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Health-related quality of life as a predictor of mortality in heterogeneous samples of older adults

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Abstract

Background

Health-related quality of life (HRQoL) is associated with survival in older people with multimorbidities and disabilities. However, older people differ in their characteristics, and less is known about whether HRQoL predicts survival in heterogeneous older population samples differing in their functional, cognitive, psychological or social disabilities. The aim of this study was to explore HRQoL in heterogeneous samples of older men and women, and to explore its prognostic significance for mortality.

Methods

We analysed combined individual patient data from eight heterogeneous study samples all of which were assessed with the same methods. We used 15D, a generic, comprehensive instrument for measuring HRQoL, which provides a single index in addition to a profile. Two-year mortality was retrieved from central registers.

Results

Health-related quality of life measurements with 15D were available for 3153 older adults. The mean HRQoL was highest among older businessmen (0.878) and lowest among nursing home residents (0.601). 15D predicted independently and significantly the 2-year survival in the total sample [hazard ratio (HR)/SD 0.44, 95% CI 0.40–0.48)]. However, 15D did not predict mortality in samples of spousal caregivers, lonely older adults and cardiovascular patients.

Conclusions

15D captures health and disability factors associated with prognosis whereas in older populations suffering from psychological and social impairments such as caregiver burden or loneliness HRQoL may not reflect their health risks.

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Acknowledgements

This study was supported by University of Helsinki and University of Western Australia.

Author information

Authors and Affiliations

  1. Department of General Practice, University of Helsinki, Helsinki, Finland

    Helena Liira, Maija Eineluoto, Hannu Kautiainen, Merja Suominen, Marja-Liisa Laakkonen & Kaisu Pitkälä

  2. Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland

    Helena Liira, Maija Eineluoto, Hannu Kautiainen, Merja Suominen, Marja-Liisa Laakkonen & Kaisu Pitkälä

  3. General Practice, School of Primary, Aboriginal and Rural Health Care, University of Western Australia, Perth, Australia

    Helena Liira & Nahal Mavaddat

  4. Geriatric Clinic, Department of Medicine, University of Helsinki, Helsinki, Finland

    Timo Strandberg

  5. Institute of Health Sciences/Geriatrics, University of Oulu, Oulu, Finland

    Timo Strandberg

  6. Oulu University Hospital, Oulu, Finland

    Timo Strandberg

  7. Centre for Continuing Education, University of Helsinki, Helsinki, Finland

    Ulla Eloniemi-Sulkava

  8. Department of Public Health, University of Helsinki, Helsinki, Finland

    Harri Sintonen

Authors
  1. Helena Liira
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  2. Nahal Mavaddat
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  3. Maija Eineluoto
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  4. Hannu Kautiainen
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  7. Marja-Liisa Laakkonen
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  8. Ulla Eloniemi-Sulkava
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  10. Kaisu Pitkälä
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Corresponding author

Correspondence to Helena Liira.

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Conflict of interest

HS is the developer of the 15D instrument and obtains royalties from the electronic versions of the instrument. Otherwise, the authors declare no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Ethical approval

Local ethics committees approved the study protocols of each individual study.

Informed consent

Written informed consent was obtained from all participants or, in the event of cognitive impairment, from the participant’s closest proxy prior to study participation.

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Liira, H., Mavaddat, N., Eineluoto, M. et al. Health-related quality of life as a predictor of mortality in heterogeneous samples of older adults. Eur Geriatr Med 9, 227–234 (2018). https://doi.org/10.1007/s41999-018-0029-3

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  • DOI: https://doi.org/10.1007/s41999-018-0029-3

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