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Quality of Life and Its Associated Factors: A Comparative Study

among Rural and Urban Elderly Population of North India
Rashmi Kumari1, Deepika Dewan2, Bhavna Langer1, Rajiv Kumar Gupta3, Parveen Singh4, Anuradha5

Financial Support: None declared

Conflict of Interest: None declared
ABSTRACT
Copy Right: The Journal retains the
copyrights of this article. However, re- Introduction: Quality of life (QOL) is an important area of concern
production is permissible with due ac- among elderly which reflects the health status and well-being of
knowledgement of the source.
this vulnerable group of population. The present study was con-
How to cite this article:
ducted with an objective of assessment of QOL and its associated
Kumari R, Dewan D, Langer B, Gupta factors among rural and urban elderly population.
RK, Singh P, Anuradha. Quality of Life Methodology: A community based cross-sectional study was
and Its Associated Factors: A Com-
conducted among 390 elderly subjects residing in rural and urban
parative Study among Rural and Urban
Elderly Population of North India. Natl
areas of Jammu. Brief version of the WHO QOL scale (WHOQOL-
J Community Med 2018;9(6):420-425 BREF) was used to assess the Quality of Life. Analysis of results
was done using Independent sample t- test and multiple linear re-
Author’s Affiliation: gression analysis.
1Assistant Professor; 2Senior Resident;
3Professor; 4Lecturer; 5Postgraduate, Results: A sample of 200 rural and 190 urban elderly subjects was
PG Department of Community Medi- analysed. Overall mean score for different domains of QOL was
cine, GMC Jammu, Jammu 59.19± 11.87 with a significantly higher score for urban subjects,
indicating a better QOL as compared to their rural counterparts
Correspondence (p<0.05). Presence of one or other forms of chronic morbidity was
Dr. Rashmi Kumari a significant determinant of QOL.
rashmi.kailu@yahoo.com
Conclusions: Morbidity status and residence emerged to be signif-
Date of Submission: 03-04-18 icant predictors of QOL. Policy makers should evaluate the im-
Date of Acceptance: 19-06-18 plementation of successful programmes for the elderly, especially
Date of Publication: 30-06-18 in rural parts of our country so as to improve their QOL.
Key words: Quality of Life (QOL), Elderly, WHOQOL-BREF,
North-India

