Kontakt X:X | DOI: 10.32725/kont.2026.020

The impact of community-based elderly schools on quality of life and health literacy among older adults in Indonesia: a cross-sectional studySocial Sciences in Health - Original article

Dwi Endah Kurniasih1, *, Sri Mulyani2, Fatwa Sari Tetra Dewi ORCID...3
1 Universitas Gadjah Mada, Faculty of Medicine, Public Health and Nursing, Yogyakarta, Indonesia
2 Universitas Gadjah Mada, Faculty of Medicine, Public Health and Nursing, Department of Mental Health and Community Nursing, Yogyakarta, Indonesia
3 Universitas Gadjah Mada, Faculty of Medicine, Public Health and Nursing, Department of Health Behaviour, Environment and Social Medicine, Yogyakarta, Indonesia

Objectives: This study aimed to evaluate the influence of participation in a community-based elderly school program on the quality of life (QoL) of older adults.

Methods: A cross-sectional analytical survey involved 303 adults aged ≥60 years from 10 sub-districts, selected through random sampling and grouped by elderly school attendance (≥4 sessions/12 months). Quality of life was assessed using the Indonesian WHOQOL-BREF (good ≥60; poor <60). Variables included education, ADL independence, and sociodemographic and health factors. Associations were analyzed using Chi-square tests and binary logistic regression.

Results: Overall, 79.2% reported good QoL. Elderly school attendance was strongly associated with good QoL (AOR 6.459; 95% CI: 3.078-13.557; p < 0.001), followed by ADL independence (AOR 4.894; p < 0.001), and higher education (AOR 2.333; p = 0.020). The model showed good fit (p = 0.995; R2 = 0.268).

Conclusion: Attending community-based elderly schools significantly enhances QoL among older adults, particularly by addressing literacy disparities and promoting functional independence. This integrated, empowerment-oriented model offers a scalable and cost-effective strategy for healthy aging in the context of developing countries.

Keywords: Community-based intervention; Elderly school; Functional independence; Health literacy; Older adults; Quality of life
Conflicts of interest:

Ethical aspects and conflict of interest The authors have no conflict of interest to declare.

Received: December 30, 2025; Revised: February 27, 2026; Accepted: April 2, 2026; Prepublished online: April 2, 2026 

Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    Attachments

    Download fileKONT_Kurniasih_1867_Suppl-mat.pdf

    File size: 87.2 kB

    References

    1. Argus-Calvo B, Clegg DJ, Francis MD, Dwivedi AK, Carrola PA, Leiner M (2024). A holistic approach to sustain and support lifelong practices of wellness among healthcare professionals: generating preliminary solid steps towards a culture of wellness. BMC Med Educ 24(1): 1364. DOI: 10.1186/s12909-024- 06353-7. Go to original source...
    2. Aryankhesal A, Niknam N, Hasani M, Mengelizadeh N, Aghaei N, Ghaedchukamei Z, et al. (2019). Determining the relationship between health literacy level and quality of life among the elderly living in nursing homes. J Educ Health Promot 8: 225. DOI: 10.4103/jehp.jehp_310_19. Go to original source... Go to PubMed...
    3. Aw S, Koh GCH, Tan CS, Wong ML, Vrijhoef HJM, Harding SC, et al. (2019). Theory and Design of the Community for Successful Ageing (ComSA) program in Singapore: connecting BioPsychoSocial health and quality of life experiences of older adults. BMC Geriatr 19(1): 254. DOI: 10.1186/s12877-019-1277-x. Go to original source... Go to PubMed...
    4. Baltes MM, Carstensen LL (1996). The Process of Successful Ageing. Ageing Soc 16(4): 397-422. DOI: 10.1017/S0144686X00003603. Go to original source...
    5. Belete S, Duke C, Hinzen H, Owusu-Boampong A, Khau HP (2022). Community Learning Centres (CLCs) for Adult Learning and Education (ALE): development in and by communities. Int Rev Educ 68: 259-290. DOI: 10.1007/s11159-022-09954-w. Go to original source... Go to PubMed...
    6. Beltz S, Gloystein S, Litschko T, Laag S, van den Berg N (2022). Multivariate analysis of independent determinants of ADL/IADL and quality of life in the elderly. BMC Geriatr 22(1): 894. DOI: 10.1186/s12877-022-03621-3. Go to original source... Go to PubMed...
    7. Berg-Weger M, Morley J (2020). Loneliness in Old Age: An unaddressed Health Problem (editorial). J Nutr Health Aging 24(3): 243-245. DOI: 10.1007/s12603-020-1323-6. Go to original source... Go to PubMed...
    8. Boyacioğlu NE, Kutlu Y (2017). The Effectiveness of Psychoeducational Interventions in Reducing the Care Burden of Family Members Caring for the Elderly in Turkey: A Randomized Controlled Study. Arch Psychiatr Nurs 31(2): 183-189. DOI: 10.1016/j.apnu.2016.09.012. Go to original source... Go to PubMed...
    9. BPS-Statisticts Indonesia (2024). Population data 2024. [online] [cit. 2026-01-22]. Available from: https://www.bps.go.id
    10. Brodie T, Pearson O, Cantley L, Cooper P, Westhead S, Brown A, Howard NJ (2021). Strengthening approaches to respond to the social and emotional well-being needs of Aboriginal and Torres Strait Islander people: the Cultural Pathways Program. Prim Health Care Res Dev 22: e35. DOI: 10.1017/S1463423621000402. Go to original source... Go to PubMed...
    11. Bursac Z, Gauss CH, Williams DK, Hosmer DW (2008). Purposeful selection of variables in logistic regression. Source Code Biol Med 3: 17. DOI: 10.1186/1751-0473-3-17. Go to original source... Go to PubMed...
    12. Carpentieri JD, Elliott J, Brett CE, Deary IJ (2017). Adapting to Aging: Older People Talk About Their Use of Selection, Optimization, and Compensation to Maximize Well-being in the Context of Physical Decline. J Gerontol B Psychol Sci Soc Sci 72(2): 351-361. DOI: 10.1093/geronb/gbw132. Go to original source... Go to PubMed...
    13. Chen TL, Feng YH, Kao SL, Lu JW, Loh CH (2022). Impact of integrated health care on elderly population: A systematic review of Taiwan's experience. Arch Gerontol Geriatr 102: 104746. DOI: 10.1016/j.archger.2022.104746. Go to original source... Go to PubMed...
    14. Dawam M, Sugiharti S, Kurniasih DE (2021). Aging management model at Dayakan Village, Kulon Progo District, Yogyakarta Special Province. J US-China Public Adm 18(4): 175-185. DOI: 10.17265/1548-6591/2021.04.003. Go to original source...
    15. de la Luz Martínez-Maldonado M, Correa-Muñoz E, Mendoza-Núñez VM (2007). Program of active aging in a rural Mexican community: a qualitative approach. BMC Public Health 7: 276. DOI: 10.1186/1471-2458-7-276. Go to original source... Go to PubMed...
