Health-related quality of life as a predictor of mortality in heterogeneous samples of older adults
- 42 Downloads
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.
KeywordsHealth-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.
Local ethics committees approved the study protocols of each individual study.
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.
- 2.Frytak J (2000) Assessment of quality of life in older adults. In: Kane RL, Kane RA (eds) Assessing older persons measures, meaning, and practical applications. Oxford University Press, New York, pp 200–236Google Scholar
- 10.Strandberg TE, Pitkala K, Berglind S, Nieminen MS, Tilvis RS (2001) Multifactorial cardiovascular disease prevention in patients aged 75 years and older: a randomized controlled trial: drugs and evidence based medicine in the elderly (DEBATE) study. Am Heart J 142(6):945–951CrossRefPubMedGoogle Scholar
- 12.Eloniemi-Sulkava U, Saarenheimo M, Laakkonen ML, Pietila M, Savikko N, Kautiainen H et al (2009) Family care as collaboration: effectiveness of a multicomponent support program for elderly couples with dementia. Randomized controlled intervention study. J Am Geriatr Soc 57(12):2200–2208CrossRefPubMedGoogle Scholar
- 19.Strandberg TE, Pitkälä K, Sintonen H, Huusko T, Kautiainen H, Tilvis R (2006) Utility, discriminant and prognostic validity of health related quality-of-life measure 15D. In: Huusko T, Strandberg T, Pitkälä K (eds) Can we measure quality-of-life among older people? (In Finnish). The Central Union for the Welfare of the Aged. Helsinki, Finland 2006Google Scholar
- 32.Suominen MH, Puranen TM, Jyväkorpi SK, Eloniemi-Sulkava U, Kautiainen H, Siljamäki-Ojansuu U, Pitkalä KH (2015) Nutritional guidance improves nutrient intake and quality of life, and may prevent falls in aged persons with alzheimer disease living with a spouse (NuAD trial). J Nutr Health Aging 19(9):901–907CrossRefPubMedGoogle Scholar
- 33.Juola AL, Bjorkman MP, Pylkkanen S, Finne-Soveri H, Soini H, Kautiainen H, Bell JS, Pitkala KH (2015) Nurse education to reduce harmful medication use in assisted living facilities: effects of a randomized controlled trial on falls and cognition. Drugs Aging 32(11):947–955CrossRefPubMedGoogle Scholar