Health-Related Quality of Life and Associated Factors among Older Adults Attending Primary Care Clinics in Nigeria: A Cross-Sectional Study.

Background The ageing process is a complex biological progression characterised by declining physiological functions and an increased burden of chronic conditions. In Nigeria, while primary care is the first point of contact, geriatric care remains under-prioritise. Understanding the factors influencing the quality of life among older adults is essential for improving service delivery. Objective This study aimed to assess the health-related quality of life and associated sociodemographic and clinical factors among elderly patients attending a primary care setting in Ilorin, Nigeria. Methods A cross-sectional study was conducted among 280 older adult patients aged 60 to 95 years (Mean age = 69 ± 6.99 SD) at the University of Ilorin Teaching Hospital primary care setting. Data were analysed to identify patterns in QoL domains and the prevalence of associated clinical factors including presence of chronic condition, depression, anxiety, and spiritual needs. Results Overall, 53.2% of respondents reported a good QoL, while 46.8% had a poor QoL. The ‘psychological’ domain recorded the highest mean score (62.92 ± 13.75), whereas the ‘Social’ domain was the lowest (53.59 ± 19.56). A high prevalence of chronic conditions was observed (92.9%), with hypertension (75.7%) and musculoskeletal conditions (58.6%) being most common. The prevalence of unmet spiritual needs, depression, and anxiety were 75.0%, 6.0%, and 6.1%, respectively. Statistical analysis revealed that marital status (p = 0.007) and educational level (p = 0.046) were significantly associated with QoL. Clinically, depression (p = 0.001), anxiety (p = 0.002), and spiritual needs (p = 0.032) showed strong significant associations with QoL. Notably, the presence of chronic conditions was not statistically associated with QoL in this population. Multivariate regression identified widowhood, lack of formal education, depression, anxiety, and spiritual needs as independent predictors of poor health-related QoL. Conclusion Nearly half of the elderly patients experienced poor QoL, influenced more significantly by psychological, social, and spiritual factors than by the presence of physical chronic illnesses. These findings highlight the urgent need for Primary Health Care centers to transition toward age-friendly services that integrate mental health screening and spiritual support into routine geriatric management.