PERCEIVED STRESS, COGNITIVE FUNCTIONING, AND HEALTH-RELATED QUALITY OF LIFE AMONG INSTITUTIONALIZED OLDER ADULTS IN KARACHI, PAKISTAN

Abstract

Background: Pakistan’s older population is projected to nearly triple by 2050, yet perceived stress, cognitive function, and health-related quality of life in this group remain largely unexamined, and the available evidence treats these outcomes separately and comes from outside South Asia. This study examined their interrelationships among institutionalized older adults in Karachi. Methods: Eighty-three residents (41 men, 42 women; aged 56–70) were recruited by convenience sampling from six Karachi old age homes. Eligibility required completion of at least Grade 5 and a Mini-Cog score of 3–5, excluding probable dementia. Working memory was assessed with the WAIS-IV Digit Span, perceived stress with the PSS-10, and HRQoL with the CDC Healthy Days measure (HRQOL-14), in individual structured interviews. Analyses used Pearson correlations, independent-samples t tests, and hierarchical regression. Results: Stress was unrelated to working memory (r = −.089, p = .43) but predicted poorer self-rated health (r = −.493, p < .001) and more unhealthy days (r = .656, p < .001); the association between Digit Span and self-rated health was positive but not significant (r = .19, p = .085). Women reported higher stress (d = −0.63, p = .005) and men higher Digit Span Total scores (d = 0.49, p = .028). Conclusion: Perceived stress significantly predicts HRQoL among institutionalized older adults in Karachi. The absent stress–cognition association may reflect limited power and the cross-sectional design rather than a true null. Stress-reduction programs merit attention as Pakistan’s elder care sector develops, while the value of cognitive stimulation remains to be established.