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Quality of Life in Old Age: Problematic Issues

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Abstract

Quality of Life (QoL) is a concept widely used in gerontology, as well as in other fields such as anthropology, health sciences, psychology, sociology and political sciences. Historically, although Aristotle is considered as an antecedent, the term QoL emerged in about the sixties in scientific literature. In the field of ageing, it is considered as an outcome of projects, programmes, services or policies and is used for describing populations, contexts and individuals. QoL is considered by most experts as a multidimensional concept involving multiple domains (health, psychological, social and environmental), containing objective and subjective components. Nevertheless, in recent years, QoL has been reduced to the subjective appraisal, to health or to subjective psychological attributes such as well-being, happiness or life satisfaction. Moreover, conceptual confusions can be found between QoL and other concepts related to positive ageing. In this conceptually-driven paper, after reviewing a set of expert and lay conceptualizations of QoL and identifying the diversity of its components, three critical issues will be discussed: its reduction to health or to the subjective appraisal of a set of domains, the confusion of QoL with other subjective or positive concepts and, finally, its methodological reductionism to self-reports as an exclusive procedure for QoL data collection. From these criticisms some conceptual and methodological suggestions are proposed.

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References

  • Andersen, R. M., Davidson, P. L., & Ganz, P. A. (1994). Symbiotic relationships of quality of life, health services research and other health research. Quality of Life Research, 3, 365–371.

    Article  Google Scholar 

  • Andersson, L. (2005). Sweden: Quality of life in old age I. In A. Walker (Ed.), Growing older in Europe (pp. 105–128). Berkshire, UK: Open University Press.

    Google Scholar 

  • Antonovsky, A. (1987). Testing the sense of coherence model. In H. S. Friedman (Ed.), Personality and disease (pp. 155–186). New York: Wiley.

    Google Scholar 

  • Baltes, P. B., & Baltes, M. M. (1990). Psychological perspectives on successful ageing: The model of selective optimization with compensation. In P. B. Baltes & M. M. Baltes (Eds.), Successful aging: Perspectives from the behavioural sciences (pp. 1–35). Cambridge UK: Cambridge University Press.

    Chapter  Google Scholar 

  • Birren, J. E., & Dieckmann, L. (1991). Concepts and content of quality of life in later years: An overview. In J. E. Birren (Ed.), The concept and measurement of quality of life in the Frail Elderly (pp. 344–360). San Diego: Academic Press.

    Google Scholar 

  • Bowling, A. (1995). What things are important in people’s lives? A survey of the public’s judgements to inform scales of health related QOL. Social Science & Medicine, 41, 1447–1462.

    Article  Google Scholar 

  • Bowling, A. (2005). Aging well: Quality of life in old age. Maidenhead: Open University.

    Google Scholar 

  • Bowling, A., Seetai, S., Morris, R., & Ebrahim, S. (2002). Quality of life among older people with poor functioning. The influence of perceived control over life. Age and Ageing Advance, 36, 310–315.

    Article  Google Scholar 

  • Brown, J., Bowling, A., & Flynn, T. N. (2004). Models of quality of life. Ataxonomy and systematic review of the literature. Sheffield: Report Commissioned by the European Forum on Population Ageing Research/ Quality of Life.

    Google Scholar 

  • Browne, J. P., O’Boyle, C. A., McGee, H. M., Joyce, C. R. B., Mc Donald, N. J., O’Malley, K., et al. (1994). Individual quality of life in the healthy elderly. Quality of Life Research, 3, 235–244.

    Article  Google Scholar 

  • Burbank, P. M. (1992). An exploratory study: assessing the meaning in life among older adult clients. Journal of Gerontological Nursing, 18, 19–28.

    Google Scholar 

  • Camfield, L., & Skevington, S. M. (2008). On subjective well-being and quality of life. Journal of Health Psychology, 13, 764–775.

    Article  Google Scholar 

  • Campbell, A. (1981). The sense of well-being in America. New York: McGraw-Hill.

