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Research project: Quality of Life in older age: Psychometric testing of the multidimensional Older People's Quality of Life (OPQOL) - Dormant - Dormant

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Increasing  numbers  of older  people,  higher expectations  for  ‘a good  life', and demands for health and social care,  have led to international  interest in the enhancement, and measurement, of  quality of life (QoL) in  older  age.  QoL is a subjective concept, yet most measures of QoL are based on ‘expert' opinions. Funder: ESRC

Project Overview

Increasing  numbers  of older  people,  higher expectations  for  ‘a good  life', and demands for health and social care,  have led to international  interest in the enhancement, and measurement, of  quality of life (QoL) in  older  age.  QoL is a subjective concept, yet most measures of QoL are based on ‘expert' opinions.

This study aimed to test a new measure of Older People's QoL (OPQOL), which is unique in being derived from the views of older people who responded to an earlier survey, funded by the ESRC Growing Older Programme. The study included the final testing of the OPQOL, and compare it with two existing measures of QoL in older age: the CASP-19 and WHOQOL-OLD.  Further aims included elicitation of perceptions of ‘active ageing', and identification of predictors.

The study was based on over 1000 respondents to surveys of older people living at home in Britain: i) two waves of the Office for National Statistics (ONS) Omnibus Surveys; ii) two waves of the national Ethnibus Surveys, and a postal follow-up of ONS Omnibus respondents aged 65+ in 1999-2000; 42 of the follow-up survey respondents were also interviewed in-depth.

  • Far more of the ethnically diverse, Ethnibus survey respondents had poor QoL than other respondents.
  • The OPQOL had good reliability and validity in all three surveys.
  • Baseline indicators of QoL were able to predict follow-up OPQOL scores in the QoL Survey follow-up sample.
  • Respondents' perceptions of active ageing were multi-faceted.
  • Despite being more likely to be aged 65<75 than 75+, Ethnibus respondents were far less likely than the other survey  respondents to consider themselves as ageing ‘very' or ‘fairly' actively.

Almost three-quarters (73%) of the Ethnibus sample scored in the worst two OPQOL categories indicating poor QoL, compared with 45% of the older QoL follow-up respondents, and 12% of ONS Omnibus respondents. Chinese people reported better QoL than other ethnic groups. Ethnibus survey respondents were also more scared of dying, of the way they would die, of being in pain before death, and not being able to control their death, than ONS Survey respondents (WHOQOL-OLD module). Chinese people reported the lowest level of fears.

The OPQOL had good acceptability, internal consistency and construct validity in all samples. Cronbach's alphas all exceeded threshold criteria for acceptability of alpha (0.70+): α: 0.748 (Ethnibus survey), α: 0.876 (ONS Omnibus survey), α: 0.901 (QoL follow-up survey). The CASP-19 and WHOQOL-OLD had good levels of reliability and validity in the British population sample, but did not satisfy criteria for Cronbach's alpha in the ethnically diverse sample.

Conclusions and policy implications

The OPQOL performed well in national population and ethnically diverse samples of older people, reflecting its multi-dimensionality, the item-generation by older people themselves, and piloting with ethnically diverse focus groups. It is of potential value in the evaluation of interventions which have a multidimensional impact on people.

The study also examined active ageing. A multifaceted approach to defining active ageing was common among older people. The most important predictors of active ageing were having concurrently good QoL, health, physical and social functioning. The qualitative research suggested that access to clubs and services could be facilitated with improved publicity; opportunities for volunteering could be promoted more widely; modification and maintenance of the home could help older people remain independent for longer; and public transport could be more accessible and user-friendly for older people. There could be better targeting of older people through local radio, local newspapers or leafleting. Better access to affordable exercise programmes would also be valuable.  As keeping active is related to having good health, removing barriers to maintaining health is important for active ageing. Models of pro-active coping and selection, optimisation and compensation were supported.

Associated research themes

Quality of Life

Older age

Psychometric assessment

Related research groups

Complex Healthcare Processes

Conferences and events associated with this project:

2012: AgeUK & Campaign to End Loneliness. International conference (Gulbenkian Foundation) on Loneliness and well-being. Invited plenary presentation: ‘What do we know about well-being, how to measure it, and what influences it.' Mansfield College, Oxford, July 2012.

2011: Centre for Ageing Research and Development in Ireland - CARDI conference, invited plenary presentation on Measuring Quality of Life. Radisson Blu Hotel, Golden Lane, Dublin 7 June 2011.

2011: International Longevity Centre national event for policy makers, academics, lay people, practitioners: invited plenary presentation of OPQOL, Institute of Actuaries, ILC-UK and the Actuarial Profession in partnership with ESRC Joint Debate: Measuring Quality of Life, Institute of Actuaries,  Holborn, 10 May 2011.

2011: Greater London Older People's Forum Kensington, invited presentation on Measuring Quality of Life, alongside Laura Ferguson of the Campaign to End Loneliness and Cllr Robert Freeman, Kensington and Chelsea BC, Kensington town Hall, 27 May 2011.

2011: Cambridge Older People's Enterprise (COPE), invited presentation on Measuring Quality of Life,  Guildhall, Cambridge, 27 July 2011.

2011: Derby 50+ forum - older people's Forum, invited presentation on Measuring Quality of Life,  Assembly Rooms, Derby, 28 July 2011.

2010: Isaac Newton Centre, London, W9: ‘Tackling isolation among older people' (housing, social & community care, safer neighbourhoods, voluntary body attendees), 3 Dec 2010, invited presentation on Measuring Quality of Life also with Laura Ferguson, Director of Campaign to End Loneliness.

2010: AgeUK Policy meeting, invited presentation on Measuring Quality of Life, AgeUK, Pentonville Rd London N1, 29 July, 2010.

2008: International Cadenza Conference on Successful Ageing: invited plenary presentation ‘Successful ageing', University of Hong Kong, November 2008.

Other international conference presentations:

Presentation on quality of life to British Gerontology Society, Plymouth, 5 July 2011.

Presentation on quality of life  to VII International Association of Geriatrics and Gerontology European Congress, Bologna, Italy 15 April 2011.

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