    16. Derhun FM, Scolari GAS, Rissardo LK, Salci MA, Llobet MP, Carreira L (2022). Contributions of university activities to active aging: grounded theory. Rev Esc Enferm USP 56: e20210237. DOI: 10.1590/1980-220X-REEUSP-2021-0237. Go to original source... Go to PubMed...
    17. Direktorat Bina Ketahanan Keluarga Lansia dan Rentan (2021). Buku Panduan Sekolah Lansia di Kelompok BKL. BKKBN/ National Population and Family Planning Board. [online] [cit. 2026-01-22]. Available from: https://www.scribd.com/document/646797183/25-Panduan-Sekolah-Lansia-Di-Kelompok-Bkl
    18. Dumbuya E (2023). Integrating social and emotional learning (SEL) into curriculum development: A pathway to holistic education. SSRN, 8 p. DOI: 10.2139/ssrn.5019755. Go to original source...
    19. Estebsari F, Dastoorpoor M, Khalifehkandi ZR, Nouri A, Mostafaei D, Hosseini M, et al. (2020). The Concept of Successful Aging: A Review Article. Curr Aging Sci 13(1): 4-10. DOI: 10.2174/1874609812666191023130117. Go to original source... Go to PubMed...
    20. Formosa M (2014). Four decades of Universities of the Third Age: Past, present, future. Ageing Soc 34(1): 42-66. DOI: 10.1017/S0144686X12000797. Go to original source...
    21. Grimes DA, Schulz KF (2002). Bias and causal associations in observational research. Lancet 359(9302): 248-252. DOI: 10.1016/S0140-6736(02)07451-2. Go to original source... Go to PubMed...
    22. Hariastuti I, Dawam M, Sugiharti S, Suratmi T, Kurniasih DE, Budiningsari D, et al. (2024). Elderly Golden Age School (EGAS): A strategy to promote health and prosperity among the elderly in Indonesia. Humanit Soc Sci Commun 11: 1098. DOI: 10.1057/s41599-024-03571-8. Go to original source...
    23. Hildon ZJ, Tan CS, Shiraz F, Ng WC, Deng X, Koh GCH, et al. (2018). The theoretical and empirical basis of a BioPsychoSocial (BPS) risk screener for the detection of older people's health-related needs, planning of community programs, and targeted care interventions. BMC Geriatr 18(1): 49. DOI: 10.1186/s12877-018-0739-x. Go to original source... Go to PubMed...
    24. Ho L, Malden S, McGill K, Shimonovich M, Frost H, Aujla N, et al. (2023). Complex interventions for improving independent living and quality of life amongst community-dwelling older adults: a systematic review and meta-analysis. Age Ageing 52(7): afad132. DOI: 10.1093/ageing/afad132. Go to original source... Go to PubMed...
    25. Hofstad H (2023). Well understood? A literature study defining and operationalising community social sustainability. Local Environ 28(9): 1193-1209. DOI: 10.1080/13549839.2023.2195620. Go to original source...
    26. Holliday A, Warner J, Hulston CJ, Corfe BM, Crabtree DR (2024). Anorexia of ageing is associated with elevated fasted and lower post-prandial ghrelin, independent of ghrelin O-acyltransferase. Appetite 196: 107259. DOI: 10.1016/j.appet.2024.107259. Go to original source... Go to PubMed...
    27. Holt-Lunstad J, Smith TB, Layton JB (2010). Social relationships and mortality risk: a meta-analytic review. PLoS Med 7(7): e1000316. DOI: 10.1371/journal.pmed.1000316. Go to original source... Go to PubMed...
    28. Jacobs M, Evans E, Ellis C (2024). Abstract WP97: Disparities in health-related quality of life among adults with heart disease, stroke, and both conditions. Stroke 55(Suppl 1). DOI: 10.1161/str.55.suppl_1.WP9. Go to original source...
    29. Keating N (2022). A research framework for the United Nations Decade of Healthy Ageing (2021-2030). Eur J Ageing 19(3): 775-787. DOI: 10.1007/s10433-021-00679-7. Go to original source... Go to PubMed...
    30. Kendir C, Breton E (2020). Health Literacy: From a Property of Individuals to One of Communities. Int J Environ Res Public Health 17(5): 1601. DOI: 10.3390/ijerph17051601. Go to original source... Go to PubMed...
    31. Kim N, Park J, Hong H, Kong ID, Kang H (2020). Orthostatic hypotension and health-related quality of life among community-living older people in Korea. Qual Life Res 29(1): 303-312. DOI: 10.1007/s11136-019-02295-6. Go to original source... Go to PubMed...
    32. Kurniasih DE, Erwanto R, Amigo TAE, Afrezah A (2022). Predisposing Factors That Influence Student Motivation in Following Elderly School in Elderly Posyandu Group. Jurnal Ilmiah Permas 12(2): 307-316.
