Health-related quality of life and associated factors among community-dwelling older adults with cardiovascular diseases in Vietnam: a multicenter cross-sectional study

Abstract

Cardiovascular diseases (CVDs) are a major cause of morbidity and functional limitation among older adults. Their chronic course and frequent coexistence with multimorbidity can impair independence, daily functioning, and health-related quality of life (HRQoL). However, large-scale community-based evidence on HRQoL and its associated factors among older adults with cardiovascular diseases in Vietnam remains limited. This study aimed to describe HRQoL and examine its associated factors among community-dwelling older adults with cardiovascular diseases in Vietnam. We conducted a multicenter cross-sectional study in eight provinces and centrally governed cities of Vietnam from October 2023 to September 2025. Participants were adults aged ≥ 60 years who had at least one cardiovascular diagnosis documented in existing health records. Data were collected through face-to-face interviews using a structured questionnaire and the EQ-5D-5 L, with index scores derived using the Vietnamese value set. Descriptive statistics were presented as frequencies and percentages, mean ± SD, and median (Q1, Q3), as appropriate. Factors associated with HRQoL were examined using a multivariable generalized estimating equations model with a normal distribution and identity link, accounting for clustering at the commune/ward level using robust sandwich covariance estimates and adjusting for study province/city. A total of 2,330 older adults with CVDs were included in the analysis. The mean EQ-5D-5 L index score was 0.7175 ± 0.1468. Across CVD subgroups, mean scores ranged from 0.6552 ± 0.1394 to 0.7482 ± 0.1417. In the multivariable model, lower HRQoL was associated with poor household economic status (β = −0.028; 95% CI: −0.046 to − 0.009; p = 0.003), ≥ 4 non-cardiovascular comorbid conditions (β = −0.028; 95% CI: −0.035 to − 0.020; p < 0.001), and longer CVD duration (2–5 years: β = −0.080; 6–10 years: β = −0.221; >10 years: β = −0.450; all p < 0.001). Secondary/high school education was also associated with lower HRQoL than university/postgraduate education (β = −0.013; 95% CI: −0.022 to − 0.005; p = 0.003). HRQoL among community-dwelling older adults with CVDs in Vietnam was lower in those with greater disease burden, particularly longer disease duration and a high non-cardiovascular comorbidity burden, and in those with socioeconomic disadvantage.