This study aimed to identify factors influencing life satisfaction with a focus on met or unmet care needs for living in older adults with disabilities.
This study analyzed the data of 2,220 disabled older people, using the fourth wave of the Disability Life Dynamic Panel Survey from the Korea Disables people’s Development Institute. We used descriptive statistics, t-tests, ANOVA, Pearson’s correlation coefficient, and multiple regression for our analyses.
Social factors, employment status, and levels of depression influenced the life satisfaction of disabled older adults. Various social factors, including meeting social/leisure activity care need, having a higher number of close people, more frequent meetings with them, and engaging in social activities, significantly influenced better life satisfaction. This regression model explained 26% of the variance in life satisfaction.
This study highlights the influence of social factors, particularly the addressed social participation care needs, on the life satisfaction of older people with disabilities. Therefore, enhancing social networks and community-based programs is essential to help individuals sustain their social connections. Additionally, providing care to those who face challenges in participating will enable their ongoing engagement in social activities.
As society ages, the prevalence of older adults with disabilities is steadily increasing. The Disability Survey by the Ministry of Health and Welfare indicated that those aged 65 and older represent 54.3% of the disabled population. This represents the highest percentage among all age groups with disabilities. This signifies an increase from 49.9% in 2020, underscoring the tendency to age within the disabled demographic [
A complex interaction of physical, social, and emotional factors influences life satisfaction in older adults. Previous studies have shown that various elements, such as social support, depression, physical health, and the ability to engage in activities of daily living (ADL), greatly influence life satisfaction in older adults [
The deterioration of daily living abilities in older adults increases dependency on others, which negatively influences both physical function and social connections. This frequently results in social isolation, depression, and a subsequent decline in quality of life [
Social factors are another critical determinant of life satisfaction in later life [
This study is a secondary analysis using the 4th wave of Disability Life Dynamic Panel Survey [
The Korea Disabled People’s Development Institute has performed the Disability Life Dynamic Panel Survey annually since 2018. It involves individuals who registered their disabilities with the Ministry of Health and Welfare from 2015 to 2017, along with their household members. Trained investigators conducted one-on-one, face-to-face interviews. In 2018, a panel of 6,121 participants was chosen to complete the first wave of the survey. Data can be acquired by submitting a request via the Disability Statistics Data Portal.
The participants in this study were 2,220 older adults aged 60 years and above who participated in the 4th survey conducted in 2021. This analysis included data that had no missing values for the key variables. This study was conducted with the approval from the Institutional Review Board (IRB) at the Gachon University (IRB No. 1044396-202410-HR-182-01).
The overall life satisfaction was measured using a question with a 10-point Likert scale, ranging from “very dissatisfied=1” to “very satisfied=10.”
Met care needs for living were assessed as follows.
The presence of a caregiver was assessed using a question asking, “Who assists with your living?” In this study, we classified those who answered “none” as “no caregiver,” while those who selected a spouse, parents, child, or others as “has caregiver.”
Met care needs for living were measured using questions about the degree of care needs required and the actual level of care received in living activities (such as washing and personal hygiene, mobility, eating, dressing, healthcare, and social/leisure activity participation). The degree of assistance required was measured with the question, “Please indicate the types and levels of living activities where you need assistance,” using a 4-point Likert scale from “no assistance needed=1” to “completely need assistance=4.” The degree of actual assistance received was measured with the question, “What areas do you mainly receive help with?” using a Likert scale from “no assistance received=1” to “completely assisted=4.” This study reclassified the items of washing and personal hygiene, mobility, eating, and dressing as ADL.
Met care needs for living were created by calculating the difference between the two questions (the degree of care needs required and the actual level of care received), categorizing as either “met” or “unmet.” If the difference between the two questions was 0 or less, it was classified as “met,” and if the difference was greater than 0, it was classified as “unmet.” For ADL, if any of the four sub-items were unmet, it was classified as “unmet.”
