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Table 3 Classification of studies by context

From: A systematic review of instruments for measuring outcomes in economic evaluation within aged care

Title Population Instruments used Main findings
Community-based dependent older people
Ability to perform activities of daily living is the main factor affecting quality of life in patients with dementia [37] Denmark EQ-5D Dependency upon others to perform ADL was the main factor affecting HRQL
N = 244
An assessment of the construct validity of the ASCOT measure of social care-related quality of life with older people [30] UK ASCOT This study provides some evidence for the construct validity of the ASCOT attributes and therefore support for ASCOT’s use in economic evaluation and demonstrated the feasibility of its use among older people
N = 301
Comorbid psychosocial symptoms and quality of life in patients with dementia [38] USA EQ-5D (patient and proxy) Authors discuss the psychometric and conceptual implications of possible differences between self- and other-ratings of quality of life, and treatment implications for caregiver-education interventions
N = 89 pairs
Comparing measurement properties of the EQ-5D-3 L, ICECAP-O and ASCOT in frail older people [24] Netherlands EQ-5D Our findings support the adoption of ICECAP-O and ASCOT as outcome measures in economic evaluations of care interventions for older adults that have a broader aim than health-related QOL
N = 190 ICECAP-O
Day care centre attendance and quality of life in depressed older adults living in the community [53] Italy EQ-5D Therefore, in older outpatients suffering from a depressive disorder without dementia the attendance of a DC was an independent correlate of the quality of life
N = 149
Depressive symptoms and cognitive status affect health-related quality of life in older patients with Parkinson’s disease [39] USA EQ-5D Patients with PD had significantly higher (worse) GDS scores than matched controls and were more likely to take antidepressant medication
N = 101
Dimensions and correlates of quality of life according to frailty status: a cross-sectional study on community-dwelling older adults referred to an outpatient geriatric service in Italy [47] Italy OPQOL Five of the seven dimensions of quality of life were negatively affected by frailty, but only one SOF criterion for frailty (reduced energy level) was independently related to quality of life after correction for age, functional status and depression
N = 239
Dutch translation and cross-cultural validation of the Adult Social Care Outcomes Toolkit (ASCOT) [48] Netherlands ASCOT This study provides preliminary evidence that the Dutch translation of the ASCOT is valid, reliable and comparable to the original English version
N = 190
Exploration of the content validity and feasibility of the EQ-5D-3 L, ICECAP-O and ASCOT in older adults [49] Netherlands EQ-5D Researchers who intend to use the EQ-5D, ICECAP-O or ASCOT in economic evaluations of care services for older adults, should be aware of the response issues that occur during the administration of these measures
Factors Related to Performance-Based Mobility and Self-reported Physical Activity in Individuals 1-3 Years after Stroke: A Cross-sectional Cohort Study [54] Sweden EQ-5D Individuals perceived disabilities that are partly potentially modifiable 1-3 years after stroke
N = 195
Health utility scores in Alzheimer’s disease: differences based on calculation with American and Canadian preference weights [40] Canada EQ-5D In AD studies, researchers should calculate health utility scores by using preference weights obtained in the general population of their country of interest
N = 216
Health-related quality of life in Parkinson disease: correlation between Health Utilities Index III and Unified Parkinson’s Disease Rating Scale (UPDRS) in U.S. male veterans [41] Canada HUI3 Poor self-care in PD reflected by worsening UPDRS-II scores is strongly correlated with low generic HRQL
N = 68
Loneliness and Quality of Life in Chronically Ill Rural Older Adults [50] USA CASP-12 Nurses should assess for loneliness as part of their comprehensive assessment of patients with chronic illness
N = 60
Measuring health status and decline in at-risk seniors residing in the community using the Health Utilities Index Mark 2 [51] Canada HUI2 The HUI2 measure of HRQL in older persons at risk for institutionalization appears to reflect health status at a point in time and to be responsive to changes in health status over time
N = 192
Measuring the outcomes of long-term care [31] UK ASCOT The results support our hypothesis that ASCOT has greater construct validity in this case
N = 224 EQ-5D
Older People’s Quality of Life (OPQOL) scores and adverse health outcomes at a one-year follow-up. A prospective cohort study on older outpatients living in the community in Italy [52] Italy OPQOL In an older outpatient population in Italy the OPQOL total score and its health-related sub-score were independent predictors of several adverse health outcomes at one year
N = 239
Predictors of Family Caregiver Ratings of Patient Quality of Life in Alzheimer Disease: Cross-Sectional Results from the Canadian Alzheimer’s Disease Quality of Life Study [42] Canada EQ-5D Caregiver ratings of patient function and depression were consistent independent predictors of caregiver-rated quality of life, using a spectrum of quality of life measures, while measures of patient cognition and caregiver burden and depression were not
