Quality of Life Research

, Volume 26, Issue 2, pp 299–309 | Cite as

Does one size fit all? Assessing the preferences of older and younger people for attributes of quality of life

  • Julie Ratcliffe
  • Emily Lancsar
  • Thomas Flint
  • Billingsley Kaambwa
  • Ruth Walker
  • Gill Lewin
  • Mary Luszcz
  • Ian D. Cameron



To systematically compare, via ranking and best worst tasks, the relative importance of key dimensions of quality of life for younger and older people.


A web-based survey was developed for administration to two Australia-wide community-based samples comprising younger people aged 18–64 years and older people aged 65 years and above. Respondents were asked to rank 12 quality of life dimensions. Respondents also completed a successive best worst task using the same 12 quality of life dimensions.


The relative importance of the quality of life dimensions differed for younger and older person samples. For older people, the ability to be independent and to have control over their daily lives were particularly important for their overall quality of life whereas for younger people, mental health was considered most important.


Many interventions accessed by older people in geriatric medicine and aged care sectors have a broader impact upon quality of life beyond health status. The findings from this study indicate that a focus on broader aspects of quality of life may also be consistent with the preferences of older people themselves as to what constitutes quality of life from their perspective.


Older people Younger people Quality of life Health status Economic evaluation 



This study was funded in part by an Australian Research Council Linkage Grant (LP110200079).

Compliance with ethical standards

Conflict of interest

Julie Ratcliffe declares that she has no conflicts of interest. Emily Lancsar declares that she has no conflicts of interest. Thomas Flint declares that he has no conflicts of interest. Billingsley Kaambwa declares that he has no conflicts of interest. Ruth Walker declares that she has no conflicts of interest. Gill Lewin declares that she has no conflicts of interest. Mary Luszcz declares that she has no conflicts of interest. Ian Cameron declares that he has no conflicts of interest.

