Association between physical activity levels and quality of life in the WHOQOL-BREF domains: a multivariable analysis in the Chilean adult population

Abstract

Objective: To evaluate the association between physical activity levels classified using the International Physical Activity Questionnaire (IPAQ) and the physical, psychological, social, and environmental domains of the WHOQOL-BREF the WHO quality-of-life instrument, in the Chilean adult population, assessing whether this association follows an ascending gradient across activity levels. Methods: A secondary analysis of the 2023-2024 National Quality of Life and Health Survey (ENCAVI) was conducted, including 16,590 participants. Physical activity was classified as inactive, active, and HEPA active (Health-Enhancing Physical Activity) according to the IPAQ. Quality of life was assessed using the four WHOQOL-BREF domains. Multivariable linear regression models were fitted, adjusting for sex, age, marital status, geographic macro-region, educational level, income quintile, and number of self-reported diseases. Results: The mean age was 52.8 years (SD = 18.2), and 68.3% of participants were women. Of the sample, 57.4% were classified as inactive, 28.9% as minimally active, and 13.7% as HEPA active. After multivariable adjustment, a positive association was observed between physical activity and quality of life across all four domains. HEPA-active participants showed the highest adjusted scores, followed by active individuals, while inactive participants had the lowest values. A significant ascending gradient (p < 0.05) was identified across all domains, particularly in the physical and psychological domains. Conclusion: Higher levels of physical activity were associated with better quality of life across all WHOQOL-BREF domains, showing a positive gradient independent of sociodemographic and health-related factors.