N = 412 QWB
Predictors of Patient Self-Ratings of Quality of Life in Alzheimer Disease: Cross-Sectional Results From the Canadian Alzheimer's Disease Quality of Life Study [43] Canada EQ-5D Self-rated symptoms of depression were a consistent independent predictor of patient-rated quality of life across diverse quality of life measures, while performance-based measures of cognition and informant-based functional status were not
N = 370 QWB
Predictors of quality of life in older people living at home and in institutions [32] Poland EQ-5D The relative contribution of functional and medical comorbidities, as well as health-promoting behaviors to quality of life, may be different in community-dwelling and institutionalized elders
N = 312
Psychometric properties of the EQ-5D in a study of people with mild to moderate dementia [44] Germany EQ-5D The study showed that the EQ-5D is especially applicable to patients with mild dementia and their caregivers as proxies
N = 390
Responsiveness and construct validity of the health utilities index in patients with dementia [45] USA HUI3 Our results support the construct validity of the proxy-rated HUI2/3 in patients with moderate to severe dementia. The proxy-rated HUI should be used in patients with moderate to severe dementia, but the self-rated HUI may be appropriate for subjects with milder cognitive impairment
N = 408 (proxy completed)
Sex differences in the relative contribution of social and clinical factors to the Health Utilities Index Mark 2 measure of health-related quality of life in older home care clients [33] Canada and USA HUI2 For females and males, HRQL scores were negatively associated with conditions predictive or indicative of disability and with markers of psychosocial stress
N = 514
Telephone reliability of the French Activity Index and EQ-5D amongst older adults [34] Australia EQ-5D Telephone administration of the FAI and EQ-5D instruments provides comparable results to face-to-face administration amongst older adults deemed to have cognitive functioning intact at a basic level, indicating that this is a suitable alternate approach for collection of this information
N = 53
A validation of the ICECAP-O in a population of post-hospitalized older people in the Netherlands [35] Netherlands ICECAP-O The ICECAP-O seems to be a valid instrument of capability-wellbeing in older, post-hospitalized people, showing good convergent validity with health and wellbeing instruments, and is able to discriminate between elderly with various health profiles
N = 296 EQ-5D
Validation study of the prototype of a disease-specific index measure for health-related quality of life in dementia [46] Netherlands EQ-5D The DQI prototype proved valid and feasible for patients and caregivers and is appropriate for very mild to moderate dementia
N = 145
What can local authorities do to improve the social care-related quality of life of older adults living at home? Evidence from the Adult Social Care Survey [36] UK ASCOT SCRQoL is significantly lower for older adults who find it more difficult to find information and advice, for those who report that their home design is inappropriate for their needs and for those who find it more difficult to get around their local area
N = 29935
Residential facility-based older people
Capabilities and quality of life in Dutch psycho-geriatric nursing homes: an exploratory study using a proxy version of the ICECAP-O [55] Netherlands ICECAP-O ICECAP-O measures a more general concept than health-related quality of life and can differentiate between restrained and non-restrained psycho-geriatric clients
N = 122 EQ-5D
Determinants of health-related quality of life in institutionalized older persons in northern Sydney [58] Australia EQ-5D Common health states that may cause loss of independence and dignity are strongly, and independently, associated with the HRQL of institutionalized older persons
N = 612
Effects of cognitive stimulation therapy Japanese version (CST-J) for people with dementia: A single-blind, controlled clinical trial [56] Japan EQ-5D The CST-J shows promising improvements in cognition, mood, and aspects of quality of life for people with dementia in Japanese care settings
N = 56
Exercise for depression in care home residents: a randomised controlled trial with cost-effectiveness analysis (OPERA) [64] UK EQ-5D The results do not support the use of a whole-home physical activity and moderate-intensity exercise programme to reduce depression in care home residents
N = 1054
Performance of the EQ-5D and the EQ-5D + C in elderly patients with cognitive impairments [57] Netherlands EQ-5D We conclude that the EQ-5D performs well for evaluating HRQL in a population with cognitive impairments
N = 196
Quality of life of older frail persons receiving a post-discharge program [59] Australia ICECAP-O The type and intensity of programs offered to older frail people post hospital admission can impact on their recovery and quality of life gains
N = 351 EQ-5D