    Google Scholar 

  • Caprara, M. G., & Corraliza, J. A. (2008). Intervención y evaluación ambiental en la vejez. In R. Fernández-Ballesteros (Ed.), Psicología de la vejez. Una psicogerontología aplicada. (Psychology of the elderly. An Applied Geropsychology (pp. 281–305). Madrid: Pirámide.

    Google Scholar 

  • Cook, T. D. (1985). Postpositivist critical multiplism. In S. Shotland & M. V. Mark (Eds.), Social science and social policy. Palo Alto, CA: Sage.

    Google Scholar 

  • Diener, E., & Diener, C. (1996). The wealth of nations revisited: income and quality of life. Social Indicators Research, 36, 275–286.

    Article  Google Scholar 

  • Diener, E., & Mark, E. (1999). National differences in subjective well-being. In D. Kahneman, E. Diener, & N. Schwarz (Eds.), Well-being. The foundations of hedonic psychology (pp. 434–453). New York: Russel Sage Foundation.

    Google Scholar 

  • Dumenci, L. (2003). Multitrait–multimethod matrices. In R. Fernández-Ballesteros (Ed.), Encyclopedia of psychological assessment (Vol. 2, pp. 610–614). London: Sage.

    Google Scholar 

  • Edlund, M., & Tancredi, L. R. (1985). Quality of life: an ideological critique. Perspectives in Biology and Medicine, 28, 591–607.

    Google Scholar 

  • Farquhar, M. (1995). Elderly people’s definitions of quality of life. Social Science and Medicine, 41, 1439–1446.

    Google Scholar 

  • Fayers, P. M., & Machin, D. (2007). Quality of life (2nd ed.). Chichester, West Sussex, England: Wiley.

    Book  Google Scholar 

  • Fernández-Ballesteros, R. (1993). The construct of quality of life among the elderly. In E. Beregi, I. A. Gergely, & K. Rajzi (Eds.), Recent advances in aging and science (pp. 1627–1630). Milano: Monduzzi Ed.

    Google Scholar 

  • Fernández-Ballesteros, R. (Ed.). (1995). Sistema de Evaluación de Residencias de Ancianos. SERA. Madrid: INSERSO.

    Google Scholar 

  • Fernández-Ballesteros, R. (1998). Quality of life: Concept and assessment. In J. G. Adair, D. Bélanger, & K. L. Dion (Eds.), Advances in psychological science (Vol. I, pp. 387–706). East Sussex, UK: Psychology Press.

    Google Scholar 

  • Fernández-Ballesteros, R. (2002). Light and dark in the psychology of human strengths: The example of psychogerontology. In K. G. Aspinwal & U. M. Staudinger (Eds.), A psychology of human strength: Perspectives on an emerging field (pp. 131–149). Washington DC: APA Book.

    Google Scholar 

  • Fernández-Ballesteros, R. (2003). Self-report questionnaires. En S. Haynes y E. Heiby (Eds.) Behavioral assessment. In M. Hersen (Ed.), A comprehensive handbook of psychological assessment (pp. 194–221). New York: Wiley.

    Google Scholar 

  • Fernández-Ballesteros, R. (2008). Active aging. The contribution of psychology. Göttingen: Hogrefe and Huber.

    Google Scholar 

  • Fernández-Ballesteros, R., & Maciá, A. (1993). Calidad de vida en la vejez (Quality of life in the elderly). Revista de Intervención Psicosocial, 5, 77–94.

    Google Scholar 

  • Fernández-Ballesteros, R., & Maciá, A. (1996). Informes de allegados sobre los mayores y de estos sobre sí mismos (Proxy’s reports about the elderly and elders’ self-reports). Revista Multidisciplinar de Gerontología, 6, 20–29.

    Google Scholar 

  • Fernández-Ballesteros, R., & Zamarrón, M. D. (1997). New findings on social desirability and faking. Psychological Reports, 78, 612–614.

    Google Scholar 

  • Fernández-Ballesteros, R., Zamarrón, M. D., & Maciá, A. (1997). Calidad de vida en la vejez en distintos contextos (Quality of Life among the elderly in different contexts). Madrid: INSERSO.

