Linking health-related behaviors to quality of life in older adults: A latent class analysis

Abstract Background and Objectives Life expectancy and healthy life years diverge considerably in Austria, and variation in quality of life (QoL) among older people cannot be fully explained by sociodemographic and health-related characteristics. We aimed to identify groups of older adults with underlying behavioral and attitudinal patterns and their associations with QoL. Research Design and Methods Latent class analysis was performed on cross-sectional data, including QoL (WHOQOL-BREF) from the 2019 Austrian Health Interview Survey (3,995 individuals aged 65+) to identify stable patterns of health behaviors associated with QoL. Variables included lifestyle factors and healthcare use. Class differences were assessed with logistic regression analyses. Results Four distinct health behavioral classes emerged. Compared with the classes “healthy–consistent–positive” (18%; healthy lifestyle, consistent preventive behavior, positive health system attitudes) and “healthy–inconsistent–positive” (25%; healthy lifestyle, inconsistent preventive behavior, lowest vaccination probabilities, positive health system attitudes), both the class with an unhealthy lifestyle, inconsistent preventive behavior and negative health system attitudes (“unhealthy-inconsistent-negative”; 17%) and the class representing a moderately healthy lifestyle with low physical activities, lower prevention but positive health system attitudes (“moderately healthy–moderately consistent–positive”; 41%) were associated with worse QoL in all domains. Classes also differed in sociodemographic characteristics and activity limitations. Discussion and Implications Most older Austrian adults were predicted to be in classes with suboptimal health behaviors associated with lower QoL. Interventions should reflect the specific characteristics of these disadvantaged groups. To reach the healthy–inconsistent–positive class, vaccination programs should target younger, healthy-living older adults.