Quality of life is the subject of much research. However it lacks an agreed theoretical basis. In studies with older populations (ill) health has been used as a proxy measure for quality of life (QoL). We have developed a needs satisfaction measure of QoL in early old age. Our measure has four ontologically grounded domains: control, autonomy, pleasure, and self-realization. The measure was piloted with focus groups, a self-completion pilot, and cognitive interview testing. This produced a 22-item scale that was included in a postal questionnaire and sent to 286 people aged 65-75 years. A 92% response rate was achieved. The scale was reduced to 19 items on the basis of statistical analysis. The domains have Cronbach's alphas between 0.6 and 0.8. Correlations between the four domains range from 0.4 to 0.7. A second order factor analysis revealed a single latent QoL factor. The scores for the 19-item scale are well distributed along the range although they exhibit a slight negative skew. Concurrent validity was assessed using the Life Satisfaction Index--well being. A strong and positive association was found between the two scales (r = 0.6, p = 0.01). The CASP-19 appears to be a useful scale for measuring QoL in older people.
This article aims to identify and analyse the lifecourse and contextual factors that influence the quality of life in early old age. We conceptualise quality of life as distinct from the factors which influence it, and employ a model of the quality of life that is derived from an explicit theory of human need. The operational measure (CASP-19) consists of 19 Likert-scaled items which cover four theoretical domains: control, autonomy, self-realisation and pleasure. A postal questionnaire was sent to 286 British people aged 65–75 years who were members of the sample for the 1930s Boyd-Orr study of health and diet and who had been followed up through retrospective interviews during the late 1990s. The 286 were broadly representative of their age group. The survey's response rate was 92 per cent. Respondents provided information on a number of contextual influences on their quality of life in early old age, notably social support and participation, the quality and quantity of social contact, feelings of trust and reciprocity about the local neighbourhood, health and financial security. In the analyses reported here, a series of conceptual and operational influences on quality of life in early old age is identified using block regression models. Finally, the relative impact of each predictor on CASP-19 is examined. The findings suggest that the legacy of the past tends to be best captured by people's feelings about the adequacy of their pensions and their status as owner-occupiers as well as a feeling that the area in which they live is deprived. The quality of the social contact people describe and how close they feel to those around them will ameliorate the negative impacts of the past and the immediate environment. In addition, we must recognise that people remain vulnerable to the impact of loss: recent bereavement, and major illnesses can impact on a person's quality of life.
The number of diseases and physical functioning difficulties tend to increase with age. The aim of this study was to examine the trajectories of physical functioning across age groups and whether the trajectories differ according to disease status in different population subgroups. Repeat data from a nationally representative population sample, the Health and Retirement Study, was used. Participants were 10,709 men and 13,477 women aged 60–107 years at baseline with biennial surveys from 1992 to 2010. Average length of follow-up was 10.3 years ranging from 0 to 18 years. Disease status and physical functioning was asked about at all study phases and 10 items were summed to obtain a physical functioning score (0–10). Age modified the relationship between number of chronic diseases and physical functioning with older participants having more physical functioning difficulties with increasing number of diseases. An average 70-year-old participant with no diseases had 0.89 (95% CI: 0.85–0.93) physical functioning difficulties, with one disease 1.72 (95% CI: 1.69–1.76) difficulties, with two diseases 2.57 (95% CI: 2.52–2.62) difficulties, and with three or more diseases 3.82 (95% CI: 3.76–3.88) difficulties. Of the individual diseases memory-related diseases, stroke, pulmonary diseases, and arthritis were associated with significantly higher physical functioning difficulties compared with other diseases. Comorbidity is associated with greater burden of physical functioning difficulties. Of the studied diseases, memory-related diseases, stroke, pulmonary diseases, and arthritis alone or in combination limit most physical functioning.
This study uses data from the English Longitudinal Study on Ageing to explore the extent and significance of the influence of “age,” “place,” and “aging in place” on the attachment to place in a large representative population of English adults aged 50 and over. It then examines the contribution of age, place, aging in place, and the attachment to place to scores on the CASP 19, a measure of well-being designed to measure some of the key sentiments and experiences of the “third age.” The results indicate that age, aging in place, place, and the attachment to place interact in complex ways to affect levels of “third age” well-being.