Validity of the older people quality of life-7 domains (OQoL-7) scale.

BACKGROUND: The Older people Quality of Life-7 domains (OQoL-7) is a 28-item multidimensional questionnaire developed to measure community-dwelling older people's QoL. The OQoL-7 assesses both importance of and satisfaction in seven QoL domains (Material resources; Close entourage; Social and cultural life; Esteem and recognition; Health and mobility; Feeling of safety; and Autonomy). This study aimed to investigate concurrent and construct validity of the OQoL-7. A secondary aim was to compare different methods of weighting participants' ratings of satisfaction according to their individual ratings of importance, as compared to the OQoL-7 total score (unweighted). METHODS: Data came from the first and second samples of the Lausanne cohort 65+ study, assessed at the same age of 72-77 years in 2011 (N = 1117) and 2016 (N = 1091), respectively. To assess concurrent validity, the OQoL-7 was compared to other measures of the same concept (single QoL item) or related concepts (self-rated health, SF-12). Construct validity was tested by comparing subscores in the seven QoL domains in the presence and absence of two stressful events during the preceding year (financial difficulties and relationship difficulties). The effect of importance weighting was assessed using moderated regression analysis. RESULTS: The OQoL-7 total score was significantly associated with the single QoL item (Spearman's rho 0.46), self-rated health (Spearman's rho 0.34), SF-12 physical (Spearman's rho 0.22) and mental (Spearman's rho 0.28) component scores. Large differences (Cohen's d > 0.8) were observed in the presence or absence of stressful events in the expected QoL domains: "Material resources" in the presence or absence of "Financial difficulties" (Cohen's d 1.34), and "Close entourage" in the presence or absence of "Relationship difficulties" (Cohen's d 0.84). Importance weighting resulted in a very small improvement in the prediction of the single QoL item (ΔR2 0.018). All results were highly consistent across 2011 and 2016 samples. CONCLUSIONS: The OQoL-7 showed adequate concurrent and construct validity in two samples of older people. In future studies, the decision to use weighted or unweighted scores will depend on the priority given to either optimizing the prediction of QoL or limiting the burden on respondents and the amount of missing data.

Quality of life profile in three cohorts of community-dwelling Swiss older people.

BACKGROUND: Quality of life (QoL) is a subjective and dynamic concept resulting from an interplay between importance of and satisfaction with different aspects of life. However, it is unclear whether social contexts experienced by individuals born at specific times in history (cohort effects) may influence QoL in old age. This study aimed to compare among older persons born before, during, and at the end of World War II: a) satisfaction with QoL, overall and per domains; b) importance of QoL domains. METHODS: This repeated cross-sectional study included representative samples of community-dwelling adults born in 1934-1938 (pre-war), 1939-1943 (war), and 1944-1948 (baby-boom) from the Lausanne cohort 65+. QoL was assessed overall, and in seven domains in 2011 and 2016. Two-by-two cohort comparisons were performed at ages 68-72 (war versus baby-boom) and 73-77 years (pre-war versus war). RESULTS: Overall satisfaction with QoL did not differ between cohorts despite increased education level across cohorts and a shift between pre-war and war cohorts towards lower morbidity and higher proportion living alone. However, "Feeling of safety" consistently showed significant improvements from earlier to later-born cohorts. Furthermore, the war cohort reported higher satisfaction than pre-war cohort in "Autonomy". Conversely, no significant difference was observed between cohorts in importance of QoL domains, except increased importance given to "Health and mobility" in the war compared to pre-war cohort. CONCLUSIONS: Societal changes reflected in the profile of successive elders' cohorts did not appear to modify the overall satisfaction with QoL.

Change in quality of life among community-dwelling older adults: population-based longitudinal study.

PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

Temporal changes in importance of quality of life domains: a longitudinal study in community-dwelling Swiss older people.

