Functioning and quality of life in Dutch oldest old with diverse levels of dependency

Abstract

Background

Frequently, a questionnaire like the EQ-5D is applied to investigate elderly health-related quality of life (HRQoL), but current literature suggests that inputs that go beyond these traditional health aspects might be of importance. The capability approach is a different method, which integrates several non-health-related factors to define the well-being of the oldest old.

Objective

We propose to investigate the differences in oldest old functionings and quality of life (QoL), given different levels of dependency, using both a utility-based (EQ-5D+C) and capability-based (Currently Achieved Functioning) questionnaire.

Methods

We interviewed 99 Dutch elderly, living in the Groningen, Veendam, and Hoogeveen areas. The average age of the elderly was 80 years, who were living independently, still looking after themselves; living semi-dependently with moderate care; or living in a nursing home requiring consistent care.

Results

The utility score for the dependent group is the lowest of all three groups, across the diseases investigated in this study. The respective average utility scores calculated for the dependent, semi-dependent, and independent subgroups were 0.56 (SD ±0.10); 0.84 (SD ±0.11), and 0.69 (SD ±0.13). Mobility and pain were reported to be the major domains where problems appeared across the three groups. Additionally, dependent elderly experience deficits in the role and control functionings while the other two subgroups experience deficits in pleasure and security.

Conclusion

The results suggest that it is important to take note of the achievability of functionings and HRQoL, in addition to care dependency, to obtain QoL and well-being outcomes of the oldest old.

Keywords:

• oldest old
• functionings
• quality of life
• dependency

Supplementary materials

Table S1 Description of the five attributes as proposed by Grewal et al¹

Reference

• GrewalILewisJFlynnTBrownJBondJCoastJDeveloping attributes for a generic quality of life measure for older people: preferences or capabilities?Soc Sci Med20066281891190116168542
   PubMed Web of Science ®Google Scholar

Acknowledgments

This study was funded by the University of Groningen as part of a PhD project. The funder had no role in the design of the study, data collection, analysis, and interpretation of data nor in writing the manuscript.

Disclosure

The authors report no conflicts of interest in this work.