Medicosocial problems of the elderly and the determinans of quality of life in persons aged 65 and over living in Balikesir city center

Objective: The aim of this study is to evaluate the medical and social problems, determine quality of life and to reveal the factors that affect the quality of life of individuals over 65 year and over elderly persons living in the center of Balıkesir. Materials and Methods: This dissertation thesis is based on a population-based cross-sectional study. The population of the study consists of 14,137 elderly individuals aged 65 and over residing in Altıeylül district, one of the two districts in the city center of Balıkesir. It is aimed to reach a minimum of 535 elderly individuals with 95% confidence level, 4% margin of error, 20.6% elderly bad quality of life prevalence and a design effect of 1.4 cluster effect. Multi-stage probabilistic sampling was used in the study. The data were obtained through a face-to-face interview through a questionnaire. The questionnaire included sociodemographic information for the elderly, their health status and use of health services, habits, relationships and violence exposure, geriatric syndromes and quality of life variables. KATZ index was also applied in order to examine elderly daily life independence (ADL). WH0-5 Well-Being Index is also used to evaluate the depression mood in the elderly. The WHOQOL-AGE scale was used to measure the quality of life. The dependent variables of the study are the quality of life total score and two sub-dimensions. Chi-square test was used in univariate analyzes and logistic regression was used in multivariate analyzes. Results: The average age of the individuals participating in our study was 71.57 ± 6.02. The research group consists of; 48.9% of male and 51.4% of female. We found that, 25.9% of the participants have not received formal education and 17.6% stated that their income was less than their expenditure. 85.1% of our study group had at least one chronic disease, 42.7% has been using any drug without a physician's recommendation, 61.0% did not have a doctor to monitor their general health and 34.4% were first admits to Family Health Centers (ASM) in a non-emergency health problem. 39.9% had incontinence, 33.1% had a history of falling within the last year, 19.6% had been exposed to violence, 41.0% had a depressive mood and 14.0% had dependence on daily tasks. In our study, the total score for quality of life was found to be 70.92 ± 13.94. Quality of life score was 2.28 times (95% CI = 1.38 ± 3.78) lower in those living in urban areas; 3.96 times lower (95% CI = 1.49 ± 10.51) in those who were single or separated; 1.90 times (95% CI = 1.06±3.40) lower in those who did not graduate from any school; 4.48-fold (95% CI = 1.85 ± 10.88) lower for those whose income is less than expenditures; 3.02-fold (95% CI = 1.62 ± 5.64) lower for those who do not have a closed-type toilet; 2.02-fold (95% CI = 1.01±4.06) lower for those with any chronic disease); 2.76-fold (95% CI = 1.32 ± 5.76) lower in those 115 with poor vision or hearing; 2.37-fold (95% CI = 1.31 ± 7.28) lower in those who do not exercise; 4.57-fold (95% CI = 2.50 ± 8.36)lower in those who are unsatisfied of social relationships; 9.33 times (95% CI = 3.18 ± 27.46) lower in physically dependent older adults and 5.20 times lower (95% CI = 3.09 ± 8.76) in those with depressive mood. Conclusion: The presence of chronic diseases, independence in activities of daily living (ADL), and irrational drug use were found at high levels in our research group. The primary care use of the elderly, the continuity of health status care by a doctor; taking precautions against falls were found to be in lower rates. The quality of life of the elderly is poor in the elderly who are physically and socio-economically dependen, who do not exercise regularly and who have poor social relations. The older adults should be involved in official high risk groups in the country that will require regular follow-ups. Efforts should be spent to increase the awareness of drug use in the older adults. Social and environmental opportunities should be created in which elderly people can spend active time and participate. In this context, accessible safe walking and exercise areas, social environments where they can be social and establish good relationships should be created. Keywords: quality of life, depression, falling