Skip to main content
SpringerLink
Log in

Predicting factors of health-related quality of life in octogenarians: a 3-year follow-up longitudinal study

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Purpose

The proportion of very old people is rising, and so, describing their health-related quality of life (HRQoL) is an important point of interest. The aim of this study was to analyse the predictive factors on HRQoL throughout a 3-year follow-up period, in a community-based cohort of octogenarian people.

Methods

From 290 subjects aged 85 and over, sociodemographic and geriatric data, including levels of frailty phenotype assessment, and HRQoL using the EuroQol 5D3L (EQ-5D) instrument were collected. A longitudinal analysis was performed by generalized estimating equations (jointly testing the bivariate effect of variables and its time dependence) and regression mixed models to evaluate the adjusted effect of variables on HRQoL after a 3-year follow-up.

Results

In the EQ-5D baseline assessment, the average visual analogue self-rating scale value was 63.82 (SD ± 19.45), the EQ-5D index was 0.67 (0.34) and the most significant issues were pain/discomfort (61.2 %), depression (45.3 %) and mobility (44.6 %). The third year index was 0.55 (0.38). Independent predictive factors of a lower HRQoL identified by the regression mixed models were female gender (marginal effect ME = −0.101; p = 0.003), being pre-frail (ME = −0.142; p = 0.011) or frail (ME = −0.071; p = 0.030), having heart failure (ME = −0.081; p = 0.037) and having a high social risk score (ME = −0.020; p = 0.015). In contrast, higher functional status (ME = 0.050; p < 0.001) and nutritional score (ME = 0.013; p = 0.011) appeared to be predictive factors of an enhanced HRQoL. The adjusted effect of “time of follow-up” had no statistical significance.

Conclusion

Frail individuals at baseline have a significant lower HRQoL, whereas a higher functional status and nutritional status are independent predicting factors of an enhanced HRQoL after 3 years of follow-up. These findings may encourage clinicians in order to asses HRQoL.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Christensen, K., Doblhammer, G., Rau, R., & Vaupel, J. W. (2009). Ageing populations: The challenges ahead. Lancet, 374, 1196–1208.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Rechel, B., Grundy, E., Robine, J. M., Cylus, J., Mackenbach, J. P., Knai, C., et al. (2013). Ageing in the European Union. Lancet, 381, 1312–1322.

    Article  PubMed  Google Scholar 

  3. Jagger, C., Matthews, R., Matthews, F., Robinson, T., Robine, J. M., & Brayne, C. (2007). Medical Research Council Cognitive Function and Ageing Study Investigators. The burden of diseases on disability-free life expectancy in later life. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 62, 408–414.

    Article  Google Scholar 

  4. Dening, T. R., Chi, L. Y., Brayne, C., Huppert, F. A., Paykel, E. S., & O’Connor, D. W. (1998). Changes in self-rated health, disability and contact with services in a very elderly cohort: A 6-year follow-up study. Age and Ageing, 27, 23–33.

    Article  CAS  PubMed  Google Scholar 

  5. Ploeg, J., Brazil, K., Hutchison, B., Kaczorowski, J., Dalby, D. M., Goldsmith, C. H., et al. (2010). Effect of preventive primary care outreach on health related quality of life among older adults at risk of functional decline: Randomised controlled trial. BMJ, 16(340), c1480.

    Article  Google Scholar 

  6. Lapid, M. I., Rummans, T. A., Boeve, B. F., McCormick, J. K., Pankratz, V. S., Cha, R. H., et al. (2011). What is the quality of life in the oldest old? International Psychogeriatrics, 23, 1003–1010.

    Article  PubMed Central  PubMed  Google Scholar 

  7. Liao, Y., McGee, D. L., Cao, G., & Cooper, R. S. (2000). Quality of the last year of life of older adults: 1986 versus 1993. JAMA, 283, 512–518.

    Article  CAS  PubMed  Google Scholar 

  8. O’Boyle, C. A. (1997). Measuring the quality of later life. Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences, 352, 1871–1879.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Orfila, F., Ferrer, M., Lamarca, R., & Alonso, J. (2000). Evolution of self-rated health status in the elderly: Cross-sectional versus longitudinal estimates. Journal of Clinical Epidemiology, 53, 563–570.

    Article  CAS  PubMed  Google Scholar 

  10. Szanton, S. L., Thorpe, R. J., Boyd, C., Tanner, E. K., Leff, B., Agree, E., et al. (2011). Community aging in place, advancing better living for elders: A bio-behavioral-environmental intervention to improve function and health-related quality of life in disabled older adults. Journal of the American Geriatrics Society, 59, 2314–2320.