Quality of life outcomes for residents and quality ratings of care homes: is there a relationship? [60] UK ASCOT The approach to providing quality ratings by the regulator in England is currently under review. Future quality indicators need to demonstrate their relationship with quality of life outcomes if they are to be a reliable guide to commissioners and private individuals purchasing care
N = 366
Quality of life and attitudes to ageing in Turkish older adults at old people’s homes [61] Turkey WHOQoL-Old The results indicated that there was significant relationship between QOL and attitudes to ageing of older adults
N = 120
Strategies to implement community guidelines on nutrition and their long tern clinical effects in nursing home residents [62] Sweden EQ-5D An extended model of implementation of nutritional guidelines, including guidance and feedback to NH staff, did not affect nutritional status but may be associated with a delayed cognitive decline in communicative NH residents
N = 101
The agreement between proxy and self-completed EQ-5D for care home residents was better for index scores than individual domains [63] UK EQ-5D (proxy respondent) Proxies appear to be an acceptable source of data for index scores and QALYs but may be less reliable if individual domains are considered
N = 565 pairs
Community based independent older people
A comparison of the ICECAP-O with EQ-5D in a falls prevention clinical setting: are they complements or substitutes? [11] Canada ICECAP-O Our study suggests that the EQ-5D and ICECAP-O provide complementary information
N = 215 EQ-5D
A concise alternative for researching health-related quality of life in older people [109] Wales EQ-5D The EQ-5D may provide a valid measure of health-related quality of life in a cross-sectional population sample of older adults, although the emphasis of the scale is very much on physical health and functioning
N = 423 SF-36
A cross-sectional study of quality of life in an elderly population (75 years and over) with atrial fibrillation: secondary analysis of data from the Birmingham Atrial Fibrillation Treatment of the Aged study [110] UK EQ-5D In the absence of co-morbidity, chronic AF has little impact on generic quality of life in an elderly non-acutely ill population
N = 1762 SF-12
A measure of quality of life in early old age: The theory, development and properties of a needs satisfaction model (CASP-19) [107] UK CASP-19 The CASP-19 appears to be a useful scale for measuring quality of life in older people
N = 286
A short measure of quality of life in older age: the performance of the brief Older People's Quality of Life questionnaire (OPQOL-brief) [111] UK OPQOL, CASP-19 and the WHOQoL-OLD The OPQOL-brief is of value in assessment of interventions where a rigorously tested, short measure is required
N = 589
An assessment of the construct validity of the descriptive system for the ICECAP capability measure for older people [16] UK ICECAP-O This study provides some early evidence for the construct validity of the ICECAP measure
N = 315
An assessment of the relationship between informal caring and quality of life in older community-dwelling adults – more positives than negatives? [112] Australia ICECAP-O A caring role is associated with a relatively high quality of life, that is comparable to that experienced by older people who categorize themselves in a non-caring role
N = 786
Assessing Quality of Life among British Older People Using the ICEPOP CAPability (ICECAP-O) Measure [92] UK ICECAP-O Distribution of ICECAP-O values by electoral ward enabled the identification of areas of deprivation, although the associations were strong only for enjoyment and control
N = 809
Assessing quality of life in the elderly: A direct comparison of the EQ-5D and AQoL [80] UK EQ-5D Although the AQoL appeared to have more favourable construct validity, the EQ-5D was easier to administer, had a higher completion rate, and appeared more sensitive to change
N = 145 AQoL
Cognition, daily living, and health-related quality of life in 85-year-olds in Sweden [113] Sweden EQ-5D Cognitive impairment is associated with reduced quality of life
N = 373
Developing capacities in aging studies in the Middle East: Implementation of an Arabic version of the CANE IV among community-dwelling older adults in Lebanon [114] Lebanon EQ-5D The Arabic version of the CANE appears acceptable in assessing needs of older adults in South Lebanon
N = 322
Development and measurement properties of the self-assessment version of the INTERMED for the elderly to assess case complexity [115] Netherlands EQ-5D and SF-36 This study supports the feasibility, reliability and validity of the IM-E-SA
N = 338
Development of the Japanese 15D instrument of health-related quality of life: verification of reliability and validity among elderly people [116] Japan 15D The Japanese version of the 15D showed sufficient internal consistency and moderate repeatability
N = 430
Drug treatment in the elderly: an intervention in primary care to enhance prescription quality and quality of life [117] Sweden EQ-5D The intervention seems to have had no effect on quality of prescriptions or quality of life
N = 150
Effect of preventive primary care outreach on health related quality of life among older adults at risk of functional decline: a randomized controlled trial [118] Canada HUI3 The results of this study do not support adoption of this preventive primary care intervention for this target population of high risk older adults
N = 719