    Google Scholar 

  • Fernández-Ballesteros, R., Montorio, I., & Izal, M. (1998). Personal and environmental relationship among the elderly living in residential settings. Archives of Gerontology and Geriatrics, 26, 185–198.

    Article  Google Scholar 

  • Fernández-Ballesteros, R., Zamarrón, M. D., Rudinger, G., Schroots, J. J. F., Hekkinnen, E., Drusini, A., et al. (2004). Assessing competence: the European Survey on Aging Protocol (ESAP). Gerontology, 50, 330–347.

    Article  Google Scholar 

  • Fernández-Ballesteros, R., Kruse, A., Zamarrón, M. D., & Caprara, M. G. (2007). Quality of life, life satisfaction, and positive aging. In R. Fernández-Ballesteros (Ed.), GeroPsychology. European perspectives for an aging world (pp. 197–223). Göttingen: Hogrefe and Huber.

    Google Scholar 

  • Fernández-Ballesteros, R., García, L. F., Abarca, D., Blanc, L., Efklides, A., Kornfeld, R., et al. (2008). Lay concept of aging well: cross-cultural comparisons. Journal of the American Geriatrics Society, 56, 950–951.

    Article  Google Scholar 

  • Fowlie, M., & Berkeley, J. (1987). Quality of life—a review of the literature. Family Practice, 4, 226–234.

    Article  Google Scholar 

  • Frisch, R. (1994). QOLI quality of life inventory. Manual and treatment manual. Minneapolis, MN: National Computer System.

    Google Scholar 

  • Fry, P. S. (2000). Whose quality of life is it anyway? Why not ask seniors to tell us about it? International Journal of Aging & Human Development, 50, 361–383.

    Article  Google Scholar 

  • George, I. K., & Bearon, I. B. (1980). Quality of life in older persons. New York: Human Sciences Press.

    Google Scholar 

  • Hadorn, D. C., & Hays, R. D. (1991). Multitrait–multimethod analysis of health-related quality-of-life measures. Medical Care, 29, 829–840.

    Article  Google Scholar 

  • Halvorsrud, L., & Kalfoss, M. (2007). The conceptualization and measurement of quality of life in older adults: a review of empirical studies published during 1994–2006. European Journal of Ageing, 4, 229–247.

    Article  Google Scholar 

  • Hilleras, P. K., Aguero-Torres, H., & Winblad, B. (2001). Factors influencing well-being in the elderly. Geriatric Psychiatry, 14, 361–365.

    Google Scholar 

  • Hughes, B. (1990). Quality of life. In S. M. Sheila & M. Peace (Eds.), Researching social gerontology. Concepts, methods and issues (pp. 46–58). Beverly Hills, CA: Sage.

    Google Scholar 

  • Lawton, R. L. (1983). Environment and other determinants of well-being in older people. The Gerontologist, 23, 349–357.

    Google Scholar 

  • Lawton, M. P. (1987). Environment and the need of satisfaction of the aging. In L. L. Carstensen & B. A. Edelstein (Eds.), Handbook of clinical gerontology (pp. 327–337). New York: Pergamon Press.

    Google Scholar 

  • Lawton, M. P. (1991). Background: A multidimensional view of quality of life in frail elders. In Birren JE, J. Lubben, J. Rowe, & D. Deutchman (Eds.), The concept and measurement of quality of life in the Frail Eldery. San Diego, CA: Academic Press.

    Google Scholar 

  • Lawton, M. P. (1996). Quality of life and affect in later life. In C. Magai & S. H. McFadden (Eds.), Handbook on emotion, human development, and aging (pp. 327–348). San Diego, CA: Academic Press.

    Google Scholar 

  • Lawton, M. P., Winter, L., Kleban, M. H., & Ruckdeschel, K. (1999). Quality of life. Objective and subjective. Journal of Aging and Health, 11, 169–198.

    Article  Google Scholar 

  • Moos, R., & Lemke, S. (1996). Evaluating residential facilities: The Multiphasic Environmental Assessment Procedure (MEAP). Thousand Oaks: Sage.

    Google Scholar 

  • Naughton, M. J., & Wiklund, I. (1993). A critical view of dimension-specific measures of health-related quality of life in cross-cultural research. Quality of Life Research, 2, 397–432.