INTRODUCTION sus, 8% of population was aged 60 years & above,

8.1% in rural settings and 7.9% in urban settings.3
Ageing is a universal phenomenon characterised
Due to epidemiologic transition, there is a shift
by an increased risk of morbidity, disability, re-
from communicable diseases to various lifestyle
duced functional capacity and eventually death.
disorders and chronic diseases. Elderly population
Due to better accessibility and availability of qual-
especially is vulnerable to chronic co-morbid con-
ity health care services, a continuous demographic
ditions, isolation, social insecurity and depression.
transition is occurring leading to an increase in life
expectancy. The proportion of people aged 60 With an increase in life expectancy, one of the
years and above is increasing over a period of greatest challenges of public health is to improve
time. By 2020, for the first time in history, the the quality of life in later years.4 The WHO defines
number of people aged 60 years and older will QOL as an individual's perception of their position
outnumber the children younger than 5 years and in life in the context of the culture and value sys-
by 2050, the world’s population aged 60 years and tems in which they live and in relation to their
older is expected to total 2 billion, up from 841 mil- goals, expectations, standards and concerns.5 Vari-
lion today.1 In India, the proportion of geriatric ous socio-demographic factors like age, education,
population was around 7% in 2001 which is ex- marital status, family structure, social and inter-
pected to rise to 11.6% by 2026.2 As per 2011 cen- personal factors also have an impact on overall
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Quality of Life (QOL). Since QOL is a subjective The total population catered by Urban Health Cen-
phenomenon and cannot be measured directly, ter is 11,997 and it is divided into extensions and
very few studies have been conducted in India de- sectors. For the purpose of study, two extensions B
termining the quality of life and its associated fac- and D were selected randomly. The population of
tors in geriatric population. these two areas is 1000 and 1400 respectively and
the combined geriatric population is 218.
Objectives of this study were to assess and com-
pare the QOL among elderly in rural and urban Strategy for data collection: The local community
areas and to elicit the association of various factors leaders of the respective areas were approached
with QOL. and sensitized about the purpose of the study be-
forehand. All the elderly in the selected areas con-
stituted the sampling frame. A lay out map includ-
MATERIALS AND METHODS: ing all households and all major landmarks in the
study area was prepared, so as not to miss any
Setting and Study Design: The present commu-
hidden structures. House to house survey was
nity based cross-sectional study was conducted
done. On reaching the house a standard technique
from July to August 2017, in both the rural as well
was followed which included knocking the door,
as urban field practice areas of PG Department of
introducing oneself and exchange of greetings, ex-
Community Medicine, Govt. Medical College
plaining the reason of visit and purpose of study,
Jammu. The department caters to the health ser-
following this a list of eligible subjects was made.
vices of Rural health block, R.S.Pura, through a
Further the participants were asked to read the
CHC and a network of PHCs and Sub centers,
consent form which was prepared in local lan-
whereas Urban Health Centre (UHC) caters to Tri-
guage and in situations like not able to read due to
kuta Nagar ward in urban area. The study was
poor eyesight or illiteracy, it was read out to them.
conducted after obtaining permission from Institu-
Those who replied in affirmation, were included in
tional Ethical Committee of the institution.
the study and those who replied in negative were
Sample size calculation: Considering the expected again requested for participation and if still not
Standard Deviation (SD) of QOL score in the eld- willing were excluded. Privacy during the inter-
erly population to be 10.886 and allowable error view was ensured by taking them in separate
1.5% at 95% confidence interval, the minimum room.
sample size came out to be 201 by the formula
Study Tool: The questionnaire used for the current
(1.962 ߪ2 ⁄݈2), where ‘σ’ is standard deviation and ‘l’
study comprised of two parts. The first part eli-
is allowable error. Taking 10 % as non-response
cited socio-demographic details while the second
rate, the final sample size was calculated as 220.
part was Brief version of the WHO QOL scale
Selection of the Study Subjects: All the elderly (WHOQOL-BREF) which is derived from the
subjects aged 60 years and above residing in the WHOQOL-100. The socio-demographic details in-
study area were eligible for the purpose of current cluded age, sex, education, religion, marital status,
study. family type, financial independence and chronic
Inclusion criteria: Elderly people aged ≥ 60 years, illness. The WHOQOL-BREF questionnaire con-
available during the study period, willing to par- tains 24 items of satisfaction that are divided into
ticipate and able to answer. four domains: Domain 1 (Physical health with 7
items), Domain 2 (Psychological health with 6
Exclusion criteria: Persons with mental disability items), Domain 3 (Social relationships with 3
which hinders them from understanding the ques- items) and Domain 4 (Environmental health with 8
tion and responding back, refusal to participate or, items). In addition, there are two items that are ex-
failure to keep appointment even after three at- amined separately i.e. about an individual’s over-
tempts. all perception of quality of life and about an indi-
Sampling Technique: For the purpose of provid- vidual’s overall perception of their health. The
ing efficient health care services, RS Pura Block has four domain scores denote an individual’s percep-
been divided into eight zones. Out of all the zones, tion of quality of life in each particular domain. All
Simbal zone was selected by Simple Random sam- the items were rated on 5-point Likert scale. Do-
pling technique. Further, two villages Tanda and main scores are scaled in a positive direction i.e.
Baga Jana falling in Simbal zone were selected for higher scores denote higher quality of life. Raw
the study purpose by convenience sampling scores of each domain were calculated by adding
method. The total population of Tanda and Bagga scores of individual items with in the domain and
Jana is 1527 and 998 respectively and combined then they were transformed in scale of 0-20 and 0-
geriatric population (≥60 years age) of these two 100 using WHO Reference table given in manual
areas is about 237. of QOL.7

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Statistical analysis RESULTS

Data was analysed using SPSS version 20.0. The A total of 390 persons constituted our study popu-
categorical variables were reported in percentages lation, out of which 200 belonged to rural area and
(%) while quantitative variables were presented as 190 to urban. Almost two-third of participants was
Mean ± Standard Deviation. Student’s t-test was in the age group of 60-70 years (66.6%), with a
used to find out the significance of difference be- mean age of 67.76±7.37 years. Males constituted
tween the two group means. Multiple Linear Re- 51.5% of the study population with majority of the
gression Analysis was performed to predict the participants being Hindu (64.4%). 58.9% of partici-
role of most significant variables in determining pants belonged to nuclear family. As far as Liter-
the QOL scores. P value less than 0.05 was taken as acy level was concerned, 67.2% of the study popu-
significant. lation was literate, with majority having studied
up to secondary level (43.8%).

