0.78) and trust in God (0.1) had the most and the least correlation with total score of MQOL, respectively (Figure 2). Univariable analysis showed that female gender, not having supplementary insurance, not being the source of family income and sleep disorder had an inverse and significant association with MQOL (Table 2). Moreover, having history of chronic diseases (liver disease, psychological disease, osteoporosis, skin disease, migraine, hematological disease, inability to walking, and sexual problem), chronic pain and facing to violence found to have an inverse correlation with MQOL (p < 0.2; Table 2). Multivariable analysis showed that, sexual problem (B = -0.17), facing to violence (B = -0.16), not having supplementary insurance (B = -0.15), inability to walking (B = -0.14), and migraine (B = -0.12) had an inverse association with MQOL (p < 0.05; Table 3).