Lifestyle behaviors and health-related quality of life: a comparative analysis of older and non-older adults

To examine and compare the associations between lifestyle behaviors and health-related quality of life (HRQoL) among older and non-older adults. A cross-sectional survey was conducted from Feb. 1 to 18, 2023 in East, Central, West, and Northeast regions of China. HRQoL was assessed by five-level EuroQol-5D scale and visual analogue scale (VAS). Demographic information and lifestyle behaviors were compared between non-older adults (aged < 60 years) and older adults (aged ≥ 60 years). Tobit regressions and generalized linear model were employed to evaluate the associations of lifestyle behaviors with utility index (-0.391,1.000) and VAS score (0,100). A total of 5,780 adults were included in the analysis (21.33% older adults, median age: 66.00 years; 78.67% non-older adults, median age: 40.00 years). The mean utility index and VAS score were 0.953 and 76.22 among older adults, and 0.980 and 82.08 among non-older adults, respectively (all P < 0.05). The median lifestyle score was 33.00 for older adults and 34.00 for non-older adults (P < 0.05). Higher lifestyle scores were associated with higher HRQoL in both age groups. Engaging in physical activity, practicing psychological decompression, maintaining work and study routines, and undergoing regular physical examinations were significantly associated with the utility index and VAS score in both groups (all P < 0.05). Smoking status showed a stronger association with HRQoL among older adults, whereas maintaining a reasonable weight, limiting unhealthy diets, obtaining sufficient sleep, and maintaining social relationships were significantly associated with HRQoL among non-older adults (all P < 0.05). Older adults reported lower HRQoL and lifestyle scores than non-older adults. Although higher lifestyle scores were associated with better HRQoL in both groups, the patterns of associations differed by age, with smoking-related factors more prominent among older adults and diet, sleep, weight, and social relationships more relevant among non-older adults. These findings highlight age-specific patterns in lifestyle-HRQoL associations.