Table 1: Association of QOL scores with socio-demographic factors (n=390)

Socio- N (%) QOL Scores ( Mean±SD )
Demographic Physical Psychological Social Environmental Overall Overall Satis-
actors relationship QOL faction with health
Age (Years)
60-70 260 (66.6) 58.15±15.4 58.10±14.9 62.65±12.9 61.77±13.4 3.66±0.7 3.26±0.8
70-80 83 (21.3) 53.98±14.7 57.30±12.6 61.53±13.9 64.56±16.2 3.51±0.8 3.10±0.8
>80 47 (12.1) 51.95±13.3 46.10±16.5 56.40±14.7 59.78±15.1 3.27±0.9 2.93±0.7
P value* 0.008 0 0.013 0.146 0.004 0.033
Sex
Males 201 (51.5) 60.73±15.1 60.29±14.3 62.88±12.6 64.09±14.5 3.67±0.7 3.34±0.8
Females 189 (48.5) 52.05±14.1 52.43±15.0 60.37±14.2 60.03±13.7 3.50±0.7 3.03±0.7
P value* 0 0 0.066 0.005 0.033 0
Religion
Hindu 251 (64.4) 55.07±15.2 55.28±16.1 60.48±14.2 62.68±14.4 3.50±0.7 3.13±0.8
Muslim 43 (11) 59.81±15.4 60.72±15.3 63.63±11.8 61.14±17.3 3.83±0.8 3.51±0.8
Sikh 96 (24.6) 58.84±14.7 57.73±11.7 63.86±11.6 61.12±12.2 3.71±0.7 3.19±0.9
P value* 0.038 0.061 0.067 0.59 0.008 0.025
Type of Family
Nuclear 230 (58.9) 55.07±15.4 56.78±14.2 61.93±13.4 62.79±14.8 3.58±0.8 3.19±0.9
Joint 160 (41.1) 57.53±15.1 56.28±15.7 61.47±13.5 61.66±13.8 3.59±0.7 3.18±0.8
P value* 0.118 0.75 0.738 0.443 0.858 0.938
Residence
Urban 190 (48.7) 57.07±14.5 58.97±13.8 62.65±12.6 67.15±12.4 3.72±0.7 3.25±0.7
Rural 200 (51.3) 56.00±15.8 54.12±15.9 60.72±14.1 57.35±14.2 3.46±0.8 3.13±0.8
P value* 0.487 0.002 0.158 0 0.001 0.155
Literacy level
Illiterate 128 (32.8) 50.16±14.7 48.83±16.3 58.60±13.9 56.34±15.0 3.36±0.8 2.95±0.8
10th pass 171 (43.8) 59.78±14.1 60.44±13.3 64.33±13.1 63.80±12.4 3.65±0.7 3.25±0.8
Higher Sec & above 91 (23.4) 59.34±15.2 59.81±12.6 60.95±12.5 67.12±13.9 3.78±0.7 3.39±0.8
P value* 0 0 0.001 0 0 0
Marital status
Married 302 (77.4) 58.16±15.1 58.78±13.5 63.73±12.4 63.14±13.5 3.65±0.7 3.25±0.8
Single** 88 (22.6) 50.89±14.3 48.61±17.5 54.56±14.3 58.64±15.9 3.38±0.8 2.95±0.8
P value* 0 0 0 0.009 0.005 0.003
Financial dependency
Dependent 181 (46.4) 53.66±14.6 53.65±14.3 60.26±15.2 59.89±13.7 3.48±0.8 3.05±0.8
Independent 166 (42.6) 61.17±14.4 60.92±14.4 64.49±11.4 65.97±14.2 3.76±0.7 3.29±0.9
Partially dependent 43 (11) 50.58±16.4 51.27±17.2 56.62±10.6 56.67±13.4 3.37±0.7 3.34±0.8
P value* 0 0 0 0 0 0.013
Any chronic morbidity
Present 314 (80.5) 54.89±15.3 55.84±15.5 61.52±13.6 60.96±14.4 3.57±0.8 3.13±0.9
Absent 76 (19.5) 56.91±14.8 56.64±13.9 61.69±12.8 62.41±13.9 3.59±0.8 3.20±0.8
P value* 0.3 0.68 0.921 0.427 0.894 0.508
*Independent samples t-test/ ANOVA; ** Single means Widow, Divorced/ Living separate from spouse

