Today's world policies are based on dynamic aging. With the increase in the elder population, in addition to increasing the QoL, attention should be paid to its relationship with ADL and the distinction between emotional loneliness, social loneliness, and other influencing factors. Thus, this paper aims at identifying factors affecting the QoL of the older adults by determining the relationship between these factors.
In this paper, emotional loneliness was found as a negative influencing factor and social loneliness was found as a positive influencing factor on the psychological component of QoL. The feeling of loneliness is a factor affecting the QoL, the feeling of loneliness is associated with illness, widowhood, and reduced social support from the family or social isolation (32,33). Elderly people live alone more than others, and some tend to be less involved in society, which affects their mental state and causes more social isolation. As a result, almost a third of them often feel lonely (34,35). The COVID-19 pandemic and the unprecedented impact it had worldwide, especially on the older adults (36), along with the risk of contracting a fatal disease led to restrictions in countries, which itself had a great impact on the mental performance of the older adults (37). During the pandemic, more attention was given to the care of the older adults, and to reduce social isolation, which was due to the fading presence of the older adults in the community, the use of creative virtual programs about social services and other online programs also led to increasing the QoL of the older adults (38,39), (40). Studies have shown that the prevalence of feeling lonely has increased in 2022 compared to previous years in elderly people, while the feeling of social loneliness has decreased and the feeling of emotional loneliness has increased during this period (41). The increase in the feeling of emotional loneliness due to the decrease in family relationships and the anxiety of contracting the disease has harmed the older adults QoL (42–44). Therefore, it seems that with the end of the spread of the covid-19 pandemic and the establishment of family relationships like before, the feeling of loneliness in different areas will undergo tremendous changes, because it is expected that in addition to the previous and traditional relationships that the older adults had with the society, the spread of this pandemic allowed them to make a significant leap in the field of technology and virtual and online communication.
Age is considered one of the influencing factors on the older adults QoL. So seniors over 70 years of age had lower scores in mental and physical components of QoL compared to younger seniors. With increasing age in disabled elderly people and sometimes normal elderly people, movement limitations and dependence on others in doing daily tasks increases, and this factor harms a person's feeling towards himself and causes a decrease in the QoL. Ageism and having a negative view of the older adults during the spread of the Covid-19 virus was one of the issues that caused a decrease in the scores of the psychological and physical components of the QoL (45). Meanwhile, the majority of the news and reports attributed the death rate to the age of people, regardless of the diseases and physical conditions of the person, while if we had a closer look at the issue, we would realize that regardless of age, individuals suffering from several diseases, subsequently, had the high mortality possibility, and not just because the person was old.
Marital status was also found to be another influencing factor on the psychological and physical components of QoL. Thus, compared to married elderly people, single elderly people had a higher mental component score of QoL, but in contrast, they had a lower physical component score. During the Covid-19 pandemic, married people had more death anxiety than losing each other, and this reduced their QoL (46). In addition, the prevalence of depression among married people was higher during this period (47). Also, single elderly people had a higher QoL due to the connection with their network of friends (48). It was observed that even if one of the family members did not follow the protocols or took lots of trips, people with close relationships and especially in cases where the person was among the vulnerable groups, contacted them, in addition to having close friends who could spend more time together. Elderly people who live alone do not necessarily have a lower psychological component than people who live with someone else (49).
ADL was found to be an influential factor in PSC. Thus, ADL-dependent elderly people had 8 times lower scores in the physical domain of QoL compared to ADL-independent elderly people. Dependence on ADLreduces the QoL in the older adults (50,51). On the other hand, elderly people who are independent in using life tools have a high QoL, and people who are dependent in terms of using life tools have a low QoL (52). During the epidemic, the older adults were advised to quarantine at home, and this led to the suspension of social activities and the closure of the favorite destinations of the older adults, such as parks, restaurants, sports clubs, and as a result, the facilities of the older adults for social interaction, participation in daily activities decreased and caused the physical component to decrease even more in the older adults.
(53–55 Unlike the younger age groups with physical activity as their daily necessity, which have many effects on various aspects of their health, especially their physical health, this demographic group, by performing physical activity, especially if a combination of Aerobic and strength activities and sports can improve most of their health problems, or from another point of view, we see that one of the criteria for successful aging is physical activity and independent performance of daily life activities.