Change in quality of life among community-dwelling older adults: population-based longitudinal study

This population-based study aimed to determine 5-year change in multidimensional QoL among community-dwelling older people, and to identify predictors of QoL change among demographic, socioeconomic, and health characteristics.

Data of the 2011 and 2016 annual assessments of 1845 older men and women (age range 68–77 years) from the Lc65 + cohort study were used. QoL was assessed using a 28-item instrument yielding a QoL overall score and seven domain-specific QoL subscores. Additional ratings of QoL included a single item (excellent; very good; good; fair; poor), expected QoL in 1 year (better; worse; same as today), and retrospective assessment of QoL 5-year change (better; worse; same as 5 years ago). The predictors of 5-year change in the QoL score were assessed using linear regression, controlling for baseline QoL score.

All prospective and retrospective indicators of QoL converged towards a slight deterioration over 5 years. QoL subscores significantly decreased in domains “Close entourage” (P = 0.004), “Social and cultural life” (P < 0.001), “Esteem and recognition” (P = 0.001), “Health and mobility” (P < 0.001), and “Autonomy” (P < 0.001), whereas “Material resources” (P = 0.345) and “Feeling of safety” (P = 0.380) remained stable. A stronger decrease in QoL was observed in the most vulnerable profiles at baseline in terms of demographic, socioeconomic, and health characteristics. Changes in depressive symptoms and in disability—either worsening or improving—predicted QoL change in the expected direction.

Age-related decline in QoL may be limited through the prevention of disability and depressive symptoms, and more generally by devoting special attention to vulnerable profiles.