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More than health: quality of life trajectories among older adults—findings from The Irish Longitudinal Study of Ageing (TILDA)

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Abstract

Purpose

To test whether ill-health is associated with a decrease in quality of life (QoL) over time and if positive social circumstances are beneficial to QoL, using the shorter form CASP-12 in a sample drawn from a nationally representative cohort of older adults. To do so, the association between factors from a number of life domains and QoL was investigated.

Methods

Data were from the first three waves of The Irish Longitudinal Study on Ageing, a prospective nationally representative study of community dwelling older adults in the Republic of Ireland. QoL was measured using the shorter form CASP-12 and the latent growth curve method was used to describe within- and between-person variation in longitudinal QoL trajectories.

Results

There was considerable variation in QoL scores cross-sectionally and longitudinally. QoL did not decline linearly with age but increased from age 50 and peaked at 68 years before declining in older age. QoL differed significantly between individuals and decreased over time. A variety of demographic, health, and social characteristics were associated with changes in QoL over time. These included cohabiting; self-rated health; functional limitations; fear of falling; mental health; loneliness; social networks; social activities; caring for grandchildren; income; and death of a spouse.

Conclusions

Changes in QoL over time were not merely a function of ageing, or declining health but resulted from factors from a variety of domains with loneliness and social participation particularly important. Policies concerned with successful ageing and QoL among older adults must consider social circumstances as well as physical and psychological well-being.

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References

  1. United Nations Department of Economic and Social Affairs Population Division. (2015). World population, ageing. In World population ageing. New York: United Nations.

  2. Bowling, A. (1996). The effects of illness on quality of life: Findings from a survey of households in Great Britain. Journal of Epidemiology and Community Health, 50(2), 149–155.

    Article  CAS  Google Scholar 

  3. Bowling, A., Gabriel, Z., Dykes, J., Dowding, L. M., Evans, O., Fleissig, A., et al. (2003). Let’s ask them: A national survey of definitions of quality of life and its enhancement among people aged 65 and over. International Journal of Aging and Human Development, 56(4), 269–306.

    Article  Google Scholar 

  4. Higgs, P., Hyde, M., Wiggins, R., & Blane, D. (2003). Researching quality of life in early old age: The importance of the sociological dimension. Social Policy and Administration, 37(3), 239–252.

    Article  Google Scholar 

  5. Bowling, A. (1997). Measuring health: A review of quality of life measurement scales (2nd ed.). Philadelphia: Open University Press.

    Google Scholar 

  6. Bowling, A. (1995). What things are important in people’s lives? A survey of the public’s judgements to inform scales of health related quality of life. Social Science and Medicine, 41(10), 1447–1462.

    Article  CAS  Google Scholar 

  7. Farquhar, M. (1995). Elderly people’s definitions of quality of life. Social Science and Medicine, 41(10), 1439–1446.

    Article  CAS  Google Scholar 

  8. Smith, A. (2000). Researching quality of life of older people: Concepts, measures and findings. Centre for Social Gerontology, Staffordshire ST5. Report No. 7.

  9. Laslett, P. (1989). A fresh map of life: The emergence of the third age. London: Weidenfeld and Nicolson.

    Google Scholar 

  10. Doyal, L., & Gough, I. (1991). A theory of human need. Hong Kong: Macmillan.

    Book  Google Scholar 

  11. Maslow, A. (1968). Toward a psychology of being. Princton: Van Nostrand.

    Google Scholar 

  12. Gilleard, C., & Higgs, P. (2000). Cultures of ageing: Self, citizen and the body. London: Prentice Hall.

    Google Scholar 

  13. Ryan, R. M., & Deci, E. L. (2001). On happiness and human potentials: A review of research on Hedonic and Eudaimonic well-being. Annual Review of Psychology, 52, 141–166.

    Article  CAS  Google Scholar 

  14. Ryff, C. D., & Singer, B. (1998). The contours of positive human health. Psychological Inquiry, 9(1), 1–28.

    Article  Google Scholar 

  15. Siegrist, J., von dem Knesebeck, O., & Pollack, C. E. (2004). Social productivity and well-being of older people: A sociological exploration. Social Theory and Health, 2, 1–17.

