Influence of Active and Healthy Ageing on Quality of Life Changes: Insights from the Comparison of Three European Countries.

This study aimed to analyze the determinants of quality of life (QoL) in older people in three European countries (Portugal, Spain and Sweden). A sample of 7589 participants in waves 4 (2011) and 6 (2015) of the Survey on Health, Aging, and Retirement in Europe (SHARE) project, aged 50 and over and living in Portugal, Spain and Sweden, was included. The CASP-12 scale was used to measure QoL. A principal component analysis was performed to group preselected variables related to active and healthy ageing into the dimensions of health, social participation, and lifelong learning. A linear regression model was built using the change in CASP-12 scores over the 4-year follow-up as the dependent variable, including the interactions between country and each independent variable in the model. After four years, the average QoL increased in Portugal (difference = 0.8, p < 0.001), decreased in Spain (-0.8, p < 0.001), and remained constant in Sweden (0.1, p = 0.408). A significant country-participation component interaction (p = 0.039) was found. In Spain, a higher participation (β = 0.031, p = 0.002) was related to a higher QoL improvement at 4 years, but not in Sweden or Portugal. Physical health and emotional components (β = 0.099, p < 0.001), functional ability (β = 0.044, p = 0.023), and cognitive and sensory ability (β = 0.021, p = 0.026) were associated with QoL changes over time in all countries. The country-specific associations between health, social participation and QoL should be taken into account when developing public health policies to promote QoL among European older people.This work is part of the QASP research project and has been funded by the Institute of Health Carlos III, Intramural Strategical Action in Health AESI 2018 (PI18CIII/00046). It has been partially funded by REDISSEC (RD16/0005/0002 and RD16/0001/0005, co-funded by European Regional Development Fund/European Social Fund “A way to make Europe”/”Investing in your future”) projects, and the ENCAGEN-CM project (H2019/HUM-5698) funded by the Community of Madrid and co-funded by the European Regional Development Fund. This paper uses data from SHARE Waves 4 and 6 (doi: 10.6103/SHARE.w4.710; 10.6103/SHARE.w6.710); see Börsch-Supan et al. (2013) for methodological details. The SHARE data collection is funded by the European Commission through FP5 (QLK6-CT-2001-00360), FP6 (SHARE-I3: RII-CT-2006-062193, COMPARE: CIT5-CT-2005-028857, SHARELIFE: CIT4-CT-2006-028812), FP7 (SHARE-PREP: GA N°211909, SHARE-LEAP: GA N°227822, SHARE M4: GA N°261982) and Horizon 2020 (SHARE-DEV3: GA N°676536, SERISS: GA N°654221) and by DG Employment, Social Affairs & Inclusion. Additional funding from the German Ministry of Education and Research, the Max Planck Society for the Advancement of Science, the U.S. National Institute on Aging (U01_AG09740-13S2, P01_AG005842, P01_AG08291, P30_AG12815, R21_AG025169, Y1-AG-4553-01, IAG_BSR06-11, OGHA_04-064 and HHSN271201300071C) and from various national funding sources is gratefully acknowledged (see www.share-project.org accessed on 13 April 2021).S