European Geriatric Medicine

, Volume 9, Issue 2, pp 227–234 | Cite as

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

  • Helena Liira
  • Nahal Mavaddat
  • Maija Eineluoto
  • Hannu Kautiainen
  • Timo Strandberg
  • Merja Suominen
  • Marja-Liisa Laakkonen
  • Ulla Eloniemi-Sulkava
  • Harri Sintonen
  • Kaisu Pitkälä
Research Paper



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.


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.


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.


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.


Health-related quality of life Older adults Mortality 



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

Compliance with ethical standards

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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Copyright information

© European Geriatric Medicine Society 2018

Authors and Affiliations

  • Helena Liira
    • 1
    • 2
    • 3
  • Nahal Mavaddat
    • 3
  • Maija Eineluoto
    • 1
    • 2
  • Hannu Kautiainen
    • 1
    • 2
  • Timo Strandberg
    • 4
    • 5
    • 6
  • Merja Suominen
    • 1
    • 2
  • Marja-Liisa Laakkonen
    • 1
    • 2
  • Ulla Eloniemi-Sulkava
    • 7
  • Harri Sintonen
    • 8
  • Kaisu Pitkälä
    • 1
    • 2
  1. 1.Department of General PracticeUniversity of HelsinkiHelsinkiFinland
  2. 2.Unit of Primary Health CareHelsinki University HospitalHelsinkiFinland
  3. 3.General Practice, School of Primary, Aboriginal and Rural Health CareUniversity of Western AustraliaPerthAustralia
  4. 4.Geriatric Clinic, Department of MedicineUniversity of HelsinkiHelsinkiFinland
  5. 5.Institute of Health Sciences/GeriatricsUniversity of OuluOuluFinland
  6. 6.Oulu University HospitalOuluFinland
  7. 7.Centre for Continuing EducationUniversity of HelsinkiHelsinkiFinland
  8. 8.Department of Public HealthUniversity of HelsinkiHelsinkiFinland

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