Ethical approval

This study was approved by Flinders Social and Behavioural Research Ethics Committee (Project no: 6682). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research 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. 1.
    Brazier, J., Ratcliffe, J., Salomon, J., & Tsuchiya, A. (2007). Measuring and valuing health benefits for economic evaluation. Oxford: Oxford University Press.Google Scholar
  2. 2.
    Milte, C., Walker, R., Luszcz, M., Lancsar, E., Kaambwa, B., & Ratcliffe, J. (2014). How important is health status in defining quality of life for older people? An exploratory study of the views of older South Australians. Applied Health Economics and Health Policy, 12(1), 73–84.CrossRefPubMedGoogle Scholar
  3. 3.
    Hopman, W., & Verner, J. (2003). Quality of life during and after inpatient stroke rehabilitation. Stroke, 34, 801–805.CrossRefPubMedGoogle Scholar
  4. 4.
    Richardson, J., & McKie, J. (2011). Review and critique of health related multi attribute utility instruments. Centre for Health Economics, Monash University, Melbourne. Research Paper (64).Google Scholar
  5. 5.
    Richardson, J., Khan, M., Iezzi, A., & Maxwell, A. (2015). Comparing and explaining differences in the magnitude, content and sensitivity of utilities predicted by the EQ-5D, HUI 3, 15D, QWB and AQoL-8D multiattribute utility instruments. Medical Decision Making, 35, 276–291.CrossRefPubMedGoogle Scholar
  6. 6.
    Chen, G., Khan, M. A., Iezzi, A., Ratcliffe, J., & Richardson, J. (2016). Mapping between 6 multi attribute utility instruments. Medical Decision Making, 36(2), 160–175.CrossRefPubMedGoogle Scholar
  7. 7.
    Coast, J., Flynn, T. N., Natarajan, L., et al. (2008). Valuing the ICECAP capability index for older people. Social Science and Medicine, 67(5), 874–882.CrossRefPubMedGoogle Scholar
  8. 8.
    Netten, A., Burge, P., Malley, J., Potoglou, D., Towers, A., Brazier, J., et al. (2012). Outcomes of social care for adults: Developing a preference-weighted measure. Health Technology Assessment, 16, 1–165.CrossRefPubMedGoogle Scholar
  9. 9.
    Grewal, I., Lewis, J., Flynn, T., Brown, J., Bond, J., & Coast, J. (2006). Developing attributes for a generic quality of life measure for older people: Preferences or capabilities? Social Science and Medicine, 62, 1891–1901.CrossRefPubMedGoogle Scholar
  10. 10.
    Coast, J., Kinghorn, P., & Mitchell, P. (2015). The development of capability measures in health economics: Opportunities, challenges and progress. Patient., 8, 119–126.CrossRefPubMedGoogle Scholar
  11. 11.
    Rowen, D., Brazier, J., & Van Hout, B. (2015). A comparison of methods for converting DCE Values onto the Full Health-Dead QALY scale. Medical Decision Making, 35, 328–340.CrossRefPubMedGoogle Scholar
  12. 12.
    Stata Corporation. (2014). Intercooled Stata 13.1 for windows. College Station: Texas.Google Scholar
  13. 13.
    Pink, B. (2006). Information paper: An introduction to Socio-Economic Indexes for Areas (SEIFA). Cat no. 2039.0. Canberra: Australian Bureau of Statistics.Google Scholar
  14. 14.
    Pink, B. (2006). Socio-Economic Indexes for Areas (SEIFA)—Technical Paper. Cat no. 2039.0.55.001. Canberra: Australian Bureau of Statistics; 2006A.Google Scholar
  15. 15.
    Altman, D. G. (1991). Practical statistics for medical research. London: Chapman & Hall/CRC.Google Scholar
  16. 16.
    Petrie, A., & Sabin, C. (2007). Medical statistics at a Glance. Chichester: Wiley.Google Scholar
  17. 17.
    De Vet, H., et al. (2006). When to use agreement versus reliability measures. Journal of Clinical Epidemiology, 59, 1033–1039.CrossRefPubMedGoogle Scholar
  18. 18.
    Lewin, G., Burton, E., Sparrow, P., et al. (2011). Development of a community care research agenda for Australia. Australasian Journal of Ageing, 30(1), 37–40.CrossRefGoogle Scholar
  19. 19.
    Makai, P., Brouwer, W., Koopmanschap, A., & Stolk, E. (2014). Quality of life instruments for economic evaluations in health and social care for older people: A systematic review. Social Science and Medicine, 102, 83–93.CrossRefPubMedGoogle Scholar
  20. 20.
    Davis, J., Liu-Ambrose, T., Richardson, C., & Bryan, S. (2013). A comparison of the ICECAP-O with EQ-5D in a falls prevention clinical setting: Are they complements or substitutes? Quality of Life Research, 22(5), 969–977.CrossRefPubMedGoogle Scholar
  21. 21.
    McCaffrey, N., Gill, L., Cameron, I. D., Patterson, J., Crotty, M., & Ratcliffe, J. (2015). What features of consumer-directed home-based support services are important to older Australians and their informal carers—development of attributes for a discrete choice experiment. Health and Social Care in the Community, 23, 654–664.CrossRefPubMedGoogle Scholar
  22. 22.
    Ratcliffe, J., Laver, K., Couzner, L., & Crotty, M. (2012). Health economics and geriatrics: Challenges and opportunities. In Atwood, C. S. (Ed.), Geriatrics, 2012 ISBN: 978-953-51-0080-5, InTech Open.Google Scholar
  23. 23.
    Ratcliffe, J., Flynn, T., Huynh, E., Stevens, K., Brazier, J., & Sawyer, M. (2016). Nothing about us without us? A comparison of adolescent and adult health state values for the Child Health Utility-9D using profile case best worst scaling. Health Economics, 25(4), 486–496.CrossRefPubMedGoogle Scholar
  24. 24.
    Ratcliffe, J., Stevens, K., Flynn, T., Brazier, J., & Sawyer, M. (2012). Whose values in health? An empirical comparison of the application of adolescent and adult values for the CHU9D and AQOL-6D in the Australian adolescent general population. Value in Health, 15, 730–736.CrossRefPubMedGoogle Scholar
  25. 25.
    Ratcliffe, J., Flynn, T., Terlich, F., Brazier, J., Stevens, K., & Sawyer, M. (2012). Developing adolescent specific health state values for economic evaluation: An application of profile case best worst scaling to the Child Health Utility-9D. Pharmacoeconomics, 30, 713–727.CrossRefPubMedGoogle Scholar
  26. 26.
    Norman, R., King, M., Clarke, D., Street, D., et al. (2010). Does mode of administration matter? Comparison of online and face to face administration of a time trade off task. Quality of Life Research, 19, 499–508.CrossRefPubMedGoogle Scholar
  27. 27.
    Australian Bureau of Statistics. (2014). Household use of information technology, Australia, 2012-13. Canberra: Australian Bureau of Statistics.Google Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Julie Ratcliffe
    • 1
  • Emily Lancsar
    • 2
  • Thomas Flint
    • 1
  • Billingsley Kaambwa
    • 1
  • Ruth Walker
    • 3
  • Gill Lewin
    • 4
  • Mary Luszcz
    • 5
  • Ian D. Cameron
    • 6
  1. 1.Flinders Health Economics GroupFlinders UniversityBedford ParkAustralia
  2. 2.Centre for Health Economics, Monash Business SchoolMonash UniversityMelbourneAustralia
  3. 3.Disability and Community Inclusion UnitFlinders UniversityBedford ParkAustralia
  4. 4.School of Nursing and MidwiferyCurtin UniversityBentleyAustralia
  5. 5.School of PsychologyFlinders UniversityBedford ParkAustralia
  6. 6.John Walsh Centre for Rehabilitation Research, Kolling Institute, Sydney Medical SchoolUniversity of SydneySydneyAustralia

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