Quality of Life Research

, Volume 14, Issue 6, pp 1443–1454 | Cite as

WHOQOL-BREF as predictors of mortality: A two-year follow-up study at veteran homes

  • Senyeong Kao
  • Kuan-Lang Lai
  • Herng-Ching Lin
  • Hong-Shen Lee
  • Hsyien-Chia Wen


The main purpose of this study was to evaluate the effectiveness of the brief version of the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire as a predictor of mortality amongst the elderly. A total of 689 male residents of veteran homes, all above the age of 65 years, were randomly selected in 2001. The Taiwan version of the WHOQOL-BREF was administered as the baseline, with each of these subjects being interviewed and subsequently followed up for mortality until the end of 2003. Data on self-reported global health, life satisfaction, medical status, physical performance and health behavior was also collected. Following the death of 105 of the 689 subjects during the 2-year follow-up period, the relative risk (RR) of death was subsequently assessed using Cox’s proportional hazard regression analyses. After adjusting for other predictors (age group, chronic diseases, emergency visits, hospitalization, physical performance, regular exercise, self-reported global health and life satisfaction), almost all of the WHOQOL-BREF items and domains failed to predict mortality; the one exception was working capacity levels (score 1–2 vs. score 4–5) which, after adjusting for other predictors, did demonstrate the ability to predict mortality (RR = 1.96, p < 0.05).


