The association between health-related quality of life and the meaning of life in community-dwelling older adults

Pain management is a major issue in age-related diseases and substantially affects health-related quality of life (HRQOL). This study examined the association between meaning in life (MIL), a positive psychological factor, and HRQOL among older adults experiencing pain. Participants were 471 community-dwelling adults aged ≥ 65 years (230 women, 241 men; mean age 71.3 years) who attended annual health checkups in Town Y, Hokkaido, Japan (2016–2019). Of these, 349 (74.1%) reported pain in at least one anatomical site (lower back, lower limb, or knee). HRQOL was assessed using the Japanese version 2 of the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36), pain severity using the Japanese version of Pain DETECT, and MIL using the MIL questionnaire. Because HRQOL and pain variables were not normally distributed, they were dichotomized at the median. Hierarchical logistic regression analyses were conducted. After adjusting for age, sex, and subjective well-being, higher MIL was associated with higher mental QOL (OR = 2.06, 95% CI 1.40–3.02) and physical QOL (OR = 1.69, 95% CI 1.14–2.49). Greater lower limb pain was associated with lower mental QOL (OR = 0.43, 95% CI 0.24–0.76), and greater right knee pain was associated with lower physical QOL (OR = 0.46, 95% CI 0.26–0.80). These associations were primarily observed among participants with low MIL. MIL was positively associated with both mental and physical QOL. The findings suggest that MIL may function as a protective psychological resource that buffers the impact of chronic pain, highlighting the potential value of meaning-centered approaches in geriatric pain management.