VOJNOSANITETSKI PREGLED Page 1
UDC: 613.98:616-058
ORIGINAL ARTICLE DOI: 10.2298/VSP140831107U
Quality of life of the elderly in urban and rural areas in Serbia
Kvalitet života starih u urbanoj i ruralnoj sredini u Srbiji
Jadranka Urošević*, Gordana Odović†, Dragan Rapaić†, Mladen Davidović‡,
Sanja Trgovčević§, Verica Milovanović||
*College of Health Studies, Ćuprija, Serbia; †Faculty for Special Education and
Rehabilitation, University of Belgrade, Serbia; ‡Faculty of Medicine, University of
Belgrade, Belgrade, Serbia; §Faculty of Political Sciences, University of Belgrade,
Belgrade, Serbia; ||Military Medical Academy, Belgrade, Serbia
Abstract Apstrakt
Background/Aim. The number of elderly people in the Uvod/Cilj. Broj starih osoba u svetu i Srbiji raste, a činje-
world is growing, in Serbia as well. Serbia is already among the nica je i da se Srbija već nalazi među deset zemalja sveta sa
top ten countries with the oldest population, it is the fact. najstarijim stanovništvom. Proces starenja na različite na-
Aging influ- ences the quality of life in different ways. The čine utiče na kvalitet života. Cilj rada bio je da se proceni
aim of this study was to assess the health-related quality of kvalitet života u vezi sa zdravljem starih u urbanoj i rural-
life of the elderly in urban and rural areas in Serbia. noj sredini u Srbiji. Metode. Istraživanje je obuhvatilo 100
Methods. The study included 100 elderly people aged 65 starih osoba od 65 godina i više, u urbanoj i ruralnoj
years and above in urban and rural areas in Serbia. The next sredi- ni. Korišćeni upitnici bili su sociodemografski
questionnaires were used: a socio- demographic questionnaire upitnik i srpska verzija standardizovanog evropskog upitnika
and a Serbian version of standard- ized European Euro-QoL Euro- QoL (EQ-5D-3L), kao bazični indeks za procenu i
questionnaire (EQ-5D-3L), as a ba- sic index for the opis kvaliteta života. Rezultati. U strukturi ispitanika
assessment and description of the quality of life. Results. In prema ostvarivanju socijalnih kontakata (p = 0,012), životu
the structure of the respondents, according to the achieved ispi- tanika sa članovima porodice (p = 0,009) i
social contacts (p = 0.012), the life of those with family zdravstvenom stanju (p = 0,000), u odnosu na mesto
members (p = 0.009), and health status (p = 0.000), in stanovanja, utvrđe- na je statistički značajna razlika.
relation to the place of residence there was a statistically Nađena je značajna razlika (p = 0,040), sa dominacijom
signifi- cant difference. There was a significant difference (p loših ocena, za usamljenost unutar ruralne populacije.
= 0.040), predominantly poor score for anxiety/depression Kod ispitanika koji žive u rural- noj sredini utvrđena je
within the rural population. The average value of quality of statistički značajna pozitivna pove- zanost između
life in urban and rural areas was not statistically significant usamljenosti i godina života, materijalnog stanja, bračnog
(p = 0.720). For those living in rural areas there was a statusa, života sa članovima domaćinstva i ostvarivanja
statistically significant positive correlation between socijalnih kontakata, dok je negativna pove- zanost uočena
anxiety/depression and age, wealth status, marital status, između usamljenosti i obrazovanja. Zaklju- čak. Na
living with family members and achieving social contacts, osnovu podataka ove studije možemo reći da su
while a negative correlation was ob- served between usamljenije stare osobe u ruralnoj sredini. Rezultati ovog
anxiety/depression and education. Conclu- sion. On the istraživanja pokazuju da se percepcija anksioznos-
basis of the data of our study, we can say that the presence of ti/depresije kod starih u ruralnoj sredini povećava poras-
anxiety/depression among older people is greater in rural tom godina starosti i siromaštva, gubitkom bračnog druga,
than in urban areas. The results of this study show that the životom bez članova porodice, neostvarivanjem socijalnih
perception of anxiety/depression among older in rural ar- kontakata i nižim stepenom obrazovanja.
eas is bigger with the age and poverty increasing, the loss of
a spouse, life without family members, lack of achievement
of social contacts and lower education.
Ključne reči:
Key words: kvalitet života; stare osobe; stanovanje; upitnici; faktori
quality of life; aged; residence characteristics; rizika.
questionnaires; risk factors.
Correspondence to: Jadranka Urošević, College of Health Studies in Ćuprija, Lole Ribara 1/2, 35 230 Ćuprija, Serbia.
Phone: +381 64 525 90 91. E-mail:
, Page VOJNOSANITETSKI
Introduction with life. Life satisfaction refers to the evaluation of their
The World Health Organization (WHO) defines quality
of life as the perception to individuals about their own posi-
tion in life in the context of culture and value systems in
which they live, and according to their goals, expectations,
standards and interests. It is a broad concept which consists
of an individual's physical health, psychological status, mate-
rial independence, social relationships and their relationships
with important external characteristics 1.