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Table 2: Multiple Linear Regression Analysis of Regarding marital status, 77.4% of subjects were
QOL Scores currently married. 46.4% of the participants were
Associated Standardized Correlations p
financially dependent on their family members. In
Factors value regards to chronic morbidity, 80.5% of study sub-
β Coefficients
jects were suffering from one or other type of dis-
Constant 0.000
ease. Age was found to be significant determinant
Sex -.045 -.011 0.446
of all the domains of Quality of Life with maxi-
Religion .028 .003 0.608
mum score in the age group of 60-70 years except
Residence -.126 -.102 0.039*
for environmental domain. Among gender, males
Education -.009 .044 0.888
Type of family .009 .047 0.858
were having significantly higher domain scores in
Financial -.105 -.086 0.054
comparison to female subjects. Muslim population
Dependence was found to have better QOL in terms of domain
Morbidity status .176 .174 0.001* scores. Urban residents were having higher do-
Marital status -.047 -.048 0.366 main scores as compared to their rural counter-
parts but the difference was statistically significant
*p value <0.05 considered as significant; R2= 0.055 only for scores of psychological, environmental
Dependent variable: Mean Total domain score and Overall QOL. Level of literacy was again
found to be significant predictor for all the domain
Independent variables: Sex, Religion, Residence, Educa-
scores. Married subjects were showing better
tional status, Type of family, Financial dependence,
Marital status and morbidity
Quality of life when compared with those who
were single (divorcees, widows, unmarried or
staying away from spouse due to any reason) and
the difference was statistically significant.

Table 3: Comparison of Total QOL scores among different variables between rural and urban popula-
tion
Variables Rural (200) Urban (190) t p value
n Mean SD n Mean SD
Age (Years)
60-70 134 58.03 10.51 126 60.95 12.21 2.069 0.04
70-80 41 58.99 12.75 42 58.54 12.33 -0.16 0.87
>80 25 54.36 12.67 22 58.95 13.4 1.207 0.23
Sex
Males 93 58.19 11.45 108 59.83 12.95 0.939 0.34
Females 107 57.4 11.2 60.66 11.58
Religion
Hindu 98 56.83 11.99 153 60.3 12.42 2.19 0.02
Muslim 21 59.04 9.57 22 58.37 14.05 -0.18 0.85
Sikh 81 58.58 10.87 15 61.66 8.99 1.034 0.3
Type of Family
Nuclear 134 57.87 10.97 96 59.32 12.66 1.812 0.07
Joint 66 57.56 12.02 94 61.06 12.03 0.929 0.35
Literacy level
Illiterate 102 57.43 10.88 26 59 10.29 0.665 0.5
10th pass 83 58.06 12.49 88 61.55 11.59 1.898 0.05
Hr.Sec & above 15 58.45 6.76 76 59 13.76 0.152 0.87
Marital status
Married 149 57.68 10.93 153 60.78 12.24 2.321 0.02
Single* 51 58.03 12.43 37 57.72 12.68 -0.12 0.91
Financial dependency
Dependent 104 58.63 12.25 77 60.91 12.32 1.235 0.21
Independent 78 58.08 9.26 88 60.01 13.16 1.079 0.28
Partially dependent 18 51.4 12.18 25 58.54 9.42 2.16 0.03
Any chronic morbidity
Present 158 56.74 10.43 156 59.13 12.52 1.839 0.06
Absent 42 61.63 13.56 34 65.01 10.44 1.195 0.23
Total score 200 57.77 11.3 190 60.19 12.4 2.017 0.04
* Single means Widow, Divorced/ Living separate from spouse