Effects of risk-based multifactorial fall prevention on health-related quality of life among the community-dwelling aged: a randomized controlled trial [119] Finland 15D Fall prevention produced positive effects on some dimensions of HRQL with men benefiting more than women
N = 591
Exercise in elderly patients with chronic heart failure in primary care: Effects on physical capacity and health-related quality of life [120] Sweden EQ-5D This study shows that exercise conducted in groups in primary care and in the patients' homes could be used in elderly patients with CHF
N = 60 SF-36
Exploration of the association between quality of life, assessed by the EQ-5D and ICECAP-O, and falls risk, cognitive function and daily function, in older adults with mobility impairments Canada ICECAP-O Both the EQ-5D and ICECAP-O demonstrate associations with falls risk and general balance and mobility; however, only the ICECAP-O was associated with cognitive status among older adults with mobility impairments
N = 215 EQ-5D
Falls and EQ-5D rated quality of life in community-dwelling seniors with concurrent chronic diseases: a cross-sectional study [121] Germany EQ-5D The findings suggest that falls are negatively associated with EQ-5D rated quality of life independent of a variety of chronic diseases and conditions
N = 1792
Falls-related self-efficacy is independently associated with quality-adjusted life years in older women [122] Canada EQ-5D Although falls-related self-efficacy was independently associated with QALYs, there may well be other factors not investigated, such as risk taking and psychological measures, which could account for some of the association
N = 135
Functional status and quality of life 12 months after discharge from a medical ICU in healthy elderly patients: a prospective observational study [123] Spain EQ-5D The survival rate of elderly medical patients 12 months after discharge from the ICU is low although functional status and quality of life remained similar to baseline in most of the survivors
N = 112
Happiness, subjective and objective oral health status, and oral health behaviors among Korean elders [124] Korea EQ-5D Oral impacts which might persistently affect one’s daily life need to be considered in designing and delivering public services aimed to promote people’s happiness
N = 479
Health status of the advanced elderly in six European countries: results from a representative survey using EQ-5D and SF-12 [125] Belgium, France, Germany, Italy, the Netherlands and Spain EQ-5D and SF-12 More than two thirds of the advanced elderly report impairment of health status
N = 1659
Health-related quality of life measurements in elderly Canadians with osteoporosis compared to other chronic medical conditions:
a population-based study from the Canadian Multicentre Osteoporosis
Study (CaMos) [126]
Canada HUI3 The decrement in HUI3 score seen in participants with osteoporosis was comparable to that observed in other chronic medical conditions, such as arthritis, COPD, diabetes mellitus or heart disease
N = 4,550
Impaired Health-Related Quality of Life in Elderly Women is Associated With Multimorbidity: Results From the Korean National Health and Nutrition Examination Survey [127] Korea EQ-5D Both the amount and pattern of chronic diseases have been associated with quality of life in elderly populations
N = 1419
Independent contribution of overweight/obesity and physical inactivity to lower health-related quality of life in community-dwelling older subjects [128] Poland EQ-5D Overweight/obesity and sedentary lifestyle are independent predictors of lower HRQL in community-dwelling seniors aged 66–79 years
N = 300
Long term effects of exercise training on physical activity level and quality of life in elderly coronary patients - a three- to six-year follow-up [129] USA EQ-5D Even a short period of supervised exercise training has the potential to positively influence physical activity level for as long as three to six years
N = 93
Measuring quality of life in older people: reliability and validity of WHOQoL-OLD [130] Australia WHOQoL-Old and SF-12 Overall, the WHOQoL-OLD performed well on tests of reliability and validity
N = 100
Medication quality and quality of life in the elderly, a cohort study [131] Sweden EQ-5D This study has shown the validity of the basic principle in prescribing: the more appropriate medication the better quality of life
N = 150
Metabolic syndrome and quality of life in the elderly: age and gender differences [132] Italy HUI3 MetS is not associated with worse HRQL in community-dwelling elderly
N = 356
Mobility Is a Key Predictor of Change in Well-Being Among Older Adults Who Experience Falls: Evidence From the Vancouver Falls Prevention Clinic Cohort [133] Canada ICECAP-O We found that 2 valid and reliable measures of mobility interacted with sex to predict changes in well-being over time
N = 244
Mortality in healthy elderly patients after ICU admission [134] Spain EQ-5D Healthy elderly non-elective medical patients admitted to the ICU have a high mortality rate related to premorbid quality of life
N = 230
Multifactorial Intervention to Reduce Falls in Older People at High Risk of Recurrent Falls A Randomized Controlled Trial [135] Netherlands EQ-5D and SF-12 This multifactorial fall-prevention program does not reduce falls in high-risk, cognitively intact older persons.