    Article  Google Scholar 

  • Nussbaum, M. C., & Sen, M. C. (2002). The quality of life. Oxford, England: Oxford Univ. Press.

    Google Scholar 

  • Palmore, E. (1980). The facts on aging quiz: a review of findings. The Gerontologist, 20, 669–672.

    Google Scholar 

  • Palys, T. S., & Little, B. R. (1983). Perceived life satisfaction and the organization of personal project system. Journal of Personality and Social Psychology, 44, 1221–1230.

    Article  Google Scholar 

  • Raphael, D., Brown, I., Renwik, R., Cava, M., Weir, N., & Heathcote, K. (1997). Measuring the quality of life of older persons. International Journal of Nursing Studies, 34, 231–239.

    Google Scholar 

  • Rowe, J. W., & Khan, R. L. (1987). Human aging: usual and successful. Science, 237, 143–149.

    Article  Google Scholar 

  • Sampson, E. E. (1981). Cognitive psychology as ideology. The American Psychologist, 36, 730–743.

    Article  Google Scholar 

  • Skevington, S. M., Lofty, M., & O’Connell, K. A. (2004). The World Health Organization’s WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial. A Report from the WHOQOL Group. Quality of Life Research, 13, 299–310.

    Article  Google Scholar 

  • Smith, K. W., Avis, N. E., & Assmann, S. F. (1999). Distinguishing between quality of life and health status in quality of life reserach: a meta-analysis. Quality of Life, 8, 447–159.

    Article  Google Scholar 

  • Sternberg, R. J. (1990). Methaphors of mind. New York: Cambridge University Press.

    Google Scholar 

  • The Economist. (2005). Quality of Life Index. The World in the 2005. The Economist. http://www.economist.com/media/pdf/QUALITY_OF_LIFE.PDF.

  • The Webster’s Dictionary of English Language. (1986). New York: Gramercy Books.

  • Tolman, E. C. (1941). Psychological man. The Journal of Social Psychology, 13, 205–218.

    Article  Google Scholar 

  • Veenhoven, R. (1996). Happy life expectance: a comprehensive measure of Quality-of-Life in Nations. Social Indicators Research, 39, 1–58.

    Article  Google Scholar 

  • Veenhoven, R. (2000). The four qualities of life. Ordering concepts and measures of the good life. Journal of Happiness Studies, 1, 1–39.

    Article  Google Scholar 

  • Walker, A. (2005a). Growing older. London, UK: Open University Press.

    Google Scholar 

  • Walker, A. (2005b). A European perspective on quality of life in old age. European Journal of Ageing, 2, 2–13.

    Article  Google Scholar 

  • Whal, H.-W., & Iwarson, S. (2007). Person–environment relations. In R. Fernández-Ballesteros (Ed.), GeroPsychology. European perspectives for an aging world (pp. 31–48). Göttingen: Hogrefe and Huber.

    Google Scholar 

  • WHO. (2002). Active ageing. A policy framework. Geneva: World Health Organization.

    Google Scholar 

  • WHOQOL. (1993). Study protocol for the World Health Organization project to develop a Quality of Life assessment instrument (WHOQOL). Quality of Life Research, 2, 153–159.

    Article  Google Scholar 

  • WHOQOL Group. (1995). The World Health Organization Quality of Life assessment (WHOQOL): position paper from the World Health Organization. Social Science & Medicine, 41, 1403–1409.

    Article  Google Scholar 

  • Ziller, R. C. (1974). Self-other orientation and quality of life. Social Indicators Research, 1, 301–327.

    Article  Google Scholar 

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  1. Department of Psychobiology and Health, Autonomous University of Madrid, 28109, Madrid, Spain

    Rocío Fernández-Ballesteros

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  1. Rocío Fernández-Ballesteros
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Correspondence to Rocío Fernández-Ballesteros.

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Fernández-Ballesteros, R. Quality of Life in Old Age: Problematic Issues. Applied Research Quality Life 6, 21–40 (2011). https://doi.org/10.1007/s11482-010-9110-x

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