PURPOSE: Population aging is a global phenomenon requiring interventions to improve quality of life (QoL), a subjective and dynamic concept. Such interventions should be based on QoL domains considered as important from older people's viewpoint. It is unclear whether and how much these domains may vary over time as people age. This study aims to assess the importance of QoL domains, their pattern and determinants of change among the non-institutionalized older population over a 5-year period. METHODS: This longitudinal study included community-dwelling older adults (N = 1947, aged 68-77 years at baseline) from the Lausanne cohort 65+. In 2011 and 2016, participants rated the importance of 28 QoL items in seven domains. The difference between scores (0-100) of importance attributed to each QoL domain between two assessments was calculated and used as a dependent variable to assess the associations with covariates in multivariable analysis for each domain. RESULTS: Importance scores slightly but significantly decreased in five of the seven QoL domains. Despite the majority of participants did not modify their ranking of importance for each QoL domain between the two time points, the proportion of change was still substantial. Bivariate and multivariable analyses showed that education and to a lesser extent age, living arrangement and morbidity, were associated with decrease in the importance of specific QoL domains; characteristics indicating vulnerability (e.g., low education or morbidity) were associated with a decline in the importance. CONCLUSION: Although aging individuals modified the importance they give to the seven QoL domains, at population level, changes in opposite directions overall resulted in only small decline; importance seems less stable over time among individuals with vulnerable sociodemographic and health profiles.

Chronic symptoms in a representative sample of community-dwelling older people: a cross-sectional study in Switzerland.

OBJECTIVES: The burden of multiple diagnoses is well documented in older people, but less is known about chronic symptoms, many of which are even not brought to medical attention. This study aimed to determine the prevalence of chronic symptoms, their relationships with disability in basic activities of daily living (BADL) and quality of life (QoL), and their public health impact. DESIGN: A large cross-sectional population-based study. SETTING: Community in 2 regions of French-speaking Switzerland. PARTICIPANTS: Community-dwelling older adults aged 68 years and older in 2011 (N=5300). OUTCOMES: Disability in BADL defined as difficulty or help needed with any of dressing, bathing, eating, getting in/out of bed or an arm chair, and using the toilet. Overall QoL dichotomised as favourable (ie, excellent or very good) or unfavourable (ie, good, fair or poor). Disturbance by any of the following 14 chronic symptoms for at least 6 months: joint pain, back pain, chest pain, dyspnoea, persistent cough, swollen legs, memory gaps, difficulty concentrating, difficulty making decisions, dizziness/vertigo, skin problems, stomach/intestine problems, urinary incontinence and impaired sexual life. RESULTS: Only 17.1% of participants did not report being disturbed by any of these chronic symptoms. Weighted prevalence ranged from 3.1% (chest pain) to 47.7% (joint pain). Most chronic symptoms were significantly associated with disability in BADL or unfavourable QoL, with substantial gender differences. The number of chronic symptoms was significantly associated with disability in BADL and unfavourable QoL, with gradients suggesting dose-response relationships. Joint pain and back pain had the highest population attributable fractions. CONCLUSIONS: Chronic symptoms are highly prevalent in older people, and are associated with disability in BADL and unfavourable QoL, particularly when multiple chronic symptoms co-occur. Owing to their high public health impact, musculoskeletal chronic symptoms represent good targets for preventive interventions.

Domains of importance to the quality of life of older people from two Swiss regions.

BACKGROUND: Quality of life (QoL) is a subjective perception whose components may vary in importance between individuals. Little is known about which domains of QoL older people deem most important. OBJECTIVE: This study investigated in community-dwelling older people the relationships between the importance given to domains defining their QoL and socioeconomic, demographic and health status. METHODS: Data were compiled from older people enrolled in the Lc65+ cohort study and two additional, population-based, stratified random samples (n = 5,300). Principal components analysis (PCA) was used to determine the underlying domains among 28 items that participants defined as important to their QoL. The components extracted were used as dependent variables in multiple linear regression models to explore their associations with socioeconomic, demographic and health status. RESULTS: PCA identified seven domains that older persons considered important to their QoL. In order of importance (highest to lowest): feeling of safety, health and mobility, autonomy, close entourage, material resources, esteem and recognition, and social and cultural life. A total of six and five domains of importance were significantly associated with education and depressive symptoms, respectively. The importance of material resources was significantly associated with a good financial situation (ß = 0.16, P = 0.011), as was close entourage with living with others (ß = 0.20, P = 0.007) and as was health and mobility with age (ß = -0.16, P = 0.014). CONCLUSION: The importance older people give to domains of their QoL appears strongly related to their actual resources and experienced losses. These findings may help clinicians, researchers and policy makers better adapt strategies to individuals' needs.