N = 217
Multi-morbidity and health-related quality of life in the older population: results from the German KORA-Age study [136] Germany EQ-5D Multi-morbidity caused greater impairments in HRQL than could be expected from given conditions individually/separately
N = 4565
Pain, Medication Use, and Health-Related Quality of Life in Older Persons With Post-herpetic Neuralgia: Results From a Population-Based Survey [137] USA EQ-5D Older persons with PHN experience longstanding, severe, and debilitating pain and poor health-related quality of life
N = 385
Perceived Participation and Health-Related Quality of Life in 85 Year Olds in Sweden [138] Sweden EQ-5D Sufficient participation was positively associated with higher health-related quality of life, and facilitating participation is an area of interest for occupational therapists
N = 380
Physical activity as a mediator of the impact of chronic conditions on quality of life in older adults [139] Canada HUI3 Physical activity partially mediates the impact of chronic conditions on quality of life
N = 22,432
Physical function and perceived quality of life in older persons [140] Italy EQ-5D Physical function influences quality of life in older persons
N = 73
Potentially Inappropriate Drug Use and Health-Related Quality of Life in the Elderly [141] USA EQ-5D The results supported others showing that a significant proportion of the elderly receive care that is potentially harmful and not supported by evidence-based practice
N = 444 SF-12
Potentially inappropriate prescribing and adverse health outcomes in community dwelling older patients [142] Ireland EQ-5D Reducing PIP in primary care may help lower the burden of ADEs, its associated health care use and costs and enhance quality of life in older patients
N = 931
Psychological approach to successful ageing predicts future quality of life in older adults [143] UK OPQOL Successful ageing is not only about the maintenance of health, but about maximising one’s psychological resources, namely self-efficacy and resilience
N = 287
Psychometric evaluation of the Korean version of the Self-Efficacy for Exercise Scale for older adults [144] South Korea EQ-5D The SEE-K appears to have satisfactory validity and reliability among older adults in South Korea
N = 212
Quality of life amongst older Brazilians: A cross-cultural validation of the CASP-19 into Brazilian-Portuguese [145] Brazil CASP-19 In this small exploratory study the CASP-19 Brazil demonstrated good psychometric properties
N = 87
Quality of life and related factors: a questionnaire survey of older people living alone in Mainland China [146] China OPQOL his study identified nine factors influencing the quality of life of older people living alone in Mainland China
N = 521
Quality of life in older outpatients living alone in the community in Italy [147] Italy OPQOL Depression, having no caregiver and having never been married could provide a valuable means of identifying older people living alone who are at greater risk of a poor quality of life
N = 239
Quality of life related to fear of falling and hip fracture in older women: A time trade off study [148] Australia EQ-5D Among older women who have exceeded average life expectancy, quality of life is profoundly threatened by falls and hip fractures
N = 194
Quality of well-being in older people with osteoarthritis [149] USA QWB The QWB appears to be a useful and sensitive generic, utility-based measure of HRQL in people with OA
N = 363
Risk of malnutrition and health-related quality of life in community-living elderly men and women: The Tromsø study [150] Norway EQ-5D HRQL was significantly reduced in elderly men and women at risk of malnutrition
N = 3286
SF-6D and EQ-5D result in widely divergent incremental cost-effectiveness ratios in a clinical trial of older women: implications for health policy decisions [151] USA EQ-5D and SF-6D The incremental QALYs estimated from the SF-6D were two- to threefold greater than those estimated from the EQ-5D
N = 155
Sleep Apnea and Health-Related Quality of Life in African-American Elderly [152] USA QWB and SF-36 Sleep disturbances may impact daily living and health as much as other medical conditions
N = 70
Societal Consequences of Falls in the Older Population: Injuries, Healthcare Costs, and Long-Term Reduced quality of life [153] Netherlands EQ-5D Fall-related injuries are age and gender related, leading to high healthcare costs, and long-term reduced quality of life
N = 668