    33. Levin KA (2006). Study design III: Cross-sectional studies. Evid Based Dent 7(1): 24-25. DOI: 10.1038/sj.ebd.6400375. Go to original source... Go to PubMed...
    34. Lim H, Jani NDB, Pang WT, Lim ECW (2024). Community-based exercises improve health status in pre-frail older adults: A systematic review with meta-analysis. BMC Geriatr 24(1): 589. DOI: 10.1186/s12877-024-05150-7. Go to original source... Go to PubMed...
    35. Llorente-Barroso C, Abad-Alcalá L, Colombo F (2023). Communication for seniors' inclusion in today's society: The effects of digitisation on active ageing. Media and Communication 11(3): 1-5. DOI: 10.17645/mac.v11i3.7039. Go to original source...
    36. Maresova P, Javanmardi E, Barakovic S, Barakovic Husic J, Tomsone S, Krejcar O, Kuca K (2019). Consequences of chronic diseases and other limitations associated with old age - a scoping review. BMC Public Health 19(1): 1431. DOI: 10.1186/s12889-019-7762-5. Go to original source... Go to PubMed...
    37. Mann CJ (2003). Observational research methods: Research design II: Cohort, cross-sectional, and case-control studies. Emerg Med J 20(1): 54-60. DOI: 10.1136/emj.20.1.54. Go to original source... Go to PubMed...
    38. Mehralian G, Yusefi AR, Davarani ER, Ahmadidarrehsima S, Nikmanesh P (2023). Examining the relationship between health literacy and quality of life: Evidence from older people admitted to the hospital. BMC Geriatr 23(1): 147. DOI: 10.1186/s12877-023-03838-w. Go to original source... Go to PubMed...
    39. Melchiorre MG, Socci M, Lamura G, Quattrini S (2025). Social Participation of Frail Older People with Functional Limitations Ageing Alone in Place in Italy, and Its Impact on Loneliness: An Urban-Rural Comparison. Urban Sci 9(6): 233. DOI: 10.3390/urbansci9060233. Go to original source...
    40. Monteiro JM, Gonçalves R, Bastos A, Barbosa MR (2024). Social engagement and wellbeing in late life: A systematic review. Ageing Soc 45(7): 1327-1354. DOI: 10.1017/S0144686X24000011. Go to original source...
    41. Narushima M, Liu J, Diestelkamp N (2018). Lifelong learning in active ageing discourse: Its conserving effect on wellbeing, health, and vulnerability. Ageing Soc 38(4): 651-675. DOI: 10.1017/S0144686X16001136. Go to original source... Go to PubMed...
    42. Nutbeam D (1998). Health promotion glossary. Health Promot Int 13(4): 349-364. DOI: 10.1093/heapro/13.4.349. Go to original source...
    43. Pardasani M, Thompson P (2012). Senior centers: Innovative and emerging models. J Appl Gerontol 31(1): 52-77. DOI: 10.1177/0733464810380545. Go to original source...
    44. Piccolo R (2024). Digitisation, health literacy, and health empowerment of older people. Int Entrep Manag J 20(4): 3001-3034. DOI: 10.1007/s11365-024-00980-8. Go to original source...
    45. Rozario PA, Kidahashi M, DeRienzis DR (2011). Selection, optimization, and compensation: strategies to maintain,maximize, and generate resources in later life in the face of chronic illnesses. J Gerontol Soc Work 54(2): 224-239. DOI: 10.1080/01634372.2010.539589. Go to original source... Go to PubMed...
    46. Sainsbury A, Seebass G, Bansal A, Young JB (2005). Reliability of the Barthel Index when used with older people. Age Ageing 34(3): 228-232. DOI: 10.1093/ageing/afi063. Go to original source... Go to PubMed...
    47. Saxena S, Orley J; WHOQOL Group (1997). Quality of life assessment: The World Health Organization perspective. Eur Psychiatry 12 Suppl 3: 263s-6s. DOI: 10.1016/S0924-9338(97)89095-5. Go to original source... Go to PubMed...
    48. Scazufca M, Seward N (2024). Addressing the threat of loneliness and depression in older adults. Lancet Healthy Longev 5(2): e84-e85. DOI: 10.1016/S2666-7568(23)00267-2. Go to original source... Go to PubMed...
    49. Setia MS (2016). Methodology series module 3: Cross-sectional studies. Indian J Dermatol 61(3): 261-264. DOI: 10.4103/0019-5154.182410. Go to original source... Go to PubMed...
    50. Silbersweig A, Pritchett CM, Gavaller M, Oh H, Hershenberg R, Wise J, et al. (2025). A novel psychoeducational intervention to promote well-being in older adult nursing home patients: Combining survey preferences with evidence-based practices in the design of a comprehensive curriculum. Int Psychogeriatr 37(6): 100093. DOI: 10.1016/j.inpsyc.2025.100093. Go to original source... Go to PubMed...