    Article  Google Scholar 

  16. Wahrendorf, M., & Siegrist, J. (2010). Are changes in productive activities of older people associated with changes in their well-being? Results of a longitudinal European study. European Journal of Ageing, 7(2), 59–68.

    Article  Google Scholar 

  17. Haywood, K. L., Garratt, A. M., & Fitzpatrick, R. (2005). Quality of life in older people: A structured review of generic self-assessed health instruments. Quality of Life Research, 14(7), 1651–1668.

    Article  CAS  Google Scholar 

  18. Hyde, M., Wiggins, R. D., Higgs, P., & Blane, D. B. (2003). A measure of quality of life in early old age: The theory, development and properties of a needs satisfaction model (CASP-19). Aging and Mental Health, 7(3), 186–194.

    Article  CAS  Google Scholar 

  19. Sexton, E., King-Kallimanis, B. L., Conroy, R. M., & Hickey, A. (2013). Psychometric evaluation of the CASP-19 quality of life scale in an older Irish cohort. Quality of Life Research, 22(9), 2549–2559.

    Article  Google Scholar 

  20. Bauman, Z. (1995). Life in fragments. Oxford: Blackwel.

    Google Scholar 

  21. Giddens, A. (1990). The consequences of modernity. Cambridge: Polity Press.

    Google Scholar 

  22. Blane, D., Netuveli, G., & Montgomery, S. M. (2008). Quality of life, health and physiological status and change at older ages. Social Science and Medicine, 66(7), 1579–1587.

    Article  Google Scholar 

  23. Netuveli, G., Wiggins, R. D., Hildon, Z., Montgomery, S., & Blane, D. (2005). Functional limitation in long standing illness and quality of life: Evidence from a national survey. BMJ, 331(7529), 1382–1383.

    Article  Google Scholar 

  24. Hyde, M., Higgs, P., Wiggins, R. D., & Blane, D. (2015). A decade of research using the CASP scale: Key findings and future directions. Aging and Mental Health, 19(7), 571–575.

    Article  CAS  Google Scholar 

  25. Layte, R., Sexton, E., & Savva, G. (2013). Quality of life in older age: Evidence from an Irish cohort study. Journal of American Geriatrics Society, 61(SUPPL2), 299–305.

    Article  Google Scholar 

  26. Sexton, E., King-Kallimanis, B. L., Layte, R., & Hickey, A. (2014). CASP-19 special section: How does chronic disease status affect CASP quality of life at older ages? Examining the WHO ICF disability domains as mediators of this relationship. Aging and Mental Health, 7863, 1–12.

    Google Scholar 

  27. Wiggins, R. D., Higgs, P. F. D., Hyde, M., & Blane, D. (2004). Quality of life in the third age: Key predictors of the CASP-19 measure. Ageing and Society, 24(5), 693–708.

    Article  Google Scholar 

  28. Zaninotto, P., Sacker, A., Breeze, E., McMunn, A., & Steptoe, A. (2016). Gender-specific changes in well-being in older people with coronary heart disease: Evidence from the English Longitudinal Study of Ageing. Aging and Mental Health, 20(4), 432–440.

    Article  Google Scholar 

  29. McGarrigle, C. A., Timonen, V., & Layte, R. (2017) Choice and constraint in the grandparent role. A mixed methods study. Gerontology and Geriatric Medicine. https://doi.org/10.1177/2333721417750944.

    Article  Google Scholar 

  30. Ateca-Amestoy, V., & Ugidos, A. (2013). The impact of different types of resource transfers on individual wellbeing: An analysis of quality of life using CASP-12. Social Indicators Research, 110(3), 973–991.

    Article  Google Scholar 

  31. Rafnsson, S. B., Shankar, A., & Steptoe, A. (2015). Informal caregiving transitions, subjective well-being and depressed mood: Findings from the English Longitudinal Study of Ageing. Aging and Mental Health, 7863, 1–9.

    Google Scholar 

  32. Siegrist, J., & Wahrendorf, M. (2009). Participation in socially productive activities and quality of life in early old age: Findings from SHARE. Journal of European Social Policy, 19(4), 317–326.

    Article  Google Scholar 

  33. Webb, E., Blane, D., McMunn, A., & Netuveli, G. (2011). Proximal predictors of change in quality of life at older ages. Journal of Epidemiology and Community Health, 65(6), 542–547.