Socioeconomic status and health-related quality of life among elderly people: Results from the Joint Canada/United States Survey of Health [154] Canada and USA HUI3 In the elderly population, HRQL was significantly associated with household income in the United States but not in Canada, controlling for socio-demographic and health indicators
N = 1906
The Health Consequences of Peripheral Neurological Deficits in an Elderly Cohort: An Oklahoma Physicians Resource-Research Network Study [155] USA HUI3 PNDs of undetermined cause, found in older patients on physical examination, appear to be associated with greater morbidity and mortality
N = 604 QWB
The health-related quality of life and cost implications of falls in elderly women [156] UK EQ-5D Interventions aimed at reducing fear of falling may produce larger gains in HRQL
N = 11802
The independent contribution of executive functions to health related quality of life in older women [157] UK EQ-5D Our study highlights the specific executive processes of set shifting and working memory were independently associated with QALYs
N = 135
The influence of lower-extremity function in elderly individuals’ quality of life: an analysis of the correlation between SPPB and EQ-5D [158] Korea EQ-5D An abnormal SPPB score was associated with lower quality of life
N = 422
The predictive value of self-rated health in the presence of subjective memory complaints on permanent nursing home placement in elderly primary care patients over 4-year follow-up [159] Denmark EQ-5D Both poor SRH and SMC were associated with permanent NH placement risk among elderly primary care patients
N = 757
The Psychometric Properties of the Older People’s Quality of Life Questionnaire, Compared with the CASP-19 and the WHOQoL-OLD [89] UK OPQOL, CASP-19 and WHOQoL-OLD The OPQOL has potential for use as a multidimensional population surveillance instrument for use with older populations, or as an outcome measure of multisector policy
The Reliability and Validity of the Turkish Version of the World Health Organization Quality of Life Instrument-Older Adults Module (WHOQoL-Old) [160] Turkey WHOQoL-Old WHOQoL-Bref The psychometric properties of the Turkish version of the WHOQoL-OLD were acceptable, indicating that the scale is reliable and valid for use with older Turkish adults (>65 years)
N = 527
Which measure of quality of life performs best in older age? A comparison of the OPQOL, CASP-19 and WHOQOL-OLD [161] UK OPQOL The OPQOL is of potential value in the outcome assessment of health and social interventions, which can have a multidimensional impact on people’s lives
Hospital and community-based older people
Economic evaluation alongside a single RCT of an integrative psychotherapeutic nursing home programme [162] Netherlands EQ-5D No significant differences were found on QALYs
N = 168
Influence of chronic cardiovascular disease and hospitalization due to this disease on quality of life of community-dwelling elderly [163] Poland EQ-5D Hospitalization due to CVD results in more pronounced reduction in quality of life than CVD alone among community dwelling elderly
N = 300
The relationship between quality of life, health and care transition: an empirical comparison in an older post-acute population [164] Australia ICECAP-O The correlations between the ICECAP-O, EQ-5D and CTM-3 instruments illustrate that capability is strongly and positively associated with health-related quality of life and the quality of care transitions
N = 82 EQ-5D
Elderly men’s quality of life and lower urinary tract symptoms: an intricate relationship [165] Brazil WHOQoL-Old Moderate to severe LUTS are associated with worse quality of life ratings for almost all evaluation parameters
N = 200 WHOQoL-Bref
Quality of Life in Elderly Men With Aging Symptoms and Lower Urinary Tract Symptoms (LUTS) [166] Brazil WHOQoL-Old and WHOQoL-Bref Moderate to severe ADAM and LUTS impact significantly all parameters of HRQL and generic quality of life proposed by the WHO
N = 200
Hospital-based older people
Activities of Daily Living and Quality of Life of Elderly Patients After Elective Surgery for Gastric and Colorectal Cancers [167] Japan EQ-5D and SF-12 Of the patients 75 years old or older who underwent elective surgery for gastric or colorectal cancer, only a few showed a protracted decline in ADL and most exhibited better quality of life after surgery
N = 232
Cognitive, Functional, and quality of life Outcomes of Patients Aged 80 and Older Who Survived at Least 1 Year After Planned or Unplanned Surgery or Medical Intensive Care Treatment [168] Netherlands EQ-5D Health-related quality of life is similar to that of an age-matched general population in the long term
