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A European perspective on quality of life in old age.

ABSTRACT: This article focuses on the scientific study of quality of life in old age and summarises, on the one hand, what we know and, on the other, what further research is needed. It consists of three main parts, with an extended introduction charting the recent evolution of a European perspective on ageing. First of all, it emphasises the amorphous, multidimensional and complex nature of quality of life and the high level of inconsistency between scientists in their approach to this subject. Secondly, the article summarises the main areas of consensus about quality of life in old age-its dynamic multifaceted nature, the combination of life course and immediate influences, the similarities and differences in the factors determining quality of life between younger and older people, the most common associations with quality of life and the likely variations between groups, and the powerful role of subjective self-assessment. Thirdly, the main research priorities and gaps in knowledge are outlined, together with the key methodological issues which must be tackled if comparative, interdisciplinary research on quality of life is to develop further. The main sources for the article are two European Framework Programme projects-the one a small five-country comparison and the other a large multidimensional project which, among other things, has been developing recommendations for research on quality of life in old age and included an extensive literature review on this topic. The article also draws on the recently completed UK Growing Older Programme of research on extending quality of life.

SUBMITTER: Walker A

PROVIDER: S-EPMC5547671 | biostudies-other | 2005 Mar

REPOSITORIES: biostudies-other

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Project description:Promoting quality of life is a central theme in recent ageing policies, but what quality of life means in concrete terms for people in different stages of old age is rather unclear. This study presents a multi-dimensional model of care-related quality of life (crQoL) and, based on analyses of three Finnish cross-sectional datasets from the years 2004-2007, examines the distinctions between dimensions of QoL by age and gender, with a special focus on older home care clients. Correlation analyses (Pearson) and stepwise linear regression were applied to analyse variation in QoL by age group and the association between QoL and perceived quality of home care. The results suggest that individual QoL and the priorities of (physical, psychical, social, and environmental) dimensions in the assessment of QoL by older persons vary considerably and exhibit distinct profiles in different stages of ageing. In addition, four dimensions for good care corresponding to the crQoL model were identified and their empirical relevance demonstrated. From the perspective of older people in need of help, home care is not just about giving them the instrumental help they need to perform their daily activities, but rather about giving responsive care that reflects their personal preferences or their view on a "good life", and treats them with dignity and respect. The criteria for the evaluation of quality of home care should reflect these insights, and policy measures should take these differences into account.

| S-EPMC5547302 | biostudies-other

Quality of Life in European Older Adults of SHARE Wave 7: Comparing the Old and the Oldest-Old.

Project description:CASP-12 (Control, Autonomy, Self-realization, and Pleasure scale) is one of the most common internationally used measures for quality of life in older adults, although its structure is not clearly established. Current research aims to test the factor structure of the CASP-12, so as to provide evidence on reliability and external validity, and to test for measurement invariance across age groups. Data from 61,355 Europeans (≥60 years old) from the Survey of Health, Ageing and Retirement in Europe wave 7 were used. CASP-12, EURO-D (European depression scale), self-perceived health, and life satisfaction measurements were included. Reliability and validity coefficients, competing confirmatory factor models, and standard measurement invariance routine were estimated. A second-order factor model with the original factor structure was retained. The scale showed adequate reliability coefficients except for the autonomy dimension. The correlation coefficients for external validity were all statistically significant. Finally, CASP-12 is scalar invariant across age. We conclude that the best-fitting factor structure retained allows using CASP-12 either by factors, or as an overall score, depending on the research interests. Findings related to CASP-12 measurement invariance encourage its use in the oldest-old too. When comparing the dimensions across age groups, as people age, autonomy slightly increases and the rest of the dimensions decline.

| S-EPMC8268858 | biostudies-literature

Retrospective life course data from European countries on how early life experiences determine health in old age and possible mid-life mediators.

Project description:The data presented in this article is related to the research paper entitled "The long arm of childhood circumstances on health in old age: Evidence from SHARELIFE" (E. Pakpahan, R. Hoffmann, H. Kröger, 2016) [1]. It presents the distribution of socioeconomic status (SES) and health from childhood until old age in thirteen European countries. In order to capture the characteristics of longitudinal data, which resembles life course data, we divide the data into three schematic periods: childhood (up to 15 years old), adulthood (30 to 60 years old), and old age (61 to 90 years old). This data set contains respondents' life histories, ranging from childhood conditions (such as housing and health) to detailed questions on education, adult SES (working history, income, and wealth) and old age health. The data can be used not only to understand on how early life experiences determine health in old age, but also to recognise the importance of possible mid-life mediators.

| S-EPMC5156599 | biostudies-literature

The home environment and quality of life-related outcomes in advanced old age: findings of the ENABLE-AGE project.