When the concept of quality of life relates to health, i.e.
to monitor certain medical interventions, often uses the term
"health-related quality of life" (HRQoL). From the
perspective of health (or disease), quality of life refers to the
social, emo- tional and physical well-being of individuals.
Areas that con- tribute to the overall quality of life are
natural and work abil- ity, psychological status, social contact
and somatic feeling 2.
Basically the person, regardless of the ages, status, edu-
cation, religion or race, lies a unique desire to live out the life
in satisfaction. Terms related to pleasure, prosperity, fulfill-
ment, and happiness are closely related to the notion of qual-
ity of life (QL) 3. Health is one of the most important prereq-
uisites for quality of life, but not the only one. Information
on quality of life can only be obtained from a person who
only has access to their feelings and thoughts 4.
Demographic research in the world and in our country
points the rapid growth in the number of elderly in the total
population. In addition to the increase in the elderly popula-
tion this period is characterized by the extension of life ex-
pectancy, which indicates the need to develop a comprehen-
sive and well-organized social care for the elderly. Old peo-
ple meet their needs, both within their families and nearest
community, and in the institutions of health and social care.
Behavior of family members and the community has an im-
portant role in adaptation to aging 5.
Most researchers agree with the statement that in old
age there is no major change in personality traits, those that
were present in the younger years are reflected, becoming
strengthened and more prominent. When we talk about the
personality traits of the elderly, it is an interesting question
whether there are personality traits that allow the elderly a
better adaptation to the aging process and old age than oth-
ers. In addition, old age is characterized by the presence of
one or more diseases. The old are often alienated, lonely,
abandoned by their primary group. Lack of social support,
change of residence, the loss of a close person, the process of
retirement and so on occur as the crisis events 6.
In the definition of the health of the WHO is also
mental health 6, 7. Anxiety/depression is a disease of modern
times. Anxiety is a feeling of restlessness, uneasiness, fear,
and de- pression is a mood disorder in which the dominant
feelings are low mood, sadness, apathy, indifference, social
withdrawal, anxiety, and feelings of guilt and lower values,
as well.
Contemporary arguments suggest that aging is not just a
series of life crises, but growing through new lifetime oppor-
tunities and challenges. Successful and active aging involves
harmonizing its capabilities with the capabilities satisfaction
Urošević J, et al. Vojnosanit Pregl 2015; Online First September (00): 107–
UDC: 613.98:616-058
ORIGINAL ARTICLE DOI: 10.2298/VSP140831107U
Quality of life of the elderly in urban and rural areas in Serbia
Kvalitet života starih u urbanoj i ruralnoj sredini u Srbiji
Jadranka Urošević*, Gordana Odović†, Dragan Rapaić†, Mladen Davidović‡,
Sanja Trgovčević§, Verica Milovanović||
*College of Health Studies, Ćuprija, Serbia; †Faculty for Special Education and
Rehabilitation, University of Belgrade, Serbia; ‡Faculty of Medicine, University of
Belgrade, Belgrade, Serbia; §Faculty of Political Sciences, University of Belgrade,
Belgrade, Serbia; ||Military Medical Academy, Belgrade, Serbia
Abstract Apstrakt
Background/Aim. The number of elderly people in the Uvod/Cilj. Broj starih osoba u svetu i Srbiji raste, a činje-
world is growing, in Serbia as well. Serbia is already among the nica je i da se Srbija već nalazi među deset zemalja sveta sa
top ten countries with the oldest population, it is the fact. najstarijim stanovništvom. Proces starenja na različite na-
Aging influ- ences the quality of life in different ways. The čine utiče na kvalitet života. Cilj rada bio je da se proceni
aim of this study was to assess the health-related quality of kvalitet života u vezi sa zdravljem starih u urbanoj i rural-
life of the elderly in urban and rural areas in Serbia. noj sredini u Srbiji. Metode. Istraživanje je obuhvatilo 100
Methods. The study included 100 elderly people aged 65 starih osoba od 65 godina i više, u urbanoj i ruralnoj
years and above in urban and rural areas in Serbia. The next sredi- ni. Korišćeni upitnici bili su sociodemografski
questionnaires were used: a socio- demographic questionnaire upitnik i srpska verzija standardizovanog evropskog upitnika
and a Serbian version of standard- ized European Euro-QoL Euro- QoL (EQ-5D-3L), kao bazični indeks za procenu i
questionnaire (EQ-5D-3L), as a ba- sic index for the opis kvaliteta života. Rezultati. U strukturi ispitanika
assessment and description of the quality of life. Results. In prema ostvarivanju socijalnih kontakata (p = 0,012), životu
the structure of the respondents, according to the achieved ispi- tanika sa članovima porodice (p = 0,009) i
social contacts (p = 0.012), the life of those with family zdravstvenom stanju (p = 0,000), u odnosu na mesto
members (p = 0.009), and health status (p = 0.000), in stanovanja, utvrđe- na je statistički značajna razlika.
relation to the place of residence there was a statistically Nađena je značajna razlika (p = 0,040), sa dominacijom
signifi- cant difference. There was a significant difference (p loših ocena, za usamljenost unutar ruralne populacije.
