The study used a qualitative approach to understand older people’s perceptions of HRQoL. The study found understanding of HRQoL to be characterized by holistic well-being, lifestyle modification, and financial stability. The key component of HRQoL that came out clearly from the study was the physical domain, which implies that older persons perceive physical well-being as an important issue in promoting well-being. Findings from previous studies are in line with the current findings where the majority highlighted the physical component of HRQoL to influence well-being compared to the mental component (Wang et al., 2023; Defar et al., 2023; Dresden et al., 2019; Lee, Cha and Kim, 2021). Other studies found common themes that were linked to older person perceptions of HRQOL in the previous study to include anxiety driven by emotional experiences, a strong desire to regain physical function, interpersonal impacts of health on quality of life driven by social aspects, socio-economic status denoted by high income, higher level of education, and individual experiences of physical and mental health status (Dresden et al., 2019; Lee, Cha and Kim, 2021). Furthermore, self-efficacy, numeracy in health literacy, physical health-promoting behavior, perceived support, and a lesser frequency of comorbidities were themes from a study conducted by Lee et al., (2021).

Findings from another study are divergent from the current findings, with poorer self-perceptions of HRQOL among elderly persons in rural areas being recorded compared to their counterparts in urban areas (Liu et al., 2020). A similar study conducted in Iran found self-reported HRQOL among older persons to be poor and characterized by poor mental health status (Tourani et al., 2018). A discrepancy in findings from middle-income and low-income countries indicates that HRQOL was perceived to be driven by poverty, lack of social support, psychological status, and negative self-perceptions of aging (Maniragaba et al., 2018; Yaya et al., 2020; Craig et al., 2016). A study done in Uganda by JL et al., (2022) shows that older persons had positive perceptions towards HRQOL which is similar to the current findings whereby only positive HRQoL was recorded. However, much as the previous study reported positive HRQoL, it did not stop the participants from having poor HRQOL as 86% of the respondents had poor HRQOL when assessed quantitatively.

Some of the issues noted to influence the perceptions of older persons towards their HRQOL include lack of social and financial support, poor housing, and loneliness (JL, 2022; Dresden et al., 2019). The differences in findings between developed countries and underdeveloped countries may be attributed to the better socio-economic status and development of the aging population in developed countries compared to low-income countries. Another observation elucidates that older people in developed countries have high mental and psychological issues which can be attributed to loneliness since most of the older persons live by themselves which psychologically impacts their mental health.

Plotnikoff et al., (2015) argue that regular physical activity, and improved health interventions like maintaining a healthy body weight and refraining from a sedentary lifestyle influence health decisively and promote HRQoL (Plotnikoff et al., 2015). Addressing both the physical and mental health aspects of HRQoL begins with the healthcare workers’ knowledge and inquiry (Syamlan et al., 2022). Understanding older persons’ perceptions of HRQoL helps to design health interventions targeting improvements in HRQoL. At the same time, it shows that older persons know what HRQoL implies, which was one of the main focus of the current study. In addition to informing primary healthcare-based geriatric patient care, the study’s findings may be most applicable in HRQoL status evaluations in the future.

The current study reported a positive perception of HRQoL among older persons, but it had some limitations. First, participants were recruited from PHC facilities in two selected districts of central Uganda. Therefore, the limited sample size and sampling methods limit generalizability to a larger population in central Uganda. Secondly, the focus group guide was well-articulated hindering leading questions. However, HRQoL being a new term to older participants, some responses may have been steered by the carefully designed question guide. Thirdly, since the participants gave their subjective opinions concerning HRQoL, it is possible that some participants gave socially desirable responses to the moderators to please them. Despite these limitations, FGDs are an important qualitative research approach to evaluate concepts, such as how older persons conceptualize HRQoL.