    Article  Google Scholar 

  34. Zaninotto, P., Falaschetti, E., & Sacker, A. (2009). Age trajectories of quality of life among older adults: Results from the English longitudinal study of Ageing. Quality of Life Research, 18(10), 1301–1309.

    Article  Google Scholar 

  35. Meraya, A. M., Dwibedi, N., & Sambamoorthi, U. (2016). Polypharmacy and health-related quality of life among US adults with arthritis, medical expenditure panel survey, 2010–2012. Preventing Chronic Disease, 13, 160092.

    Article  Google Scholar 

  36. Montiel-Luque, A., Núñez-Montenegro, A. J., Martín-Aurioles, E., Canca-Sánchez, J. C., Toro-Toro, M. C., González-Correa, J. A., et al. (2017). Medication-related factors associated with health-related quality of life in patients older than 65 years with polypharmacy. PLoS ONE, 12(2), 1–16.

    Article  Google Scholar 

  37. Dueñas, M., Ojeda, B., Salazar, A., Mico, J. A., & Failde, I. (2016). A review of chronic pain impact on patients, their social environment and the health care system. Journal of Pain Research, 9, 457–467.

    Article  Google Scholar 

  38. McGarrigle, C. A., Timonen, V., & Layte, R. (2018). Choice and constraint in the negotiation of the grandparent role: A mixed-methods study. Gerontology and Geriatric Medicine, 4, 233372141775094.

    Article  Google Scholar 

  39. Banks, J., Breeze, E., Crawford, R., Demakakos, P., de Oliveira, C., Gjonça, E., et al. (2010). Well-being in older age: A multidimensional perspective. In Financial circumstances, health and well-being of the older population in England—The 2008 English Longitudinal Study of Ageing (pp. 115–177). Wave 4 Technical Report. London: National Centre for Social Research.

  40. Netuveli, G., & Blane, D. (2008). Quality of life in older ages. British Medical Bulletin, 85(1), 113–126.

    Article  Google Scholar 

  41. McCrory, C., Leahy, S., & Mcgarrigle, C. (2014). What factors are associated with change in older41 people’s quality of life? In A. Nolan, C. O’Regan, C. Dooley, D. Wallace, A. Hever, H. Cronin, E. Hudson, & R. A. Kenny (Eds.). The over 50s in a changing Ireland. Economic Circumstances, Health and Well-Being (pp. 153–186). Dublin: The Irish Longitudinal Study on Ageing. https://tilda.tcd.ie/publications/reports/pdf/w2-key-findings-report/Wave2-Key-Findings-Report.pdf. Accessed 11 Sept 2018.

  42. Scheffer, A. C., Schuurmans, M. J., Van dijk, N., Van der hooft T., De Rooij, S. E. (2008). Fear of falling: Measurement strategy, prevalence, risk factors and consequences among older persons. Age and Ageing, 37(1), 19–24.

    Article  Google Scholar 

  43. Netuveli, G., Wiggins, R. D., Hildon, Z., Montgomery, S. M., & Blane, D. (2006). Quality of life at older ages: Evidence from the English longitudinal study of aging (Wave 1). Journal of Epidemiology and Community Health, 60(4), 357–363.

    Article  Google Scholar 

  44. Ichida, Y., Hirai, H., Kondo, K., Kawachi, I., Takeda, T., & Endo, H. (2013). Does social participation improve self-rated health in the older population? A quasi-experimental intervention study. Social Science and Medicine, 94, 83–90.

    Article  Google Scholar 

  45. Palgi, Y., Shrira, A., & Zaslavsky, O. (2015). Quality of life attenuates age-related decline in functional status of older adults. Quality of Life Research, 24(8), 1835–1843.

    Article  Google Scholar 

  46. Tampubolon, G. (2015). Delineating the third age: Joint models of older people’s quality of life and attrition in Britain 2002–2010. Aging and Mental Health, 19(7), 576–583.

    Article  Google Scholar 

  47. Tessari, A. A., Giehl, M. W. C., Schneider, I. J. C., & Gonzalez-Chica, D. A. (2016). Anthropometric measures change and quality of life in elderly people: A longitudinal population-based study in Southern Brazil. Quality of Life Research, 25(12), 3057–3066.

