Factors associated with quality of life among older adults screening positive for cognitive impairment in a social welfare development center: A mixed methods study

Abstract

The quality of life of older adults screening positive for cognitive impairment significantly affects their daily functioning. This explanatory sequential mixed-methods study aimed to examine factors associated with quality of life and to explore approaches for improving the quality of life among older adults screening positive for cognitive impairment. The quantitative phrase comprised 38 older adults screening positive for cognitive impairment at a social welfare development center for older persons, selected via simple random sampling. For the qualitative phase, key informants included the center director, caregivers, and older adults screening positive for cognitive impairment. Data were collected using the Thai Geriatric Depression Scale, the Thai Barthel Index for Activities of Daily Living, the Thai Mini-Mental State Examination, and the Thai version of the World Health Organization Quality of Life Scale for Older Adults. The instruments demonstrated Cronbach’s alpha coefficients of .85, .87, .80, and .75, respectively. In addition, in-depth interviews were conducted. Data analysis utilized Pearson’s correlation, eta correlation, Spearman’s rank correlation, and content analysis. The findings revealed that the overall quality of life of older adults screening positive for cognitive impairment was at a moderate level, though the death and dying domain was rated at a good level. Regarding associated factors, depression showed a very high significant negative correlation with quality of life (rₛ=-.900, p<.001). Conversely, cognitive function demonstrated a high significant positive correlation (rₛ=.782, p<.001), while the ability to perform basic activities of daily living showed a low significant positive correlation (rₛ=.324, p=.047). Guidelines for improving the quality of life of older adults screening positive for cognitive impairment include mitigating depression through social interaction activities, integrating cognitive stimulation activities into activities of daily living training, and fostering a care environment that enhances participation and self-esteem of older adults.