Open Access Open Badges Research article

Health-related quality of life and long-term care needs among elderly individuals living alone: a cross-sectional study in rural areas of Shaanxi Province, China

Ning Liu1, Lingxia Zeng2, Zhe Li3 and Jue Wang1*

Author affiliations

1 The Key Laboratory of Biomedical Information Engineering of Ministry of Education, and Research Center of Rehabilitation Science and Technology, School of Life Science and Technology, Xi’an Jiaotong University; National Engineering Research Center of Health Care and Medical Devices; Xi’an Jiaotong University Branch, Xi’an, , 710049, P.R. China

2 Department of Public Health, College of Medicine, Xi’an Jiaotong University, Xi’an, Shaanxi Province, 710061, P.R. China

3 Shaanxi Branch of China Telecom, Xi’an, Shaanxi Province, 710065, P.R. China

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Citation and License

BMC Public Health 2013, 13:313  doi:10.1186/1471-2458-13-313

Published: 8 April 2013



The number of elderly individuals living alone is rising, especially in rural areas of China, and their health-related quality of life (HRQoL) is an increasing public health concern. However, little is known about factors that influence HRQoL and the need for long-term care services. The aim of the study was to identify these factors and the long-term care requirements of persons aged 60 and older living alone in rural areas of Shaanxi Province, China.


The study included 424 older subjects, selected by stratified random sampling. Logistic regression adjusted for age was conducted to analyze factors influencing HRQoL and the need for long-term care services. Pearson correlative analysis was conducted to assess the correlation between HRQoL score and long-term care needs.


HRQoL among elderly subjects living alone declined with age in both males and females. The main diseases influencing HRQoL among the elderly were hypertension, cardiac disease, chronic bronchitis, neurological disease and cancer. Cataract disease was the most important factor related to HRQoL. This was followed by long-term care needs, living conditions, economic status, Cardiovascular disease, osteoporosis and age. Factors affecting long-term care needs were economic status, education level, alcohol intake, living conditions, general health and age. HRQoL and long-term care needs among this elderly population were significantly correlated (r=−0.204, p<0.01).


For elderly persons living alone, factors such as chronic disease, lower income level and living in a rural area may limit their ability to form social relationships. Reducing the level of loneliness, with better care and support, may be helpful in improving their HRQoL. There is a need for an overall improvement in the planning, provision and financing of long-term care and psychogeriatric services for elderly individuals living alone in China.

Health-related quality of life; SF-36; Long-term care; Elderly subjects living alone