    51. Silva PA, Soares SM, Santos JF, Silva LB (2014). Cut-off point for WHOQOL-bref as a measure of quality of life of older adults. Rev Saude Publica 48(3): 390-397. DOI: 10.1590/s0034-8910.2014048004912. Go to original source... Go to PubMed...
    52. Sirisuwan P, Phimha S, Banchonhattakit P (2022). Influence of active ageing and health literacy on quality of life among elderly persons in northeast Thailand. Health Educ J 81(6): 693-704. DOI: 10.1177/00178969221109329. Go to original source...
    53. Skevington SM, Lotfy M, O'Connell KA; WHOQOL Group (2004). The World Health Organization's WHOQOL-BREF quality of life assessment: Psychometric properties and results of the international field trial. Qual Life Res 13(2): 299-310. DOI: 10.1023/B:QURE.0000018486.91360.00. Go to original source... Go to PubMed...
    54. Sugiharti S, Kurniasih DE, Erwanto R, Dawam M, Hamid IN, Sumariati R, et al. (2021). The effectiveness of elderly school integration in Bina Keluarga Lansia Group (ESI-BKL) in achieving the seven dimensions of robust elderly. Int Med J 28(1): 3811-3818.
    55. Tcymbal A, Abu-Omar K, Hartung V, Bußkamp A, Comito C, Rossmann C, et al. (2022). Interventions simultaneously promoting social participation and physical activity incommunity living older adults: A systematic review. Front Public Health 10: 1048496. DOI: 10.3389/fpubh.2022.1048496. Go to original source... Go to PubMed...
    56. Toledano-González A, Labajos-Manzanares T, Romero-Ayuso D (2019). Well-Being, Self-Efficacy and Independence in Older Adults: A Randomized Trial of Occupational Therapy. Arch Gerontol Geriatr 83: 277-284. DOI: 10.1016/j.archger.2019.05.002. Go to original source... Go to PubMed...
    57. WHO (2002). Active ageing: a policy framework. [online] [cit. 2026-01-22]. Available from: https://iris.who.int/items/46476232-b305-47b4-ab28-e3931607c70c
    58. WHO (2015). World report on ageing and health. [online] [cit. 2026-01-22]. Available from: https://www.who.int/publications/i/item/9789241565042
    59. WHOQOL Group (1998). Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychological Medicine 28(3): 551-558. DOI: 10.1017/S0033291798006667. Go to original source... Go to PubMed...
    60. Wister A (2024). Social isolation among marginalized older adults: Applying a unified model of resilience. Innov Aging 8(Suppl 1): 33. DOI: 10.1093/geroni/igae098.0098. Go to original source...
    61. Wu C, Lim GG (2024). Investigating older adults users' willingness to adopt wearable devices by integrating the technology acceptance model (UTAUT2) and the Technology Readiness Index theory. Front Public Health 12: 1449594. DOI: 10.3389/fpubh.2024.1449594. Go to original source... Go to PubMed...
    62. Wulandari W, Zakiyah N, Rahayu C, Puspitasari IM, Suwantika AA (2025). Health-related quality of life in hypertensive patients with chronic kidney disease in low and middle-income countries. BMC Nephrol 26(1): 34. DOI: 10.1186/s12882-025-03957-z. Go to original source... Go to PubMed...
    63. Zhang K, Kan C, Luo Y, Song H, Tian Z, Ding W, et al. (2022). The promotion of active aging through older adult education in the context of population aging. Front Public Health 10: 998710. DOI: 10.3389/fpubh.2022.998710. Go to original source... Go to PubMed...
    64. Zheng H, Ma W, Li J, Botero J, Ma W (2023). Relationship between internet use and negative affect. Appl Res Qual Life 1: 1-21. DOI: 10.1007/s11482-023-10158-z. Go to original source... Go to PubMed...
    65. Zhou JJ, Zhang Y, Ren QZ, Li T, Lin GD, Liao MY, et al. (2023). Mediating effects of meaning in life on the relationship between family care, depression, and quality of life in Chinese older adults. Front Public Health 11: 1079593. DOI: 10.3389/fpubh.2023.1079593. Go to original source... Go to PubMed...

    This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0), which permits non-comercial use, distribution, and reproduction in any medium, provided the original publication is properly cited. No use, distribution or reproduction is permitted which does not comply with these terms.


    Return