Elderly HRQOL Predictor of mortality WHOQOL-BREF 



confidence interval


Eastern Co-operative Oncology Group


health-related quality of life


relative risk


brief version of the World Health Organization Quality of Life questionnaire


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  1. 1.
    Hazzard, WR, Andres, R, Bierman, EL, Blass, JP. 1990Principles of Geriatric Medicine and GerontologyMcGraw-HillNew YorkGoogle Scholar
  2. 2.
    Patrick, DL, Erickson, P. 1993Health Status and Health Policy: Allocating Resources to Health CareOxford University PressNew YorkGoogle Scholar
  3. 3.
    Mossey, JM, Shapiro, E. 1982Self-rated health: A predictor of mortality among the elderlyAm J Public Health.72800808PubMedGoogle Scholar
  4. 4.
    Kaplan, G, Barell, V, Lusky, A. 1988Subjective state of health and survival in elderly adultsJ Gerontol Soc Sci.43S114S220Google Scholar
  5. 5.
    Jylhä, M, Aro, S. 1989Social ties and survival among the elderly in Tampere, FinlandInt J Epidemiol.18158164PubMedGoogle Scholar
  6. 6.
    Grand, A, Grosclaude, P, Bocquet, H, Pous, J, Albarede, JL. 1990Disability, psychosocial factors and mortality among the elderly in a runal French populationJ Clin Epidemiol.43773782CrossRefPubMedGoogle Scholar
  7. 7.
    LaCroix, AZ, Guralnik, JM, Curb, JD, Wallace, RB, Ostfeld, AM, Hennekens, CH. 1990Chest pain and coronary heart disease mortality among older men and women in three communitiesCirculation.81437446PubMedGoogle Scholar
  8. 8.
    Idler, EL, Kasl, S. 1991Heal perceptions and survival: Do global evaluations of health status really predict mortality?J Gerontol Soc Sci.46S55S65Google Scholar
  9. 9.
    Crooks, V, Waller S. Smith, T, Haln, TJ. 1991The use of the ECOG performance scale in determining outcomes and risk in geriatric outpatientsJ Gerontol.46M139M144PubMedGoogle Scholar
  10. 10.
    Wolinsky, FD, Johnson, RJ. 1992Perceived health status and mortality among older men and womenJ Gerontol Soc Sci.47S304S312Google Scholar
  11. 11.
    Parker, MG, Thorslund, M, Nordström, ML. 1992Predictors of mortality for the oldest old. A 4-year follow-up of community-based elderly in SwedenArch Gerontol Geriatr.14227237CrossRefPubMedGoogle Scholar
  12. 12.
    McCallum, J, Shadbolt, B, Wang, D. 1994Self-rated health and survival: A 7-year follow-up study of Australian elderlyAm J Public Health.8411001105PubMedGoogle Scholar
  13. 13.
    Tsuji, I, Minami, Y, Keyl, PM,  et al. 1994The predictive power of self-rated health, activities of daily living and ambulatory activity for cause-specific mortality among the elderly: A three-year follow-up in urban JapanJ Am Geriatr Soc.42153156PubMedGoogle Scholar
  14. 14.
    Konstam, V, Salem, D, Pouleur, H,  et al. 1996Baseline quality of life as a predictor of mortality and hospitalization in 5,025 patients with congestive heart failure. SOLVD Investigations. Studies of Left Ventricular Dysfunction Investigators.Am J Cardiol.78890895PubMedGoogle Scholar
  15. 15.
    Gustafsson, TM, Isacson, DGL, Thorslund, M. 1998Mortality in elderly men and women in a Swedish municipalityAge Ageing.27585593PubMedGoogle Scholar
  16. 16.
    Fried, LP, Kronmal, RA, Newman, AB,  et al. 1998for the Cardiovascular Health Study Collaborative Research Group. Risk factors for 5-year mortality in older adultsJAMA.279585592PubMedGoogle Scholar
  17. 17.
    Kåreholt, I, Brattberg, G. 1998Pain and mortality risk among elderly persons in SwedenPain.77271278PubMedGoogle Scholar
  18. 18.
    Bosworth, HB, Schaie, KW, Willis, SL. 1999Cognitive and sociodemographic risk factors for mortality in the Seattle longitudinal studyJ Gerontol Psychol Sci.54P273P282Google Scholar
  19. 19.
    Rumsfeld, JS, MaWhinney, S, McCarthy, M,Jr,  et al. 1999Health-related quality of life as a predictor of mortality following coronary artery bypass graft surgery. Participants of the Department of Veterans Affairs Cooperative Study Group on Processes, Structures, and Outcomes of Care in Cardiac Surgery.JAMA.28112981303PubMedGoogle Scholar
  20. 20.
    Mapes, DL, Lopes, AA, Satayathum, S,  et al. 2003Health-related quality of life as a predictor of mortality and hospitalization: the Dialysis Outcomes and Practice Patterns Study (DOPPS)Kidney Int.64339349PubMedGoogle Scholar
  21. 21.
    Meinow, B, Kåreholt, I, Parker, MG, Thorslund, M. 2004The effect of the duration of follow-up in mortality analysis: The temporal pattern of different predictorsJ Gerontol Soc Sci.59S181S189Google Scholar
  22. 22.
    The WHOQOL Group. Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol Med 1998; 28: 551–558Google Scholar
  23. 23.
    Morris, LA, Miller, DW. 2002The regulation of patient-reported outcome claims: need for a flexible standardValue Health.5372381PubMedGoogle Scholar
  24. 24.
    Division of Statistics, Department of Domestic Affairs, Executive Yuan, R.O.C. Monthly Bulletin of Interior Statistics, Taiwan and Fuchien Area, R.O.C. Taipei: Division of Statistics, Department of Domestic Affairs, Execute Yuan, 2004Google Scholar
  25. 25.
    Yao, G, Chung, CW, Yu, CF, Wang, JD. 2002Development and verification of validity and reliability of the WHOQOL-BREF Taiwan versionJ Formos Med Assoc.101342351PubMedGoogle Scholar
  26. 26.
    The WHOQOL-Taiwan Group. The User’s Manual of the Development of the WHOQOL-BREF Taiwan Version. Taipei: WHOQOL-Taiwan Group, 2000Google Scholar
  27. 27.
    Lin, MR, Huang, W, Huang, C, Hwang, HF, Tsai, LW, Chiu, YN. 2002The impact of the Chi-Chi earthquake on quality of life among elderly survivors in Taiwan – A before and after studyQual Life Res.11379388PubMedGoogle Scholar
  28. 28.
    Bush, TL, Miller, SR, Golden, AL, Hale, WE. 1989Self-report and medical record report agreement of selected medical conditions in the elderlyAm J Public Health.7915541556PubMedGoogle Scholar
  29. 29.
    Jones, AS, Fenton, JE, Husband, DJ. 2000Performance data and survival in head and neck cancerClin Otolaryngol.25396403PubMedGoogle Scholar
  30. 30.
    Power, M, Harper, A, Bullinger, M. 1999The World Health Organization WHOQOL-100: Tests of the universality of Quality of Life in 15 different cultural groups worldwideHealth Psychol.18495505PubMedGoogle Scholar
  31. 31.
    Kazis, LE, Miller, DR, Clark, J,  et al. 1998Health-related quality of life in patients served by the Department of Veterans Affairs: Results from the Veterans Health StudyArch Int Med.158626632Google Scholar
  32. 32.
    Casellas, F, López-Vivancos, J, Casado, A, Malagelada, JR. 2002Factor affecting health quality of life of patients with inflammatory bowel diseaseQual Life Res.11775781PubMedGoogle Scholar
  33. 33.
    Sullivan, MD, Kempen, GIJM, Sonderen, EV, Ormel, J. 2000Models of health-related quality of life in a population of community-dwelling Dutch elderlyQual Life Res.9801810PubMedGoogle Scholar
  34. 34.
    The WHOQOL Group. The development of the World Health Organization quality of life assessment instrument (the WHOQOL). In: Orley J, Kuyke W (eds), Quality of Life Assessment: International Perspectives. Heidelberg: Springer-Verlag, 1994Google Scholar
  35. 35.
    Thorson, JA. 2002Aging in a Changing SocietyBrunner-RoutledgePhiladelphia.Google Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  • Senyeong Kao
    • 1
  • Kuan-Lang Lai
    • 2
  • Herng-Ching Lin
    • 3
  • Hong-Shen Lee
    • 4
  • Hsyien-Chia Wen
    • 3
  1. 1.School of Public HealthNational Defense Medical CenterTaipeiTaiwan
  2. 2.Graduate Institute of Life SciencesNational Defense Medical CenterTaipeiTaiwan
  3. 3.School of Health Care AdministrationTaipei Medical UniversityTaipeiTaiwan
  4. 4.Department of Public HealthChung Shan Medical UniversityTaichungTaiwan

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