    Article  PubMed Central  PubMed  Google Scholar 

  11. Boyd, C. M., Xue, Q. L., Simpson, C. F., Guralnik, J. M., & Fried, L. P. (2005). Frailty, hospitalization, and progression of disability in a cohort of disabled older women. American Journal of Medicine, 118, 1225–1231.

    Article  PubMed  Google Scholar 

  12. Chou, C. H., Hwang, C. L., & Wu, Y. T. (2012). Effect of exercise on physical function, daily living activities, and quality of life in the frail older adults: A meta-analysis. Archives of Physical Medicine and Rehabilitation, 93, 237–244.

    Article  PubMed  Google Scholar 

  13. Ishimoto, Y., Wada, T., Hirosaki, M., Kasahara, Y., Kimura, Y., Konno, A., et al. (2009). Health-related differences between participants and nonparticipants in community-based geriatric examinations. Journal of the American Geriatrics Society, 57, 360–362.

    Article  PubMed  Google Scholar 

  14. Layte, R., Sexton, E., & Savva, G. (2013). Quality of life in older age: Evidence from an Irish cohort study. Journal of the American Geriatrics Society, 61(s2), S299–S305.

    Article  PubMed  Google Scholar 

  15. Ferrer, A., Formiga, F., Almeda, J., Alonso, J., Brotons, C., & Pujol, R. (2010). Health-related quality of life in nonagenarians: Gender, functional status and nutritional risk as associated factors. Medicina Clinica (Barc), 134, 303–306.

    Article  Google Scholar 

  16. Ferrer, A., Padrós, G., Formiga, F., Rojas-Farreras, S., Perez, J. M., & Pujol, R. (2012). Diabetes mellitus: Prevalence and impact of morbidities in the oldest old. The octabaix study. Journal of the American Geriatrics Society, 60, 462–467.

    Article  PubMed  Google Scholar 

  17. Mahoney, F. I., & Barthel, D. W. (1965). Functional evaluation: The Barthel Index. A simple index of independence useful in scoring improvement in the rehabilitation of the chronically ill. Md State Medical Journal, 14, 61–65.

    CAS  Google Scholar 

  18. Lawton, M. P., & Brody, E. M. (1969). Assessment of older people: Self-maintaining and instrumental activities of daily living. Gerontologist, 9, 179–186.

    Article  CAS  PubMed  Google Scholar 

  19. Lobo, A., Saz, P., Marcos, G., Día, J. L., de la Cámara, C., Ventura, T., et al. (1999). Revalidación y normalización del Mini-Examen Cognoscitivo (primera versión en castellano del Mini-mental Status Examination) en la población general geriátrica. Medicina Clinica (Barc), 112, 767–774.

    CAS  Google Scholar 

  20. Charlson, M. E., Pompei, P., Ales, K. L., & MacKenzie, C. R. (1987). A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. Journal of Chronic Diseases, 40, 373–375.

    Article  CAS  PubMed  Google Scholar 

  21. Guigoz, Y. (2006). The mini nutritional assessment (MNA) review of the literature–What does it tell us? Journal of Nutrition Health and Aging, 10, 466–485.

    CAS  Google Scholar 

  22. Alarcón, M. T., & González, J. I. (1998). La escala sociofamiliar de Gijón, instrumento útil en el hospital general. Review Esp Geriatr Gerontol, 33, 178–180.

    Google Scholar 

  23. Badia, X., Roset, M., Herdman, M., & Kind, P. (2001). A comparison of United Kingdom and Spanish general population time trade-off values for EQ-5D health states. Medical Decision Making, 21, 7–16.

    Article  CAS  PubMed  Google Scholar 

  24. Schafer, J. L. (1999). Multiple imputation: A primer. Statistical Methods in Medical Research, 8, 3–15.

    Article  CAS  PubMed  Google Scholar 

  25. Fritz, T., Caidahl, K., Krook, A., Lundström, P., Mashili, F., Osler, M., et al. (2013). Effects of Nordic walking on cardiovascular risk factors in overweight individuals with type 2 diabetes, impaired or normal glucose tolerance. Diabetes Metabolism Research Reviews, 29, 25–32.

    Article  CAS  PubMed  Google Scholar 

  26. Collerton J, Davies K, Jagger C, Kingston A, Bond J, Eccles MP et al. (2009) Health and disease in 85 year olds: Baseline findings from the Newcastle 85+ cohort study. BMJ 339 b4904.

  27. Pepine, C. J. (2013). Effects of pharmacologic therapy on health-related quality of life in elderly patients with atrial fibrillation: A systematic review of randomized and nonrandomized trials. Clinical Medicine Insights Cardiology, 7, 1–20.

    Article  PubMed Central  PubMed  Google Scholar 

  28. Azpiazu, M., Cruz, A., Villagrasa, J. R., Abanades, J. C., García, N., & Alvarez, C. (2003). Quality of life in noninstitutionalized persons older than 65 years in two health care districts in Madrid. Atencion Primaria, 31, 285–292.