N = 204
Costs and health outcomes of intermediate care: results from five UK case study sites [169] UK EQ-5D Our work suggests a need for the development and application of robust and reliable clinical criteria for admission to IC, and close co-operation between hospital and community service providers over selection of patients and targeting of IC and acute care services to meet defined clinical need
N = 2253
Effectiveness of a video-based exercise programme to reduce falls and improve HRQL among older adults discharged from hospital: a pilot randomized controlled trial [170] Australia EQ-5D No significant difference in self-reported quality of life and falls prevention between groups; need for further research
N = 53 Completed by both patient and proxy
Health-Related Quality of Life After Transcatheter Aortic Valve Implantation in Elderly Patients With Severe Aortic Stenosis [171] France EQ-5D In high-risk patients with severe aortic stenosis, quality of life and health status improved substantially at 1 month and improvement persisted 6 months after TAVI
N = 164
Health-related Quality of Life among hospitalized older people awaiting residential aged care [172] Australia AQoL People making the transition to residential aged care from hospital have very poor HRQL, but small gains in function seem to be related to improvement
N = 320
Long-term outcome of elderly patients requiring intensive care admission for abdominal pathologies: survival and quality of life [173] Switzerland EQ-5D A high mortality rate and a decrease in quality of life were observed in elderly patients with severe abdominal pathologies
N = 36 SF-36
Multicomponent Geriatric Intervention for Elderly Inpatients With Delirium: Effects on Costs and Health-Related Quality of Life [174] Finland 15D Comprehensive geriatric intervention improved HRQL without increasing overall costs of care
N = 174
Outcome and quality of life of elderly critically ill patients: An Italian prospective observational study [175] Italy EQ-5D One year after ICU discharge, medical and orthopedic patients had significantly more severe problems vis-a` -vis mobility, self-care and activity than abdominal surgical patients and control population
N = 288
Outcomes among older people in a post-acute inpatient rehabilitation unit [176] Ireland EQ-5D Positive quality of life outcomes occurred in a range of measures in an older, frail inpatient rehabilitation population
N = 32
Patients undergoing sub-acute rehabilitation have accurate expectations of their health-related quality of life at discharge [177] Australia EQ-5D Patients admitted for subacute in-hospital rehabilitation were able to anticipate their discharge health-related quality of life on the EQ-5D instrument with a moderate level of accuracy
N = 232
Proxy reporting of quality of life using the EQ-5D [178] Canada EQ-5D Proxy EQ-5D responses, either for a specific point in time or for assessing change over time, may not be valid measures of self-reported quality of life among older medically-ill patients
N = 231
Quality of life after a sub-trochanteric fracture: A prospective cohort study on 87 elderly patients [179] Sweden EQ-5D A sub-trochanteric fracture in elderly patients had a substantial negative effect on both their short and long-term HRQL
N = 87
Self-reported quality of life in elderly patients with aggressive non-Hodgkin’s lymphoma treated with CHOP chemotherapy [180] Netherlands EQ-5D In the elderly patients the quality of life was determined by two factors, i.e. aggressiveness of disease and toxicity of treatment
N = 132 EORTC QLQ-C30
Specialist geriatric medical assessment for patients discharged from hospital acute assessment units: randomised controlled trial [181] UK ICECAP-O This specialist geriatric medical intervention applied to an at risk population of older people attending and being discharged from acute medical units had no effect on patients' outcomes or subsequent use of secondary care or long term care
N = 433 EQ-5D
Systematic comprehensive geriatric assessment in elderly patients on chronic dialysis: a cross-sectional comparative and feasibility study [182] Netherlands EQ-6D Older patients on chronic dialysis have a high risk of functional decline
N = 50
The correlation between patients, patient's relatives and healthcare professionals interpretation of quality of life - A prospective study [183] UK EQ-5D Preliminary results would suggest NOK have a better perception than healthcare professionals of patient's quality of life, however doctors may be better at predicting resuscitation decisions of patients
