Quality of life in older people

Measurement of health related quality of life (HQoL) has been developed as a way of describing health states in terms of an individual's perception of his/her position in life. In the UK, the HQoL approach has become a cornerstone of health services research, particularly in relation to the purchaser-provider relationship. For elderly people, it may be particularly relevant when considering whether intervention is of overall benefit. Psychiatric morbidity, physical disability and quality of life were assessed by standardized questionnaire in older people living at home in an inner-city area. Seven-hundred subjects were interviewed. More than 75% of subjects who completed other instruments also completed the IHQL (Index of Health-Related Quality of Life). There was no significant correlation between physical discomfort and somatic symptoms; emotional distress and depression or generalized anxiety; or disability and dependence in activities of daily living. There is a clear need to develop measures of HQoL appropriate for older people. The IHQL in its present version does not however show concurrent validity in older people in the community, suggesting that IHQL data should not be used in resource allocation decisions where older people are involved.