HEALTH-RELATED QUALITY OF LIFE

Health-related quality of life should be a major focus of health outcomes research for older individuals. This research should continue to examine how to define and measure those dimensions of health-related quality of life that are particularly important to older individuals. In particular, more and better global and targeted functional measures should be developed for older individuals to describe and assess functional outcomes (a) in general, (b) for distinct clinical conditions, and (c) within specific settings.

Rationale

  • Health-related quality of life is perhaps the most important dimension of health outcomes for older individuals. Traditionally, the goal of health care has been to treat acute illness and delay or avert death. Increasingly, however, the goal of many older individuals and their families is not simply to add “years to life” but also to add “life to years.”

  • Although the importance of assessing health-related quality of life for older individuals is increasingly being recognized, it remains a difficult concept to measure validly or reliably, especially among the older segments of these populations and for those with cognitive or communicative impairments.

  • Several instruments have been developed to measure health-related quality of life, but more needs to be known about how accurately they take into account older peoples’ values, perceptions, and preferences and how contextual factors affect measurements.

  • Functional health status is a significant dimension of health-related quality of life for older individuals. Maintenance of function or the slowing of deterioration in function may be the primary goal of treatment of many older people, especially those with multiple health conditions.

  • Targeted measures are needed to compare the efficacy and effectiveness of new interventions and to assess the impact of particular diseases and impairments (e.g., measuring the ability of arthritis patients’ to walk without pain or the ability of patients with dental disease to chew food). The relative importance of certain aspects of functional status varies by setting; indeed, functional status is a key factor determining a person’s setting (e.g., where not having adequate cognitive functioning to live independently in the community requires residing in an institution).

Background

For the vast majority of older individuals, quality of life may have nothing to do with health care delivery. However, many quality-of-life issues do relate



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