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Advances in Social Sciences Research Journal – Vol. 10, No. 11
Publication Date: November 25, 2023
DOI:10.14738/assrj.1011.15861.
Morisaki, N., & Numata, K. (2023). Relationship Between Changes in Daily Living and Quality of Life During the Coronavirus Disease
2019 Pandemic Among the Older Population of Japan. Advances in Social Sciences Research Journal, 10(11). 164-171.
Services for Science and Education – United Kingdom
Relationship Between Changes in Daily Living and Quality of Life
During the Coronavirus Disease 2019 Pandemic Among the Older
Population of Japan
Naoko Morisaki
Himeji University, School of Nursing
Keizo Numata
Himeji Dokkyo University, Medical Health Faculty
ABSTRACT
Aim: This study aimed to examine changes in daily living and quality of life (QOL)
among older adults living at home in Japan during the coronavirus disease 2019
(COVID-19) pandemic and to determine the relationship between the two. Methods:
The participants in this study were Japanese adults aged ≥65 years who agreed to
participate. This study was conducted using a questionnaire survey from 2021 to
2022 during the COVID-19 pandemic. Survey items included participants' age, sex,
need for care, changes in daily living, and QOL. To assess changes in daily living, the
participants were asked about changes in time spent standing, exercising, going out,
talking, laughing, sleeping, and alone. QOL was assessed using the SF-8. The
relationship between QOL and changes in daily living was analyzed using multiple
regression analysis. Results: Of the 485 participants included, 198 (40.8%), 196
(40.4%), 284 (58.6%), 163 (33.6%), 149 (30.7%), and 43 (8.9%) reported a
decrease in time spent standing, exercising, outside, talking, laughing, and sleeping,
respectively. Additionally, 131 (27.0%) participants reported an increase in time
spent alone. Multiple regression analyses indicated that physical QOL was
associated with time spent outside, sleeping, and standing, and mental QOL with
time spent standing, laughing, and alone. Conclusions: Physical and mental QOL
were significantly associated with changes in daily living. Since time spent standing
is associated with both physical and mental QOL, guidelines for maintaining time
spent standing are particularly important.
Keywords: COVID-19, daily living, elderly, pandemic, quality of life
INTRODUCTION
In December 2019, the world's first case of coronavirus disease 2019 (COVID-19) was
reported.1, 2 Subsequently, within a few months, COVID-19 was declared a pandemic. In Japan,
the first case of infection was confirmed in January 2020, and in April 2020, Japan's first state
of emergency was declared, resulting in restrictions imposed on daily activities.3 Subsequently,
four emergency declarations had been issued by the end of 2022.
The pandemic has changed the daily lives of people around the world,4 necessitating the use of
masks and restrictions on movement. Changes in daily living are believed to affect quality of life
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Morisaki, N., & Numata, K. (2023). Relationship Between Changes in Daily Living and Quality of Life During the Coronavirus Disease 2019 Pandemic
Among the Older Population of Japan. Advances in Social Sciences Research Journal, 10(11). 164-171.
URL: http://dx.doi.org/10.14738/assrj.1011.15861
(QOL). The older population has naturally been susceptible to the social environment.5–7 In
addition, the economic setbacks and vulnerability experienced by the older adults caused by
the pandemic are worsening,8 arising a concern regarding the declining QOL. Studies of older
populations during the pandemic have shown decreased QOL in the infected9, 10 as well as in
the uninfected11–14 individuals. Moreover, it is clear that the QOL of the older population
during the pandemic is affected by an individual's attributes, such as country14 and place of
residence,13 income,14 employment status,13 marital status,13 and the degree of isolation.14
Regarding changes in daily living, there have been reports of increased levels of isolation due
to reduced contact with others.15, 16 In the older Japanese population, a decrease in physical
activity due to the pandemic17 and associated changes in QOL have been reported.18 However,
no indication of a direct relationship with QOL has been discovered yet. We believe that
clarifying whether changes in daily living caused by the pandemic affects QOL will provide
important information for developing appropriate support measures during the pandemic.
Therefore, this study aimed to investigate the changes in daily living and QOL of the older
population living at home during the COVID-19 pandemic and to clarify the relationship
between the two.