Project description:With the present research, we further exploited the potential of the ENABLE-AGE Project, more precisely the Swedish and German data. We hypothesised that the magnitude of accessibility problems (MAP) in the home environment and external housing-related control beliefs (HCB) play a substantial role for a range of outcomes related to quality of life. Our sample at T1 consisted of 847 single-living and community-dwelling individuals aged between 80 and 89 years, from urban regions in Sweden and Germany, 636 of whom were re-assessed 1 year later. MAP was measured with the Housing Enabler instrument, while external HCB assessment was based on a questionnaire proved useful in earlier research. Outcomes were assessed with established measures of ADL independence/dependence, general well-being, positive and negative affect and depression. Cross-sectional regressions underscored that MAP and external HCB were rather consistently associated with outcomes, with MAP being more strongly associated with ADL independence/dependence and external HCB more strongly with well-being related outcomes. Furthermore, significant and marginally significant interaction terms underscored that being high in external HCB in the situation of large MAP was linked with more negative outcomes, while external HCB did not play a role in the situation of small MAP. In the longitudinal regression analysis, MAP at T1 was predictive for T1-T2 change in ADL independence/dependence and depression, while external HCB did not show substantial relations with any change in outcomes. Our study underlines and qualifies substantial relations between objective and perceived person-physical environment measures and a range of outcomes. Such evidence is required to further improve housing-oriented prevention and intervention strategies in advanced old age.

| S-EPMC5547301 | biostudies-other

Life-Course Circumstances and Frailty in Old Age Within Different European Welfare Regimes: A Longitudinal Study With SHARE.

Project description:ObjectivesThis study aimed to assess whether cumulative disadvantage in childhood misfortune and adult-life socioeconomic conditions influence the risk of frailty in old age and whether welfare regimes influence these associations.MethodData from 23,358 participants aged 50 years and older included in the longitudinal SHARE survey were used. Frailty was operationalized according to Fried's phenotype as presenting either weakness, shrinking, exhaustion, slowness, or low activity. Confounder-adjusted mixed-effects logistic regression models were used to analyze associations of childhood misfortune and life-course socioeconomic conditions with frailty.ResultsChildhood misfortune and poor adult-life socioeconomic conditions increased the odds of (pre-)frailty at older age. With aging, differences narrowed between categories of adverse childhood experiences (driven by Scandinavian welfare regime) and adverse childhood health experiences (driven by Eastern European welfare regime), but increased between categories of occupational position (driven by Bismarckian welfare regime).DiscussionThese findings suggest that childhood misfortune is linked to frailty in old age. Such a disadvantaged start in life does not seem to be compensated by a person's life-course socioeconomic trajectory, though certain types of welfare regimes affected this relationship. Apart from main occupational position, our findings do not support the cumulative dis/advantage theory, but rather show narrowing differences.

| S-EPMC7265805 | biostudies-literature

The association between life course socioeconomic position and life satisfaction in different welfare states: European comparative study of individuals in early old age.

Project description:Backgroundwhether socioeconomic position over the life course influences the wellbeing of older people similarly in different societies is not known.Objectiveto investigate the magnitude of socioeconomic inequalities in life satisfaction among individuals in early old age and the influence of the welfare state regime on the associations.Designcomparative study using data from Wave 2 and SHARELIFE, the retrospective Wave of the Survey of Health, Ageing, and Retirement in Europe (SHARE), collected during 2006-07 and 2008-09, respectively.Settingthirteen European countries representing four welfare regimes (Southern, Scandinavian, Post-communist and Bismarckian).Subjectsa total of 17,697 individuals aged 50-75 years.Methodsslope indices of inequality (SIIs) were calculated for the association between life course socioeconomic position (measured by the number of books in childhood, education level and current wealth) and life satisfaction. Single level linear regression models stratified by welfare regime and multilevel regression models, containing interaction terms between socioeconomic position and welfare regime type, were calculated.Resultssocioeconomic inequalities in life satisfaction were present in all welfare regimes. Educational inequalities in life satisfaction were narrowest in Scandinavian and Bismarckian regimes among both genders. Post-communist and Southern countries experienced both lower life satisfaction and larger socioeconomic inequalities in life satisfaction, using most measures of socioeconomic position. Current wealth was associated with large inequalities in life satisfaction across all regimes.ConclusionsScandinavian and Bismarckian countries exhibited narrower socioeconomic inequalities in life satisfaction. This suggests that more generous welfare states help to produce a more equitable distribution of wellbeing among older people.

| S-EPMC4001174 | biostudies-literature

Spirometry reference equations for central European populations from school age to old age.

