Associations of Mobility, Physical Activity, and Work Ability with Quality of Life among Hemodialysis Patients in Coastal and Wetland Communities: A Cross-Sectional Study

Abstract Background Patients undergoing hemodialysis experience various functional limitations that can reduce their quality of life. However, most studies still focus on the clinical aspects of the disease, while the contributions of functional capacity, including mobility, physical activity, and work ability, remain incompletely understood, particularly among populations living in geographically distinct settings such as coastal and wetland communities. This study aimed to analyze the independent associations of mobility, physical activity, and work ability with quality of life among hemodialysis patients living in coastal and wetland communities in Riau Province, Indonesia. Methods This cross-sectional study included 272 patients undergoing hemodialysis at three hemodialysis centers in Riau Province, Indonesia, from June to August 2026. Quality of life was measured using the Kidney Disease Quality of Life Short Form (KDQOL-SF); mobility was assessed using the Mobility Domain of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0); physical activity was assessed using the International Physical Activity Questionnaire-Short Form (IPAQ-SF); and work ability was assessed using the Work Ability Index (WAI). Multivariable linear regression analysis was performed to evaluate the independent associations of these functional variables with quality-of-life domains (KDCS, PCS, and MCS) after adjusting for demographic and clinical factors. Results WAI showed consistent, independent associations with all quality-of-life domains. WAI was positively associated with KDCS (β = 0.470; p < 0.001), PCS (β = 0.202; p = 0.002), and MCS (β = 0.406; p < 0.001). Higher WHODAS Mobility Domain scores were negatively associated with KDCS (β = -0.380; p < 0.001) and PCS (β = -0.421; p < 0.001), but were not significantly associated with MCS. Physical activity showed no independent association with any quality-of-life domain after adjustment. The regression models explained 44.5% of the variance in KDCS, 36.2% of the variance in PCS, and 20.5% of the variance in MCS. Conclusion Work ability and mobility were independently associated with quality of life among hemodialysis patients in coastal and wetland communities in Riau Province. These findings underscore the importance of a function-centered care approach that incorporates functional capacity assessment and rehabilitation strategies while considering patients’ individual conditions and environmental contexts.