General characteristics include demographic and social factors. Demographic factors were measured using variables such as age, gender, education level, severity of disability, employment status, and depression. Depression was assessed using the Center for Epidemiological Studies-Depression Scale-11. This scale consists of 11 items rated on a 4-point Likert scale from “rarely or none=1” to “most or all of the time=4.” The total score is calculated by summing the responses to the 11 items, with higher scores indicating greater levels of depression [
The general characteristics and status of care needs for living were analyzed using descriptive statistics. The characteristics of life satisfaction by general characteristics were identified using t-test and ANOVA. The relationships between depression, the number of close people, and life satisfaction were analyzed using Pearson’s correlation coefficient. Multiple regression was used to identify factors influencing life satisfaction.
Among the participants, 54.3% were man, and 45.7% were woman. The highest proportion of participants (45.9%) were high school graduates or above. Approximately 78% of participants stated that they were not working at the moment. The average score of depression was 18.99, with 57.6% categorized as having mild disabilities. Regarding social factors, the average number of close persons was 2.06, and the most common frequency of meeting others was 1–2 times per year (33.7%). A total of 62.6% of participants responded that they did not engage in any social activities (
Approximately 66.8% of the participants reported having a caregiver. The prevalence of those who met ADL care needs was 62.1%. For health care and social/leisure activity participation, 83.8% and 79.2% of participants reported receiving sufficient care, respectively (
The average score of life satisfaction was 5.32 (
As for met care needs for living, having a caregiver (t=–4.10,
Multiple regression was used to identify factors influencing life satisfaction. This regression model explained 26% of the variance in quality of life. The variance inflation factor values ranged from 1.08 to 3.48, all of which were below 10. This indicates that no multicollinearity problems exist among the predictor variables. The multiple regression analysis revealed that meeting social/leisure activity care needs led to higher life satisfaction (ß=0.04,
This study was conducted to assess the met care needs for living and the factors affecting the life satisfaction of older individuals with disabilities in the community. This study revealed that the life satisfaction of older adults with disabilities was 5.32 out of 10, indicating a moderate level. This result is similar to previous studies on the life satisfaction of older individuals with disabilities, which reported a score of 3.22 out of 5 [
Various factors, such as social support, depression, physical health, and the ability to perform ADL, influence life satisfaction [
In this study, the life satisfaction of older adults with disabilities also showed significant differences based on social factors, employment status, and depression. Specifically, the study revealed that various social factors significantly influence the life satisfaction of disabled older adults. An increased number of close friends, neighbors, or acquaintances, along with regular interactions and engagement in social activities, correlates positively with life satisfaction. This finding is consistent with previous studies, which indicated that life satisfaction rises with the frequency of contact with friends, family, and neighbors [
Furthermore, this study’s findings suggest a close relationship between met care needs for living are and overall life satisfaction. A significant difference in life satisfaction existed based on whether care needs for living were met or unmet. Participants who met their care needs for social/leisure activities, ADL, and healthcare demonstrated higher life satisfaction compared to those who did not. The availability of support for social/leisure participation was recognized as an important factor influencing life satisfaction.
The percentage of participants who needed care to participate in social or leisure activities was higher than those who actually received care. The rate of unmet care needs for participation in social/leisure activity was also high. There are few studies addressing the issue of met care needs. The findings were similar to the 27% unmet needs for social activities reported among community-dwelling older adults with dementia [
As previously discussed, social participation plays a significant role in life satisfaction [
Depression is an important influencing factor in this study. This shows similar results to previous studies, indicating that depression has an influence on life satisfaction [
This study has several limitations. First, it did not consider the type of disability. Future research should examine the differences based on disability types and severity levels to identify factors influencing life satisfaction. Secondly, this study solely examined the existence or non-existence of a caregiver because it relied on secondary data. The quality of the relationship between caregivers and older adults may influence their life satisfaction, necessitating further research.
Additionally, we used secondary data in this study, categorizing the age in 10-year intervals. In this study, we defined older adults as over 60 years rather than over 65 years old. Comparing the findings of this study with those of other research presents a challenge. However, this study holds significance as it evaluates how the satisfaction of older adults with disabilities is influenced by their met care needs. Based on this study, the following recommendations are made: Firstly, we need to improve the quality of care for individuals. It is necessary to provide tailored support that reflects individual needs, going beyond physical assistance. In particular, care provision should focus not only on ADL but also on healthcare and social/leisure activity participation. Second, it is important to create an environment that fosters social relationships. We should activate community-based programs to prevent social isolation among older individuals with disabilities and strengthen their social networks. Furthermore, we should provide care to individuals who struggle with participation, ensuring their continued engagement in social activities for disabled older people.
