Association Between Study-Specific ADL and Perceived Quality-of-Life Scores Among Older Adults in Indonesian Residential Care: A Cross-Sectional Analysis
ADL and Quality of Life in Older Adults
Keywords:
activities of daily living, exploratory analysis, measurement uncertainty, older adults, perceived quality of life, residential careAbstract
Background: Functional status and perceived quality of life are related but non-equivalent outcomes in residential care. This study relied on retrospective score records from one facility; the locally assembled measures had incomplete development and scoring documentation. The analysis therefore concerns recorded study-specific composites rather than validated ADL and quality-of-life constructs.
Methods: This exploratory cross-sectional secondary analysis included 50 communicative residents from one Indonesian social-care facility. Archived ADL materials contained an unresolved nine-versus-ten-item inconsistency. Three recorded ADL totals of 19 were top-coded to the documented analytic maximum of 18. The outcome was a recorded nine-item perceived quality-of-life composite (9-45). Spearman correlation with a 20,000-resample bootstrap confidence interval was primary; Kendall tau-b, an age- and sex-adjusted HC3 linear model, and threshold-based profiles were exploratory analyses.
Results: Median corrected ADL and perceived quality-of-life scores were 17 (IQR 13-18) and 40 (IQR 32-43). Corrected totals were modestly associated (Spearman rho=0.332, 95% bootstrap CI 0.015-0.599; P=0.019). Estimates were similar using Kendall tau-b (0.256). The adjusted associational mean difference was 0.874 quality-of-life points per one-point higher corrected ADL score (95% CI 0.344-1.404; P=0.001). The threshold-defined mismatch was 28%.
Conclusion: The recorded composites showed a modest positive association, but the single-facility sample, upper-end score concentration, unresolved scoring provenance, and threshold sensitivity limit clinical and population interpretation. The 28% mismatch is descriptive rather than a prevalence estimate. Validated functional screening should be paired with direct, validated assessment of resident-reported well-being.
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