This book explores concepts of quality of life in older age in the theoretical literature and presents the views of a national sample of people aged sixty- five years or older.
- Introduction: the emergence of a European perspective on ageing!
- Quirky Sides of Scientists: True Tales of Ingenuity and Error from Physics and Astronomy!
- A European perspective on quality of life in old age!
- The War of Howdy.
- Mutfantasie - Fantasiereisen und Mutsprüche für Klein und Groß (German Edition).
Quality of Life in Old Age. What is quality of life? Bur quality of life is not simply reducible to personal circumstances. While income and functional capacity are crucial in determining their quality of life, good neighbourhood environments, valued interaction with friends and family members, as well as, the existence of close confiding relationships can make a difference to a person's life.
Our identification of both positive and negative factors that influence quality of life is important because it relates our findings to the literature on resilience, with its emphasis on both risk and protective factors. Appendix 1 and appendix 2 are available on line http: We have benefited from comments by Professor Ann Bowling and an anonymous reviewer on previous versions of this paper.
- Lehrbuch der ökonomischen Analyse des Zivilrechts (Springer-Lehrbuch) (German Edition).
- Quirky Sides of Scientists: True Tales of Ingenuity and Error from Physics and Astronomy.
- What Every Kid Wished their Parents Knew.
- Out of the Ordinary: Finding Hidden Threats by Analyzing Unusual Behavior.
- A Sparrow Hawk Proud;
National Center for Biotechnology Information , U. J Epidemiol Community Health. Accepted Nov This article has been cited by other articles in PMC. Abstract Objectives To investigate whether longstanding illnesses, social context, and current socioeconomic circumstances predict quality of life. Design Secondary analysis of wave 1 of the English longitudinal study of aging. Conclusions Efforts to improve quality of life in early old age need to address financial hardships, functionally limiting disease, lack of at least one trusting relationship, and inability to move out of a disfavoured neighbourhood.
Explanatory variables We selected variables related to health, functioning, social relations, and material circumstances as our predictor variables. Treatment of missing values Our analysis was conducted in two phases: Employed or self employed Open in a separate window. Multiple regression We repeated analyses for the complete and the five filled in datasets.
Age effects We repeated the above analyses for three age groups: Gender effects We examined for gender effects by running models separately for men and women results not shown. Discussion There was no single key determinant of quality of life; and all the variables in our model were statistically significant. What is known on this topic Aging is perceived to decrease quality of life, but the emergence of a third age demands we look for predictors of quality of life other than age.
What this study adds No single factor determines quality of life in older ages and there is evidence that quality of life can increase during early old age. Policy implications Quality of life at older ages could potentially be high and policies should be directed towards the development of this potential. Supplementary Material [web only appendix] Click here to view. Acknowledgements We have benefited from comments by Professor Ann Bowling and an anonymous reviewer on previous versions of this paper.
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The politics of old age in Europe. Open University Press, — Psychol Aging 15 — Int J Aging Hum Dev 24 29— Life satisfaction and associations with social network and support variables in three samples of elderly people. International Journal of Geriatric Psychiatry 6 — BMJ — Models of quality of life. Therefore, the maintenance and improvement quality of life should be included among the goals of clinical management. Every one has an opinion about their quality of life, but no one knows precisely what it means in general.
This review, for example, assumes that older age groups are sufficiently peculiar in this respect to merit such a review, perhaps due to the perception that the elderly are peculiarly vulnerable due to 1 declining physical and mental capabilities; 2 exit from labour market with greater dependence on pensions; 3 break down of extended families; and 4 isolation due to death of contemporaries, especially that of spouse or partner.
A common experience of the reviewers of quality of life literature is how it has exponentially increased from s and the multiplicity of instruments developed for measuring quality of life.
Quality of life at older ages: evidence from the English longitudinal study of aging (wave 1)
The aim of this review is to provide a narrative overview of studies on the quality of life in older ages. We restrict ourselves to sketching and highlighting a few regions of importance while referring the readers to other excellent sources for the details. A broader canvas than that could be afforded by this brief overview is needed to paint the full picture of quality of life in older ages. In choosing the contents of this review we assumed that the population of our interest was in the developed Western world where new phases of life course such as the Third Age were emerging.
We do not attempt to describe or to discuss the many instruments used to measure quality of life see References 6 , 10 for reviews nor do we touch upon such substantive themes as happiness see part 1 of Reference 11 and flourishing See Reference Although there is a plethora of statements about quality of life, they tend to be descriptive rather than definitive. Most of the energy in this field is spent on measuring quality of life; therefore, the definition of quality of life, by necessity, has to be considered together with its measurement.
