Change in quality of life among community-dwelling older adults: population-based longitudinal study
This population-based study aimed to determine 5-year change in multidimensional QoL among community-dwelling older people, and to identify predictors of QoL change among demographic, socioeconomic, and health characteristics.
Data of the 2011 and 2016 annual assessments of 1845 older men and women (age range 68–77 years) from the Lc65 + cohort study were used. QoL was assessed using a 28-item instrument yielding a QoL overall score and seven domain-specific QoL subscores. Additional ratings of QoL included a single item (excellent; very good; good; fair; poor), expected QoL in 1 year (better; worse; same as today), and retrospective assessment of QoL 5-year change (better; worse; same as 5 years ago). The predictors of 5-year change in the QoL score were assessed using linear regression, controlling for baseline QoL score.
All prospective and retrospective indicators of QoL converged towards a slight deterioration over 5 years. QoL subscores significantly decreased in domains “Close entourage” (P = 0.004), “Social and cultural life” (P < 0.001), “Esteem and recognition” (P = 0.001), “Health and mobility” (P < 0.001), and “Autonomy” (P < 0.001), whereas “Material resources” (P = 0.345) and “Feeling of safety” (P = 0.380) remained stable. A stronger decrease in QoL was observed in the most vulnerable profiles at baseline in terms of demographic, socioeconomic, and health characteristics. Changes in depressive symptoms and in disability—either worsening or improving—predicted QoL change in the expected direction.
Age-related decline in QoL may be limited through the prevention of disability and depressive symptoms, and more generally by devoting special attention to vulnerable profiles.
KeywordsQuality of life Epidemiology of ageing Gerontology Cohort studies
This work was supported by a prize awarded by the Leenaards Foundation. The Lc65 + study has been supported by University of Lausanne Hospital Centre; University of Lausanne Department of Ambulatory Care and Community Medicine; Canton de Vaud Department of Public Health; City of Lausanne; Loterie Romande [research grant 2006–2008]; Lausanne University Faculty of Biology and Medicine [multidisciplinary research grant 2006]; Swiss National Foundation for Scientific Research [grant 3247B0-120795/1]; and Fondation Médecine Sociale et Préventive, Lausanne. The sponsors had no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.
Compliance with ethical standards
Conflict of interest
The authors have no conflict of interest to declare.
All procedures were in accordance with the ethical standards of the local Ethics Committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 1.World Health Organization. (2012). World Health Day: Are You Ready? What You Need to Know About Ageing. Geneva. Retrieved February 25, 2015 from http://www.who.int/world-health-day/2012/toolkit/background/en/index.html.
- 4.Laslett, L. L., Quinn, S. J., Winzenberg, T. M., Sanderson, K., Cicuttini, F., & Jones, G. (2012). A prospective study of the impact of musculoskeletal pain and radiographic osteoarthritis on health related quality of life in community dwelling older people. BMC Musculoskeletal Disorders, 13, 168.CrossRefGoogle Scholar
- 6.Eisele, M., Kaduszkiewicz, H., Konig, H. H., Lange, C., Wiese, B., & Prokein, J. et al. (2015). Determinants of health-related quality of life in older primary care patients: Results of the longitudinal observational AgeCoDe study. British Journal of General Practice, 65, e716–e723.CrossRefGoogle Scholar
- 22.Calderon-Larranaga, A., Vetrano, D. L., Onder, G., Gimeno-Feliu, L. A., Coscollar-Santaliestra, C., Carfí, A. et al. (2017). Assessing and measuring chronic multimorbidity in the older population: A proposal for its operationalization. The Journals of Gerontology Series A Biological Sciences and Medical Sciences, 72, 1417–1423.Google Scholar
- 26.UNESCO. International Standard Classification of Education. UNESCO Institute for Statistics; 2011 [Accessed 26 October 2016]; Retrieved October 26, 2016 from http://www.uis.unesco.org/Education/Pages/international-standard-classification-of-education.aspx.