N = 22 SF-36
(patient and proxy)
Two perspectives of proxy reporting of health-related quality of life using the Euroqol-5D, an investigation of agreement [184] Australia EQ-5D (proxy correspondent) Clinician (physiotherapist) proxy-reports among this population generally had good agreement with patient self-report though this was affected by proxy perspective, patient cognition, and timing
N = 272
Validation of the Charlson Comorbidity Index in acutely admitted elderly patients [185] Spain EQ-5D This study shows that an increased CCI predicts both short and long term mortality adequately but is not able to predict post-discharge functional decline in acutely admitted elderly patients
N = 1313
An investigation into the association between nutritional status and quality of life in older people admitted to hospital [186] UK EQ-5D Malnutrition risk is linked to a poorer quality of life in older people on admission to hospital
N = 149 SF-36
Assessing Health State Utilities in Elderly Patients at Cardiovascular Risk [187] USA HUI3 In this large implementation of the HUI in elderly patients, the instrument did not detect any differences in estimated utilities related to having a MI
N = 4677
Femoral neck fractures in the elderly: Functional outcome and quality of life according to EuroQol [188] Sweden EQ-5D Changes in the quality of life may be useful to identify patients who might benefit from reoperation, i.e. arthroplasty
N = 90
Health-related quality of life and psychological well-being in elderly patients with haemophilia [189] Italy WHOQoL-Old EQ-VAS and WHOQoL-BREF Compared to age-matched controls elderly patients with haemophilia had an impaired HRQL in association with their health status
N = 82
Health-related quality of life in elderly patients with familial hypercholesterolemia [190] Sweden 15D and SF-36 HRQL appears to be similar to that of age-standardized controls in the general population
N = 37
Internal fixation compared with total hip replacement for displaced femoral neck fractures in the elderly - A randomised, controlled trial [191] Sweden EQ-5D The results of our study strongly suggest that THR provides a better outcome than IF for elderly, relatively healthy, lucid patients with a displaced fracture of the femoral neck
N = 102
Predictors of Improvement in Health-Related Quality of Life Among Elderly Patients With Depression [192] USA MOS-6 (SF-6D) Severity of depressive symptoms at baseline was predictive of failure to improve HRQL
N = 100
Quality of life (QOL) among community dwelling older people in Taiwan measured by the CASP-19, an index to capture quality of life in old age [193] Taiwan CASP-19 and CASP-12 There was an inverse relationship between the CASP total scores and frailty, chronic diseases, depressive disorders, living alone and fall events in the past 12 months
N = 699
Quality of life related to fracture displacement among elderly patients with femoral neck fractures treated with internal fixation [194] Sweden EQ-5D The rate of fracture healing complications and reoperations in patients with displaced fractures was high, and even in patients with uneventfully healed fractures, there was a substantial decrease in the quality of life
N = 90
Responsiveness of the EuroQol (EQ 5-D) and the SF-36 in elderly patients with displaced femoral neck fractures [195] Sweden EQ-5D The results showed high responsiveness for both the EQ-5D and the SF-36, indicating that both instruments are suitable for use as outcome measures in clinical trials in elderly hip fracture patients
N = 110 SF-36
The Importance of Acuity, Stereopsis, and Contrast Sensitivity for Health-Related Quality of Life in Elderly Women with Cataracts [196] UK EQ-5D Acuity, stereopsis, and contrast sensitivity each contributed to quality of life, across a range of measures, in elderly women with cataract
N = 306
All settings
Whose Quality of Life Is It Anyway? The Validity and Reliability of the Quality of Life-Alzheimer's Disease (QoL-AD) Scale [25] UK EQ-5D The QoL-AD has very good psychometric properties and can be completed with people with a wide range of severity of dementia
N = 261
Quality of life in dementia - A one-year follow-up study [19] UK EQ-5D The main finding of this study is that people with dementia do not perceive that their quality of life declined over a period of one-year
N = 60
Valuation studies
Valuing the ICECAP capability index for older people [12] UK ICECAP-O Values that were estimated are feasible for use in practical applications of the index to measure the impact of health and social care interventions
N = 19