The association of activity and participation with quality of life between Japanese older adults living in rural and urban areas

Quality of life (QOL) is an important health outcome of the aged population, and it is determined by many factors. Evidence shows that the place where older people live is associated with their health and QOL; however, the environmental factors of QOL have not been clearly investigated. Therefore, the purpose of our study was to verify the difference in QOL between Japanese elderly people living in rural and urban areas and the role of activity and participation routine in their QOL. Participants were 830 community-dwelling older adults recruited in a municipal college in an urban area (n = 550, age = 68.5 ± 4.3 years) and in a health center in a rural area (n = 280, age = 69.8 ± 7.8 years), both in Japan. QOL was assessed by WHOQOL-BREF and WHOQOL-OLD, both developed by the World Health Organization. The occupational routine was measured by a questionnaire concerning frequency of engagement in several activities. Variables were compared by t test, Chi-square test and the Mann–Whitney U test. Additionally, multiple regression analysis was used to verify the relation between QOL and occupational routine. Participants living in the urban area had higher QOL scores than those living in the rural area (BREF urban = 3.68 ± 0.42 vs. rural = 3.43 ± 0.40, p < 0.01; OLD urban = 3.56 ± 0.42 vs. rural = 3.46 ± 0.41, p < 0.05). In WHOQOL-BREF, physical, work, and reading and writing activities were positively related with QOL in the urban group; and physical and art activities in rural participants. In WHOQOL-OLD, no difference was found; however, social activity was important for both groups. Our findings showed that QOL states and related occupational routine differed between urban and rural areas. Urban participants had better QOL scores than rural ones and (among the activities) physical, work, and reading and writing activities were associated with their QOL. For the rural group, physical and art activities were important. Furthermore, social activity was an important activity for QOL in both populations.