Association between transportation independence and multidimensional quality of life of older adults

Background
Malaysia is experiencing a demographic shift characterized by low fertility rates and increased life expectancy. Age-related decline in physical ability raises concerns about the quality of life (QoL) and well-being of older adults. In this study, we aimed to examine the association between transportation independence and quality of life among older adults in Malaysia.

Methods
A cross-sectional study was conducted with 100 older adults aged 60 years and above (mean ± SD: 68.4 ± 5.3). Face-to-face interviews assessed participants’ biopsychosocial status and transportation independence patterns. Environmental characteristics were obtained from the National Geospatial Centre (NGC). Binary logistic regression was performed to examine the association between transportation independence and QoL. Models were adjusted for biological factors (age, sex, comorbidities), physical factors (frailty), psychological factors (depression), and environmental factors (density of places of worship).

Results
In the unadjusted analysis, participants who were independent in transportation were more likely to report better social relationship domain of quality of life, with 4.36 times higher odds than those who were not independent (95% CI 1.21–15.75, p = 0.025). After adjusting for potential confounding factors, transportation independence remained significantly associated with higher overall quality of life (Adj OR = 4.85, 95% CI 1.06–22.14) and with improvements across multiple domains: physical health (Adj OR = 2.60, 95% CI 1.81–37.49), psychological health (Adj OR = 5.79, 95% CI 1.03–32.67), and social relationships (Adj OR = 10.41, 95% CI 2.23–48.77).

Conclusion
Transportation independence plays a critical role in determining multidomain quality of life among older adults, even when accounting for biological, psychological, and environmental factors. These findings highlight the importance of accessible transportation in promoting well-being in ageing populations.