Dr. Young KO had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. All authors reviewed this manuscript and agreed to individual contributions.
Conceptualization: all authors. Formal analysis: SYH. Writing–original draft: YK. Writing–review & editing: all authors.
No existing or potential conflict of interest relevant to this article was reported.
None.
Public data was used, and the URL is
General characteristics (N=2,220)
| Category | Subcategory | Value |
|---|---|---|
| Age (yr) | 60–69 | 1,795 (80.9) |
| ≥70 | 425 (19.1) | |
| Gender | Man | 1,206 (54.3) |
| Woman | 1,014 (45.7) | |
| Education level | ≤Elementary | 661 (29.8) |
| Middle | 540 (24.3) | |
| ≥High | 1,019 (45.9) | |
| Employment status | Yes | 481 (21.7) |
| No | 1,739 (78.3) | |
| Depression (score range, 11–44) | 18.99±6.25 | |
| Disability severity | Mild | 1,278 (57.6) |
| Severe | 942 (42.4) | |
| Number of close people | 2.06±2.18 | |
| Frequency of meetings with close people | Nearly every day | 113 (5.1) |
| 1–2 times a week | 406 (18.3) | |
| 1–2 times a month | 618 (27.8) | |
| 1–2 times every 3 months | 335 (15.1) | |
| 1–2 times or less per year | 748 (33.7) | |
| Social activities | Yes | 831 (37.4) |
| No | 1,389 (62.6) | |
| Caregivers | Yes | 1,482 (66.8) |
| No | 738 (33.2) | |
| Met care needs for activities of daily living | Met | 1,379 (62.1) |
| Unmet | 841 (37.9) | |
| Met care needs for healthcare | Met | 1,861 (83.8) |
| Unmet | 359 (16.2) | |
| Met care needs for social/leisure activity participation | Met | 1,758 (79.2) |
| Unmet | 462 (20.8) | |
| Life satisfaction (score range, 1–10) | 5.32±1.86 |
Values are presented as number (%) or mean±standard deviation.
Care needs for living (N=2,220)
| Washing and personal hygiene | Mobility | Eating | Dressing | Healthcare | Social/leisure activity participation | |
|---|---|---|---|---|---|---|
| No care received | 1,437 (64.7) | 1,310 (59.0) | 1,093 (49.2) | 1,524 (68.6) | 1,376 (62.0) | 1,246 (56.1) |
| Rarely receive care | 360 (16.2) | 274 (12.3) | 249 (11.2) | 351 (15.8) | 371 (16.7) | 283 (12.7) |
| Some care received | 268 (12.1) | 386 (17.4) | 609 (27.4) | 242 (10.9) | 324 (14.6) | 437 (19.7) |
| Completely receive care | 155 (7.0) | 250 (11.3) | 269 (12.1) | 103 (4.6) | 149 (6.7) | 254 (11.4) |
| No requires care | 1,232 (55.5) | 1,064 (47.9) | 796 (35.9) | 1,351 (60.9) | 1,184 (53.3) | 1,001 (45.1) |
| Hardly requires care | 480 (21.6) | 384 (17.3) | 429 (19.3) | 491 (22.1) | 522 (23.5) | 410 (18.5) |
| Generally requires care | 326 (14.7) | 483 (21.8) | 694 (31.3) | 259 (11.7) | 355 (16.0) | 510 (23.0) |
| Completely requires care | 182 (8.2) | 289 (13.0) | 301 (13.6) | 119 (5.4) | 159 (7.2) | 299 (13.5) |
Values are presented as number (%).