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Financial dependence was another significant pre- Urban geriatric population in the current study,
dictor for domain scores, with significantly higher had higher scores for all the domains as compared
scores among independent subjects. (Table 1) to rural geriatric population but a significant dif-
ference was elicited for Psychological & Environ-
Table 2 shows that when different variables affect-
mental domains. Comparable results have been
ing the Quality of life were analysed using Mul-
shown by other studies conducted in different
tiple Linear Regression using Enter method, only
parts of India.10,12 This difference can be attributed
residence and morbidity status have shown an in-
to difference in their lifestyle and socio-
dependent association.
demographic factors.
Table 3 depicts that when total mean scores were
Married subjects in the present study enjoyed a
compared among urban and rural subjects using
better QOL in terms of higher domain scores as
independent sample t test, significantly higher
compared to singles (widow, divorcees or living
scores were observed in urban subjects as com-
separate from spouse due to any reason) and the
pared to their rural counterparts (60.19±12.4 vs
difference was statistically significant. Elderly
57.77±11.3). Statistically significant differences
married living with their spouse is being cared in a
among residence were observed in subjects of 60-
better way, which explains their better QOL. Barua
70 years age group, Hindus, married subjects and
A et al also observed in their study on geriatric
those who were partially dependent on their fam-
population that currently married had better qual-
ily in terms of financial aspects.
ity of life.16 However in a study conducted by Sax-
ena S et al, those living as single scored higher
scores than married in all the domains except the
DISCUSSION
social relationship.17
Quality of Life (QOL) among elderly is a neglected
Literacy play a major role in predicting QOL as il-
issue especially in developing countries including
literate scored least in all the domains and this re-
India. Keeping this in mind, the present study was
lationship was significant for all domains of QOL.
designed and conducted to assess QOL in rural
Literates have better understanding of their ageing
and urban elderly population and to determine the
process and better accommodate to lifestyle
association of various factors. Total overall mean
changes. These findings were concurrent with
score for all domains of QOL was 59.19± 11.87
other studies.17-18 But Barua et al did not find any
which was almost comparable with study con-
significant association between education and
ducted by Kritika et al in Dehradun.8 Mean scores
QOL.14
for physical, Psychological , Social relationship
and Environmental domains were 56.52±15.23, Similar to the findings of Hameed S et al19, we did
61.66±13.46, 56.48±15.15 and 62.13±14.25 respec- not find any significant association between the
tively, with a maximum score in environmental type of family and QOL. Other studies done in dif-
domain, the findings supported by Praveen V et ferent parts of India by Kumar GS et al20, Sowmiya
al.9 Mudey et al in their study concluded that the KR et al21 had showed that the elderly living in
QOL of rural elderly population was better in joint families had better QOL than those living in
physical and psychological domain, whereas QOL nuclear families. Living in a nuclear family or a
in urban slum elderly was better in social relation- joint family has its own advantages and disadvan-
ship and environmental domain.10 However in a tages. So, QOL depends more on the warmth of
study conducted by Shah VR et al, mean score of relationship with family members rather than the
social domain was maximum (69.4 ± 9.7) with type of family alone.
lowest mean score (57.6 ± 10.0) for environmental
Financially independent subjects were spending a
domain.11
significantly better Quality of life as compared to
In the present study, mean age of the study par- their counterparts, the findings supported by
ticipants was 67.76 ± 7.37 years. Mean scores for all Kritika et al.8 Financial independency brings the
the domains were significantly higher for 60-70 power of autonomy and opportunities to fulfil the
years old age group except for environmental do- needs in an independent way. Presence of Chronic
main. Similar findings have been reported by morbid conditions also determine QOL as illus-
Mudey A et al in study conducted in Maharash- trated in other studies.21
tra.10 Males enjoyed a better QOL by showing sig-
nificantly higher domain scores as reported by
other studies also.12-13 In studies conducted by Ba- CONCLUSION
rua A et al14 and Bishak YK15, males scored higher
Elderly residing in urban areas had shown compa-
than females but without any statistical difference.
ratively better QOL which can be attributed to dif-
However, Praveen V et al in their study reported a
ference in their lifestyle and easy accessibility and
lower mean score for males.9