METHODS
Participants
The cohort of the study comprised older adults aged ≥65 years residing at home in Japan who
consented to participate in the survey. Independent older adults were approached at a
community center they visited daily and asked to participate in the survey. Those requiring
nursing care were asked to participate in the daycare facilities they used.
Survey Period
The survey was conducted from 2021 to 2022, during the COVID-19 pandemic.
Survey Methods
A questionnaire-based survey was conducted in which participants completed the
questionnaire independently, if possible. If a participant required assistance, an assistant was
present to record their responses. After completion, the response sheets were deposited in a
collection box for a designated period.
Survey Contents
Basic Attributes:
Participants’ age, sex, and need for care (independent or in need of care) were surveyed.
Change in Daily Living:
Respondents were asked seven items regarding changes in their daily lives due to the
pandemic: time spent standing, exercising, outside, talking, laughing, sleeping, and alone. The
response options were: 0: decreased, 1: no change, and 2: increased.
QOL:
SF-8 is used globally to evaluate health-related QOL as it facilitates measurements of QOL in
eight health-related areas.19, 20 Accordingly, the SF-8 was used in this study to evaluate QOL.
The eight areas were physical functioning (PF), role physical (RP), bodily pain (BP), general
health (GH), vitality (VT), social functioning (SF), role emotional (RE), and mental health (MH).
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Advances in Social Sciences Research Journal (ASSRJ) Vol. 10, Issue 11, November-2023
Services for Science and Education – United Kingdom
Physical Component Summary (PCS) and Mental Component Summary (MCS) scores were
calculated from the scores of the eight areas. Each score was calculated based on national
standards using the SF-8 scoring program. The national standard value for these scores is 50.
High scores indicated high QOL.
Analysis Methods
The association between QOL and changes in daily living was analyzed using multiple
regression analysis. In the analyses, the dependent variables were the PCS and MCS scores, and
the independent variables were age, sex, need for care, and the seven items of daily living. The
significance level was set at p < 0.05. IBM SPSS Ver. 29.0 (SPSS Inc., Tokyo, Japan) was used for
statistical analysis.
Ethical Considerations
The study purpose, procedure, optional nature of participation, protection of personal
information, and publication of results were completely explained to the participants before
the survey. The survey was conducted after approval was obtained from the Research Ethics
Review Committee of xxx (approval number: 2021-04) and the study conforms to the
Declaration of Helsinki.
RESULTS
Characteristics of the Participants
Basic Attributes:
Responses were obtained from 485 participants. The mean age was 81.6 ± 7.1 years, and 341
(70.3%) were female and 144 (29.7%) males. Of these, 175 (36.1%) were independent, and 310
(63.9%) required care.
Changes in Daily Living:
Of those who reported a decrease in time spent performing daily activities due to the pandemic,
198 (40.8%) reported a decrease in time spent standing, 196 (40.4%) in time spent exercising,
284 (58.6%) in time spent outside, 163 (33.6%) in time spent talking, 149 (30.7%) in time spent
laughing, and 43 (8.9%) in time spent sleeping. Time spent alone increased for 131 (27.0%)
participants.
SF-8:
The mean PCS score was 46.36 ± 6.37 and the mean MCS score was 47.64 ± 6.31. The following
mean scores were obtained in the SF-8 sub-areas: PF, 47.38 ± 6.26; RP, 46.83 ± 7.48; BP, 47.93
± 8.93; GH, 48.95 ± 6.75; VT, 48.44 ± 6.51; SF, 46.21 ± 7.47; RE, 48.29 ± 6.64; and MH, 48.14 ±
6.30. The PCS and MCS scores for each response are shown in the Table 1.
Multiple Regression Analysis Results
Multiple regression analysis with PCS score as the dependent variable resulted in a significant
model (F = 18.70, P < 0.001, Adj. R2 = 0.16). PCS scores were significantly associated with sex,
need for care, time spent standing, outside, and sleeping. The details are presented in Table 2.
Analysis of the MCS score as the dependent variable resulted in a significant model (F = 39.89,
P < 0.001, Adj.R2 = 0.25). The MCS scores were significantly associated with the need for care,
time spent standing, time spent laughing, and time spent alone. The details are presented in
Table 3.