Differences in life satisfaction according to the general characteristics (N=2,220)
| Category | Subcategory | Mean±SD | t or F | |
|---|---|---|---|---|
| Age (yr) | 60–69 | 5.33±1.75 | 0.89 | 0.374 |
| ≥70 | 5.24±1.92 | |||
| Gender | Man | 5.40±1.90 | 2.19 | 0.029 |
| Woman | 5.22±1.80 | |||
| Education level | ≤Elementarya | 5.08±1.77 | 12.73 | <0.001 |
| Middleb | 5.21±1.79 | a=b≤c | ||
| ≥Highc | 5.53±1.93 | |||
| Employment status | Yes | 6.20±1.54 | 12.21 | <0.001 |
| No | 5.07±1.86 | |||
| Disability severity | Mild | 5.61±1.75 | 8.76 | <0.001 |
| Severe | 4.92±1.92 | |||
| Frequency of meetings with close people | Nearly every daya | 6.17±2.09 | 71.25 | <0.001 |
| 1–2 times a weekb | 6.02±1.83 | a=b>c=d>e | ||
| 1–2 times a monthc | 5.66±1.66 | |||
| 1–2 times every 3 monthsd | 5.40±1.61 | |||
| 1–2 times or less per yeare | 4.49±1.78 | |||
| Social activities | Yes | 5.94±1.72 | 12.62 | <0.001 |
| No | 4.95±1.84 | |||
| Caregivers | Yes | 5.20±1.92 | –4.10 | <0.001 |
| No | 5.54±1.71 | |||
| Met care needs for ADL | Met | 5.47±1.82 | 4.87 | <0.001 |
| Unmet | 5.07±1.89 | |||
| Met care needs for health care | Met | 5.38±1.83 | 3.48 | 0.001 |
| Unmet | 5.01±1.96 | |||
| Met care needs for social/leisure activity participation | Met | 5.42±1.86 | 5.31 | <0.001 |
| Unmet | 4.91±1.79 | |||
| post-hoc test: Duncan test |
ADL, activities of daily living; SD, standard deviation.
Correlation among depression, the number of close persons, and life satisfaction (N=2,220)
| Variable | r ( |
||
|---|---|---|---|
| Life satisfaction | Depression | Number of close people | |
| Life satisfaction | 1 | ||
| Depression | –0.50 (<0.001) | 1 | |
| Number of close people | 0.30 (<0.001) | –0.28 (<0.001) | 1 |
Factors influencing life satisfaction (N=2,220)
| Variable (reference) | Unstandardized coefficients | Standardized coefficients | t | ||
|---|---|---|---|---|---|
| B | SE | ß | |||
| Gender (woman) | 0.06 | 0.06 | 0.02 | 0.98 | 0.329 |
| Education level: middle (≤elementary) | –0.13 | 0.10 | –0.03 | –1.37 | 0.172 |
| Education level: ≥high (≤elementary) | 0.14 | 0.08 | 0.04 | 1.69 | 0.091 |
| Employment status (no) | 0.47 | 0.07 | 0.12 | 7.12 | <0.001 |
| Depression | –0.12 | 0.01 | –0.37 | –22.65 | <0.001 |
| Disability severity (severe) | 0.19 | 0.06 | 0.05 | 3.07 | 0.002 |
| Frequency of meetings: 1–2 times every 3 months (1–2 times or less per year) | 0.18 | 0.12 | 0.04 | 1.57 | 0.116 |
| Frequency of meetings: 1–2 times a month (1–2 times or less per year) | 0.30 | 0.11 | 0.08 | 2.76 | 0.006 |
| Frequency of meetings: 1–2 times a week (1–2 times or less per year) | 0.68 | 0.11 | 0.16 | 6.03 | <0.001 |
| Frequency of meetings: nearly every day (1–2 times or less per year) | 1.09 | 0.15 | 0.15 | 7.40 | <0.001 |
| Social activities (no) | 0.34 | 0.06 | 0.09 | 5.72 | <0.001 |
| Number of close people | 0.06 | 0.01 | 0.07 | 4.24 | <0.001 |
| Caregiver (yes) | –0.21 | 0.06 | –0.06 | –3.43 | 0.001 |
| Met care need: ADL (unmet) | 0.01 | 0.07 | 0.01 | 0.22 | 0.829 |
| Met care need: healthcare (unmet) | –0.05 | 0.09 | –0.01 | –0.49 | 0.623 |
| Met care need: social/leisure activity participation (unmet) | 0.19 | 0.08 | 0.04 | 2.38 | 0.018 |
| R2=0.27, adjusted R2=0.26, F ( |
|||||
ADL, activities of daily living; SE, standard error.