There are three approaches to measuring quality of life: This process of measurement has replaced the individuality, which Mill considered as an essential constituent of well-being, with a multi-dimensional approach: He argued that both objective and subjective dimensions were important for quality of life.
His scheme is characterized by socio-normative approaches in the objective dimensions and individualistic approaches for the subjective dimensions. In his conceptualization the domains form a hierarchy so that objective dimensions should be treated as antecedent to subjective ones. In an exploratory analysis he tested the hypothesis that objective and subjective dimensions are related in a diverse group of older people and found that objective contact with friends, and family, and time use in discretionary activities was significantly related to subjectively assessed quality in all three domains.
Ultimately quality of life in his model is decided by psychological well-being and all that comes before that could be considered as influences on it. Exhibit 1 presents a simple taxonomy of quality of life models and measures according to types of dimensions, domains and instruments. Dimensions Objective , on the basis of observations external to the individual such as standard of living, income, education, health status and longevity.
Example of a definition of quality of life in the objective dimension Subjective , on the basis of psychological responses by the individual such as life satisfaction, happiness and self-ratings. Example of a definition of quality of life in the subjective dimension Domains Physical health , general e.
Quality of life at older ages: evidence from the English longitudinal study of aging (wave 1)
Most of the quality of life measures are not developed in elderly populations, although they are capable of thinking and talking about their quality of life. In a survey of individuals aged 65 years or more, the respondents were familiar with the term quality of life and talked about it in both positive and negative terms.
They evaluated their quality of life positively on the basis of comparison with others, social contacts especially with family and children, health, material circumstances and activities. In making negative evaluations, they stressed on dependency and functional limitations, unhappiness and reduced social contacts through death of friends and family members. Family, activities and social contacts were the factors, which they thought gave their life quality.
Different kinds of losses such as ill health and functional limitations were seen as making quality of life worse. One of the significant findings of this study was that assessment of quality of life should include factors other than health. However, in a Brazilian study that used similar methodology, health was the most stated response to most questions on what is currently wrong with and what could increase or decrease their quality of life.
In a national survey of individuals aged 65 years or more, living in England and Scotland, Bowling and colleagues tried to find out older people's concepts about quality of life by asking them. The same order stood for factors constituting good quality of life while health and home and neighbourhood came on the top as factors that can take away quality of life.
Gabriel and Bowling attempted to develop a conceptual framework about the quality of life using older people's views. In a recent study from Sweden, men and women aged more than 67 years were asked what quality of life was for them; responses in rank order were social relations, health, activities, functional ability, well-being, living in one's own home, personal finances, and personal beliefs and attitudes. These studies clearly demonstrate that quality of life goes beyond health; other factors such as having good social relations, being active and able to participate in socially and personally meaningful activities and having no functional limitations are sometimes more important for older people.
It is logical to wonder whether these perceptions are a result of older people living now having less health problems.
The widely accepted definition of successful ageing by Rowe and Kahn contains three components: The distinction between successful ageing and quality of life lies in the emphasis on physical health for defining successful ageing. However, well-being is often incorporated into the concept of successful ageing and ageing well adds to the quality of life.
It might also be possible that there are definitions of health which are akin to that of quality of life, for example, health as going and doing something meaningful. The influence of age on quality of life can be due to a direct effect of ageing and indirectly through the effect of ageing on factors that influence quality of life. From being marginal and dependent, the older person has become active and flourishing as a new life course period—the third age, the period between exit from labour force and the beginning of physical dependency—has emerged. The age curve showed that as one progressed from 50 years onwards, the quality of life actually increased and peaked at 68 years before it started to decline.
It decreased below the level of quality of life at age 50 only after 86 years of age. As age increased the confidence intervals became wider suggesting that individual variations in factors influencing quality of life increased with age. Studies had noted the stability of life satisfaction in the older ages in the face of decline in objective measures of well-being leading to a paradox. Quality of life was found to be significantly higher in the elderly people compared with younger people using an individual quality of life measure the Schedule for the Evaluation of Individual Quality of Life, SElQoL in which individuals identify five most important areas in their life and weigh them according to their significance.
Adaptation is sometimes used as an explanation of how good quality of life is maintained in old age. In the Berlin Ageing Study, it is described in terms of selection, compensation and optimization. Adaptation is also described in terms of response shift, by which individuals change their internal standards, values and conceptualizations of quality of life to accommodate some hardship or negative circumstance.
Closely allied to adaptation is resilience, which is the phenomenon of people beating the odds and doing well against expectation. A mediating role for older people's sense of mastery of their environment has been suggested to improve life satisfaction. There is an ethical dimension to adaptation that is salient to quality of life in older people: Social comparison plays a role in preservation of quality of life in older ages as health and other circumstances deteriorate.