Inter-Connections Among Multidimensional Domains of Quality of Life in Middle-Aged and Older Adults in Hong Kong: A Network Analysis

Key findings from this study

• The study found that quality of life dimensions show deeply intertwined connections at the item level rather than operating as separate factors.
• The researchers identified Work capacity, Satisfaction with self, and Concentration as key bridge nodes that integrate multiple quality of life pathways.
• The study found that disorientation as a spiritual factor negatively correlates with life meaning, affect, concentration, and sleep quality.

Overview

This network analysis examined item-level interconnections among quality of life domains in 843 middle-aged and older adults in Hong Kong. The study integrated the WHOQOL-BREF instrument with spiritual well-being measures to map complex relationships across physical, psychological, social, and environmental dimensions.

Methods and approach

Participants (mean age 75.7 years) completed the WHOQOL-BREF and spiritual well-being assessments between 2018 and 2020. Network analysis identified central and bridge nodes within the quality of life framework. The researchers examined whether network structure varied by age group and sensory impairment status.

Results

The WHOQOL-BREF did not demonstrate a clear four-factor structure in this sample. Network analysis revealed tightly intertwined pathways across domains, particularly between physical and psychological quality of life. Work capacity, Satisfaction with self, and Concentration functioned as bridge nodes integrating multiple network pathways.

Spiritual well-being demonstrated a distinct three-factor structure encompassing tranquility, disorientation, and resilience. Disorientation showed negative partial correlations with Life meaning, Affect, Concentration, and Sleep. Tranquility linked positively with Affect; Resilience linked positively with Transport. Network structure and global strength remained stable across age groups and sensory impairment categories.

Implications

The study demonstrates that quality of life dimensions operate as an integrated system rather than discrete domains. The prominence of bridge nodes suggests that targeting work capacity, self-satisfaction, and concentration may generate cascading improvements across multiple quality of life aspects. This systems-level perspective supports intervention strategies addressing mind-body connections holistically.

Incorporating spiritual dimensions into quality of life assessment frameworks enhances understanding of well-being in older populations. The stability of network relationships across demographic subgroups indicates that integrated approaches may benefit diverse older adult populations. Future interventions might prioritize bridge node domains to maximize systemic improvements in overall well-being.

Scope and limitations

This summary is based on the study abstract and available metadata. It does not include a full analysis of the complete paper, supplementary materials, or underlying datasets unless explicitly stated. Findings should be interpreted in the context of the original publication.