Project description:BackgroundSpirometry reference values are important for the interpretation of spirometry results. Reference values should be updated regularly, derived from a population as similar to the population for which they are to be used and span across all ages. Such spirometry reference equations are currently lacking for central European populations.ObjectiveTo develop spirometry reference equations for central European populations between 8 and 90 years of age.MaterialsWe used data collected between January 1993 and December 2010 from a central European population. The data was modelled using "Generalized Additive Models for Location, Scale and Shape" (GAMLSS).ResultsThe spirometry reference equations were derived from 118'891 individuals consisting of 60'624 (51%) females and 58'267 (49%) males. Altogether, there were 18'211 (15.3%) children under the age of 18 years.ConclusionWe developed spirometry reference equations for a central European population between 8 and 90 years of age that can be implemented in a wide range of clinical settings.

| S-EPMC3540072 | biostudies-literature

Same old, same old? Age differences in the diversity of daily life.

Project description:Some research suggests that compared with younger adults, older adults have more homogeneous, less diverse daily life experiences because everyday situations and activities become increasingly stable and routine. However, strong empirical tests of this assumption are scarce. In two complementary studies, we examined whether older age is associated with less diversity in daily life experiences (e.g., regarding social interaction partners, activities, and places across and within days) and, if so, to what extent health limitations account for these age differences. In Study 1, we used daily diaries to investigate diversity across days among younger (N = 246; Mage = 21.8 years, SD = 2.5) and older adults (N = 119; Mage = 67.7 years, SD = 5.3). In Study 2, we investigated diversity within days employing experience sampling methods over three weeks in an adult life span sample (N = 365; range = 14-88 years). Results showed that across and within days, the daily lives of older adults were less diverse regarding their social interaction partners. Yet, older adults reported more diversity in activities within days and across days in the afternoons, whereas younger adults reported less diverse activities partly due to working or studying more often. Age differences remained statistically significant when controlling for health limitations. We conclude that age differences in the diversity of daily life are nuanced, depending on the domain and the level of analysis. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

| S-EPMC8021140 | biostudies-literature

Clinical data quality: a data life cycle perspective.

Project description:Clinical data is the staple of modern learning health systems. It promises to accelerate biomedical discovery and improves the efficiency of clinical and translational research but is also fraught with significant data quality issues. This paper aims to provide a life cycle perspective of clinical data quality issues along with recommendations for establishing appropriate expectations for research based on real-world clinical data and best practices for reusing clinical data as a secondary data source.

| S-EPMC7133741 | biostudies-literature

Children's perspective of quality of life in epilepsy.

Project description:ObjectiveTo study child mental health, parental support, and social support of children with epilepsy as these relate to quality of life (QOL) using child self-report, seizure-related variables, and estimated verbal intelligence based on receptive vocabulary.MethodsA cross-sectional structural equation model of baseline data from the QUALITÉ cohort study, which includes 6 Canadian child epilepsy ambulatory programs. A sample of 3,481 children were screened for the following eligibility: 8 to 14 years of age, with active or medication-managed epilepsy. Of 894 eligible children, 506 agreed to participate, of whom 26 were then excluded because of an inability to self-report based on a standard cutoff score of receptive vocabulary lower than 70. The primary outcome of child-reported QOL was measured using the Child Epilepsy QOL Questionnaire.ResultsFrom the child's perspective, epilepsy-specific QOL is strongly related to their mental health and social support but not to their seizures. Specifically, child mental health and peer support exhibit direct associations with QOL; parental support has both direct and indirect associations with QOL (via child mental health); estimated verbal intelligence exerts its strongest association with QOL through mental health; and seizure status exhibits a weak relationship to QOL only through mental health.ConclusionsAmong children with epilepsy aged 8 to 14 years, mental health and social support should be areas of focus in the assessment of QOL. Controlling seizures is insufficient care for influencing the child's perception of their life.

| S-EPMC4433469 | biostudies-literature

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