Quality of Life of Older People: Intra-urban Disparities among Three Neighbourhoods of Koumassi (Côte d'Ivoire)

Background: Quality of life among older people is influenced by sociodemographic characteristics, social relationships and residential environments. In rapidly urbanising sub-Saharan African cities, differences in neighbourhood conditions may contribute to disparities in well-being among older residents. However, evidence on intra-urban variations in quality of life remains limited, particularly in Francophone West Africa. Aims: To compare the quality of life (QoL) of older people in three Koumassi neighbourhoods with contrasting residential profiles and identify associated sociodemographic characteristics. Study Design: A descriptive and analytical cross-sectional study. Place and Duration of Study: Campement, Sicogi and Sopim neighbourhoods of Koumassi, Abidjan Autonomous District, Côte d'Ivoire, during November and December 2022. Methodology: A total of 196 people aged 65 years and over were recruited through purposive sampling; neighbourhood of residence was documented for 193 (76 Campement, 59 Sicogi, 58 Sopim). QoL was assessed using an 18-item adaptation of the World Health Organization Quality of Life brief assessment (WHOQOL-BREF), covering four domains (physical health, psychological, social relationships, environment) plus a single global QoL item, all transformed to a 0–100 scale. Analyses combined chi-square tests, non-parametric comparisons, principal component analysis (PCA) and multiple linear regression, with a Bonferroni sensitivity correction. Results: The sample was 54.9% female and 53.9% aged 65–70 years. Profiles differed markedly across neighbourhoods by marital status (P < .001) and sex (P = .002). The composite QoL score varied strongly by neighbourhood (Campement: 57.7 ± 6.2; Sicogi: 62.8 ± 6.7; Sopim: 67.5 ± 4.3; P < .001), Sopim scoring highest on the physical health, psychological and environmental domains. PCA extracted two components explaining 81.7% of total variance: the first (58.1%) loaded on the physical, psychological and environmental domains, the second (23.6%) on social relationships alone. Neighbourhood remained the strongest correlate of the composite score in the multivariable analysis, but it was almost completely confounded with marital status in this purposive sample (variance inflation factors up to 5.61), so their respective effects cannot be disentangled. Conclusion: QoL among older people in Koumassi showed pronounced intra-urban disparities linked to residential setting rather than age. These exploratory findings support neighbourhood-differentiated social gerontology interventions and call for replication using stratified sampling.