    Article  Google Scholar 

  29. De Rivas, B., Permanyer-Miralda, G., Brotons, C., Brotons, C., Aznar, J., & Sobreviela, E. (2008). Health-related quality of life in unselected outpatients with heart failure across Spain in two different health care levels. Magnitude and determinants of impairment: The INCA study. Quality of Life Research, 17, 1229–1238.

    Article  PubMed  Google Scholar 

  30. Westlake, C., Dracup, K., Creaser, J., et al. (2002). Correlates of health-related quality of life in patients with heart failure. Heart and Lung, 3, 85–93.

    Article  Google Scholar 

  31. Van der Weele, G. M., Gussekloo, J., De Waal, M. W., De Craen, A. J., & Van der Mast, R. C. (2008). Co-occurrence of depression and anxiety in elderly subjects aged 90 years and its relationship with functional status, quality of life and mortality. International Journal of Geriatric Psychiatry, 21, 2162.

    Google Scholar 

  32. Kanauchi, M., Kubo, A., Kanauchi, K., & Saito, Y. (2008). Frailty, health-related quality of life and mental well-being in older adults with cardiometabolic risk factors. International Journal of Clinical Practice, 62, 1447–1451.

  33. Whitehead, S. J., & Ali, S. (2010). Health outcomes in economic evaluation: The QALY and utilities. British Medical Bulletin, 96, 5–21.

    Article  PubMed  Google Scholar 

  34. Erceg, P., Despotovic, N., Milosevic, D. P., Soldatovic, I., Zdravkovic, S., Tomic, S., et al. (2013). Health-related quality of life in elderly patients hospitalized with chronic heart failure. Clinical Interventions in Aging, 8, 1539–1546.

    Article  PubMed Central  PubMed  Google Scholar 

  35. Shyu, Y. I., Liang, J., Tseng, M. Y., Li, H. J., Wu, C. C., Cheng, H. S., et al. (2013). Comprehensive and subacute care interventions improve health-related quality of life for older patients after surgery for hip fracture: A randomised controlled trial”. CT. International Journal of Nursing Studies, 50, 1013–1024.

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

None.

Members of the Octabaix Study

J Almeda (Unitat de Suport a la Recerca de Costa de Ponent, IDIAP J Gol), Oriol Cunillera (Unitat de Suport a la Recerca de Costa de Ponent, IDIAP J Gol), C Fernández (CAP Rambla), A Gil (ABS Sant Andreu de la Barca), C Llopart (ABS Sant Andreu de la Barca), MJ Megido (ABS Just Oliveras), G Padrós (Laboratori Clínic L’Hospitalet), M Sarró (CAP Florida Nord) and A Tobella (ABS Martorell Rural) data collection.

Author information

Authors and Affiliations

  1. Primary Healthcare Centre ‘El Plà’ CAP-I, CAP - El Plà, Pl. Felip Alcantara s/n, 08980, Sant Feliu de Llobregat, Barcelona, Spain

    Assumpta Ferrer

  2. Primary Health Care Research Institute (IDIAP) Jordi Gol, ICS, Barcelona, Spain

    Assumpta Ferrer, Oriol Cunillera, M. Jesús Megido & Jesús Almeda

  3. Geriatric Unit, Internal Medicine Service, Hospital Universitari de Bellvitge, Barcelona, Spain

    Francesc Formiga & Xavier Corbella

  4. Bellvitge Biomedical Research Institute, IDIBELL, L’Hospitalet de Llobregat, Spain

    Francesc Formiga & Xavier Corbella

  5. Unitat de Suport a la Recerca Metropolitana Sud, Direcció d’Atencío Primària Costa de Ponent, ICS, Cornellà de Llobregat, Spain

    Oriol Cunillera & Jesús Almeda

  6. Primary Healthcare Centre Just Oliveres, L’Hospitalet de Llobregat, Spain

    M. Jesús Megido

  7. Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain

    Xavier Corbella

  8. CIBER Epidemiologia i Salut Pública (CIBERESP), Barcelona, Spain

    Jesús Almeda

Authors
  1. Assumpta Ferrer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Francesc Formiga
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Oriol Cunillera
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Jesús Megido
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Xavier Corbella
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jesús Almeda
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

Octabaix Study Group

Corresponding author

Correspondence to Assumpta Ferrer.

Appendix

Appendix

See Table 4.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ferrer, A., Formiga, F., Cunillera, O. et al. Predicting factors of health-related quality of life in octogenarians: a 3-year follow-up longitudinal study. Qual Life Res 24, 2701–2711 (2015). https://doi.org/10.1007/s11136-015-1004-9

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-015-1004-9

Keywords

Search

Navigation