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availability of health services. Morbidity status 1996.Programme on Mental Health .World Health Organi-
zation.Geneva.
emerged to be other significant predictors of QOL.
Although the process of ageing, disorders and dis- 8. Kritika , Kakkar R, Aggarwal P, Semwal J. Quality of Life
abilities of old age cannot be totally prevented, (QOL) among the Elderly in Rural Dehradun. Indian Jour-
nal Of Community Health 2017; 29 (1): 39-45.
suitable measures can be taken that would retard
this progress thereby preserving their quality of 9. Praveen V, M AR. Quality of life among elderly in a rural
area. Int J Community Med Public Health. 2016; 3 (3):754-7.
life. Policy makers should evaluate the implemen-
tation of successful programmes for the elderly in 10. Mudey A, Ambekar S, Goyal RC, Agarekar S and Wagh
our country. VV. Assessment of Quality of Life among Rural and Urban
Elderly Population of Wardha District, Maharashtra, India.
Ethno Med 2011; 5 (2): 89-93.
11. Shah VR, Christian DS, Prajapati AC, Patel MM, Sonaliya
Limitation
KN. Quality of life among elderly population residing in
Convenience sampling technique with a smaller urban field practice area of a tertiary care institute of Ah-
medabad city, Gujarat. Journal of Family Medicine and
sample size and cross-sectional nature of data limit Primary Care 2017;6:101-5.
the generalization of results in wider population.
12. Akbar F, Kumar M, Das N, Chatterjee S, Mukhopadhyay S,
Unknown confounders might have affected the re-
Chakraborty M, Sarkar K. Quality of Life (QOL) Among
sults because of multidimensionality of QOL. Geriatric Population in Siliguri Sub-division of District Dar-
jeeling, West Bengal. Nat.J.Res. Com.Med 2013; 2 (1): 17– 22.
Relevance
13. Qadri S, Ahluwalia SK, Ganai A, Bali S, Wani F, Bashir H.
Limited evidence is available in literature on com- An Epidemiological Study On Quality Of Life Among Ru-
parison of QOL among rural and urban popula- ral Elderly Population Of Northern India. International
tion, so the study is relevant to the future re- Journal of Medical Science and Public Health 2013 ; 2 (3):
514-22.
searchers. The findings of the study are also of
relevance to administrators and health programme 14. Barua A, Mangesh R, Harsha KHN, Mathew S. A cross-
planners who are dealing with elderly population sectional study on quality of life in geriatric population. In-
dian J Comm Med. 2007;32:146-7.
to develop strategies for their healthy and active
ageing. 15. Bishak YK, Payahoo L, Pourghasem B, Jafarabadi MA. As-
sessing the Quality of Life in Elderly People and Related
Factors in Tabriz, Iran. J Caring Sci. 2014 ; 3 (4): 257–263
.PMCID: PMC4334177 ( Pubmed)
REFERENCES
16. Barua A, Mangesh R, Kumar HN, Saajan M. Assessment of
1. World Health Organization. Ageing Well Must Be a Global the domains of quality of life in the geriatric population.
Priority; 2014. Available from:http://www.who.int/ medi- Indian J Psychiatry. 2005 Jul;47 (3):157-9. doi: 10.4103/0019-
acentre/news/releases/2014/lancet‑ageing‑series/en/. 5545.55940. PubMed PMID: 20814459; PubMed Central
Accessed on Sep 16, 2017. PMCID: PMC2919792.[PubMed].
2. Dyson T, Cassen R, Visaria L. Twenty-first century India: 17. Saxena S, Misra PJ, Vishwanath N S, Varma RP, Soman B.
population, economy, human development and the envi- Quality of life and its correlates in Central India. Int J Res
ronment. New York, NY. Oxford University Press. 2004: Dev Health 2013; 1 (2): 85-96.
438.
18. Molzahn AE, Kalfoss M, Schick Makaroff K, Skevington
3. Census of India 2011. Provisional population totals. Na- SM: Comparing the importance of different aspects of qual-
tional Commission on Population. Office of the Registrar ity of life to older adults across diverse cultures. Age Ageing
General & Census Commissioner, New Delhi, India. Avail- 2011; 40 (2): 192–99. (Pubmed) PMID: 21186234
able from: http://censusindia.gov.in/. Accessed on Sep 18,
19. Hameed S, Brahmbhatt KR, Dipak C Patil DC, S. PK,
2017.
Jayaram S. Quality of life among the geriatric population in
4. UN. World population prospects: the 2012 revision. Meth- a rural area of Dakshina Kannada, Karnataka, India. Global
odology of the United Nations population estimates and J Med Public Health. 2014;3 (3):1-5.
projections. United Nations Department of Economic and
Social Affairs PD; 2014. 20. Kumar GS, Majumdar A, Pavithra G. Quality of Life (QOL)
and Its Associated Factors Using WHOQOL-BREF Among
5. Mosalem FA, Mahfouz EM, Fattah MA, Hassan EE. Quality Elderly in Urban Puducherry, India. Journal of Clinical and
of life (QOL) among geriatric rural population - El-Minia - Diagnostic Research 2014 ;8 (1): 54-57. doi: 10.7860/JCDR
Egypt. El-Minia Medical Bulletin 2009;20 (1):1-15. /2014/ 6996.3917. Epub 2013 Jan 12. PubMed PMID:
24596723; PubMed Central PMCID: PMC3939587. [Pub-
6. Power M, Schmidt S. WHOQOL-OLD Manual. Copenha- Med].
gen: WHO, Office E; 2006.
21. Sowmiya KR, Nagarani. A Study on Quality of Life of Eld-
7. World Health Organization's. Quality of Life group: erly Population in Mettupalayam, A Rural Area of Tamil-
WHOQOL-BREF. Introduction. Administration Scoring and nadu. Nat J Res Com Med 2012;1 (3):123-77.
Generic Version of assessment. Field Trial version.

National Journal of Community Medicine│Volume 9│Issue 6│June 2018 Page 425