= 0.040), predominantly poor score for anxiety/depression Kod ispitanika koji žive u rural- noj sredini utvrđena je
within the rural population. The average value of quality of statistički značajna pozitivna pove- zanost između
life in urban and rural areas was not statistically significant usamljenosti i godina života, materijalnog stanja, bračnog
(p = 0.720). For those living in rural areas there was a statusa, života sa članovima domaćinstva i ostvarivanja
statistically significant positive correlation between socijalnih kontakata, dok je negativna pove- zanost uočena
anxiety/depression and age, wealth status, marital status, između usamljenosti i obrazovanja. Zaklju- čak. Na
living with family members and achieving social contacts, osnovu podataka ove studije možemo reći da su
while a negative correlation was ob- served between usamljenije stare osobe u ruralnoj sredini. Rezultati ovog
anxiety/depression and education. Conclu- sion. On the istraživanja pokazuju da se percepcija anksioznos-
basis of the data of our study, we can say that the presence of ti/depresije kod starih u ruralnoj sredini povećava poras-
anxiety/depression among older people is greater in rural tom godina starosti i siromaštva, gubitkom bračnog druga,
than in urban areas. The results of this study show that the životom bez članova porodice, neostvarivanjem socijalnih
perception of anxiety/depression among older in rural ar- kontakata i nižim stepenom obrazovanja.
eas is bigger with the age and poverty increasing, the loss of
a spouse, life without family members, lack of achievement
of social contacts and lower education.
Ključne reči:
Key words: kvalitet života; stare osobe; stanovanje; upitnici; faktori
quality of life; aged; residence characteristics; rizika.
questionnaires; risk factors.
Correspondence to: Jadranka Urošević, College of Health Studies in Ćuprija, Lole Ribara 1/2, 35 230 Ćuprija, Serbia.
Phone: +381 64 525 90 91. E-mail:
, Page VOJNOSANITETSKI
Introduction with life. Life satisfaction refers to the evaluation of their
The World Health Organization (WHO) defines quality
of life as the perception to individuals about their own posi-
tion in life in the context of culture and value systems in
which they live, and according to their goals, expectations,
standards and interests. It is a broad concept which consists
of an individual's physical health, psychological status, mate-
rial independence, social relationships and their relationships
with important external characteristics 1.
When the concept of quality of life relates to health, i.e.
to monitor certain medical interventions, often uses the term
"health-related quality of life" (HRQoL). From the
perspective of health (or disease), quality of life refers to the
social, emo- tional and physical well-being of individuals.
Areas that con- tribute to the overall quality of life are
natural and work abil- ity, psychological status, social contact
and somatic feeling 2.
Basically the person, regardless of the ages, status, edu-
cation, religion or race, lies a unique desire to live out the life
in satisfaction. Terms related to pleasure, prosperity, fulfill-
ment, and happiness are closely related to the notion of qual-
ity of life (QL) 3. Health is one of the most important prereq-
uisites for quality of life, but not the only one. Information
on quality of life can only be obtained from a person who
only has access to their feelings and thoughts 4.
Demographic research in the world and in our country
points the rapid growth in the number of elderly in the total
population. In addition to the increase in the elderly popula-
tion this period is characterized by the extension of life ex-
pectancy, which indicates the need to develop a comprehen-
sive and well-organized social care for the elderly. Old peo-
ple meet their needs, both within their families and nearest
community, and in the institutions of health and social care.
Behavior of family members and the community has an im-
portant role in adaptation to aging 5.
Most researchers agree with the statement that in old
age there is no major change in personality traits, those that
were present in the younger years are reflected, becoming
strengthened and more prominent. When we talk about the
personality traits of the elderly, it is an interesting question
whether there are personality traits that allow the elderly a
better adaptation to the aging process and old age than oth-
ers. In addition, old age is characterized by the presence of
one or more diseases. The old are often alienated, lonely,
abandoned by their primary group. Lack of social support,
change of residence, the loss of a close person, the process of
retirement and so on occur as the crisis events 6.
In the definition of the health of the WHO is also
mental health 6, 7. Anxiety/depression is a disease of modern
times. Anxiety is a feeling of restlessness, uneasiness, fear,
and de- pression is a mood disorder in which the dominant
feelings are low mood, sadness, apathy, indifference, social
withdrawal, anxiety, and feelings of guilt and lower values,
as well.
Contemporary arguments suggest that aging is not just a
series of life crises, but growing through new lifetime oppor-
tunities and challenges. Successful and active aging involves
harmonizing its capabilities with the capabilities satisfaction
Urošević J, et al. Vojnosanit Pregl 2015; Online First September (00): 107–
