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The prediction of mortality by quality of life assessed with the WHOQOL-BREF: a longitudinal analysis at the domain and item levels using a seven-year follow-up period

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Abstract

Purpose

To determine the predictive value of quality of life for mortality at the domain and item levels.

Methods

This longitudinal study was carried out in a sample of 479 Dutch people aged 75 years or older living independently, using a follow-up of 7 years. Participants completed a self-report questionnaire. Quality of life was assessed with the WHOQOL-BREF, including four domains: physical health, psychological, social relationships, and environment. The municipality of Roosendaal (a town in the Netherlands) indicated the dates of death of the individuals.

Results

Based on mean, all quality of life domains predicted mortality adjusted for gender, age, marital status, education, and income. The hazard ratios ranged from 0.811 (psychological) to 0.933 (social relationships). The areas under the curve (AUCs) of the four domains were 0.730 (physical health), 0.723 (psychological), 0.693 (social relationships), and 0.700 (environment). In all quality of life domains, at least one item predicted mortality (adjusted).

Conclusion

Our study showed that all four quality of life domains belonging to the WHOQOL-BREF predict mortality in a sample of Dutch community-dwelling older people using a follow-up period of 7 years. Two AUCs were above threshold (psychological, physical health). The findings offer health care and welfare professionals evidence for conducting interventions to reduce the risk of premature death.

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Availability of data

All data were pseudonymized and stored in a central and secure server at Inholland University of Applied Sciences. Furthermore, we have complied with the law with regard to personal data privacy information (Dutch Data Protection Authority) [52].

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Acknowledgements

The authors would like to thank the municipality in Roosendaal, the Netherlands, and the Dutch Public Health Services in West-Brabant, the Netherlands, for their support in making available the data. In addition, the authors would like to thank the study participants for their contributions to this study.

Funding

No funds, grants, or other support was received.

Author information

Authors and Affiliations

  1. Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, De Boelelaan 1109, 1081 HV, Amsterdam, the Netherlands

    Robbert J. J. Gobbens

  2. Zonnehuisgroep Amstelland, Amstelveen, the Netherlands

    Robbert J. J. Gobbens

  3. Department Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium

    Robbert J. J. Gobbens

  4. Faculty of Engineering, Design and Computer Technology, Inholland University of Applied Sciences, Alkmaar, the Netherlands

    Tjeerd van der Ploeg

Authors
  1. Robbert J. J. Gobbens
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  2. Tjeerd van der Ploeg
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Contributions

RG involved in study concept and design, acquisition of subjects and data, and preparation of the manuscript (drafting, final approval). TP participated in study concept and design, analysis and interpretation of the data, and preparation of the manuscript (drafting, final approval). Both authors agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Robbert J. J. Gobbens.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

For the present study, medical ethics approval was not necessary because particular treatments or interventions were not offered or withheld from respondents. Moreover, the integrity of respondents was not encroached upon as a consequence of participating in this study, which is the main criterion in medical–ethical procedures in the Netherlands [53]. This research was conducted according to the guidelines for good clinical practice [54]. The researchers did not make the questionnaire long so the burden on participants would be limited; the average time for completing the questionnaire was 20 min. In addition, the questionnaire contained measures that have already been used in many previous studies among older people, including the WHOQOL-BREF. Both researchers have a PhD; during the PhD trajectory, much attention was paid to ethical aspects of good research.

Informed consent

Informed consent related to detailing the study (e.g., information about the purpose of the study) and maintaining confidentiality was observed.

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Gobbens, R.J.J., van der Ploeg, T. The prediction of mortality by quality of life assessed with the WHOQOL-BREF: a longitudinal analysis at the domain and item levels using a seven-year follow-up period. Qual Life Res 30, 1951–1962 (2021). https://doi.org/10.1007/s11136-021-02790-9

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