    Article  Google Scholar 

  48. Kearney, P. M., Cronin, H., O’Regan, C., Kamiya, Y., Savva, G. M., Whelan, B., et al. (2011). Cohort profile: The Irish Longitudinal Study on Ageing. International Journal of Epidemiology, 40(4), 877–884.

    Article  Google Scholar 

  49. Kenny, R. A., Whelan, B. J., Cronin, H., Kamiya, Y., Kearney, P., O’Regan, C., et al. (2010). The Design of the Irish Longitudinal Study on Ageing. Dublin: The Irish Longitudinal Study on Ageing. https://tilda.tcd.ie/publications/reports/pdf/Report_DesignReport.pdf. Accessed 11 Sept 2018.

  50. Whelan, B. J., & Savva, G. M. (2013). Design and methodology of the Irish Longitudinal Study on Ageing. Journal of American Geriatrics Society, 61(SUPPL2), 265–268.

    Article  Google Scholar 

  51. Donoghue, O., Foley, M., & Kenny, R. A. (2017). Cohort maintenance strategies used by The Irish Longitudinal Study on Ageing (TILDA). Dublin: The Irish Longitudinal Study on Ageing. https://tilda.tcd.ie/publications/reports/pdf/Report_CohortMaintenance.pdf. Accessed 11 Sept 2018.

  52. Wiggins, R. D., Netuveli, G., Hyde, M., Higgs, P., & Blane, D. (2008). The evaluation of a self-enumerated scale of quality of life (CASP-19) in the context of research on ageing: A combination of exploratory and confirmatory approaches. Social Indicators Research, 89(1), 61–77.

    Article  Google Scholar 

  53. Borrat-Besson, C., Ryser, V. A., & Gonçalves, J. (2015). An evaluation of the CASP-12 scale used in the Survey of Health, Ageing and Retirement in Europe (SHARE) to measure quality of life among people aged 50+. FORS Working Paper Series.

  54. Niedzwiedz, C. L., Pell, J. P., & Mitchell, R. (2015). The relationship between financial distress and life-course socioeconomic inequalities in well-being: Cross-national analysis of European welfare states. American Journal of Public Health, 105(10), 2090–2098.

    Article  Google Scholar 

  55. Fulton, M. M., & Allen, E. R. (2005). Polypharmacy in the elderly: A literature review. Journal of American Academy of Nurse Practitioners, 17(4), 123–162.

    Article  Google Scholar 

  56. Karim, J., Weisz, R., Bibi, Z., & ur Rehman, S. (2015). Validation of the eight-item center for epidemiologic studies depression scale (CES-D) among older adults. Current Psychology, 34(4), 681–692.

    Article  Google Scholar 

  57. Radloff, L. S. (1977). A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401.

    Article  Google Scholar 

  58. Berkman, L. F., & Syme, S. L. (1979). Social networks, host resistance, and mortality: A nine-year follow-up study of Alameda County residents. American Journal of Epidemiology, 109, 186–204.

    Article  CAS  Google Scholar 

  59. Russell, D. (1996). The UCLA Loneliness Scale (Version 3): Reliability, validity, and factor structure. Journal of Personality Assessment, 66, 20–40.

    Article  CAS  Google Scholar 

  60. House, J., Robbins, C., & Metzner, H. (1982). The association of social relationships and activities with mortality: Prospective evidence from the Tecumseh Community Health Study. American Journal of Epidemiology, 116, 123–140.

    Article  CAS  Google Scholar 

  61. Royston, P. (2004). Multiple imputation of missing values. Journal of Statistical Software, 4(3), 227–241.

  62. Royston, P., & White, I. (2011). Multiple imputation by chained equations (MICE): Implementation in Stata. Journal of Statistical Software, 45(4), 1–20.

    Article  Google Scholar 

  63. Byrne, B. M. (2012). Structural equation modelling with Mplus: Basic concepts, applications, and programming. East Sussex: Taylor & Francis.

    Google Scholar 

  64. Duncan, T. E., Duncan, S. C., & Strycker, L. A. (2011). An introduction to latent variable growth curve modelling: Concepts, issues, and applications (2nd ed.). Oxfordshire: Taylor & Francis.

    Google Scholar 

  65. Kline, R. B. (2011). Principles and practice of structural equation modelling (3rd ed.). London: The Guilford Press.

    Google Scholar 

  66. Muthén, L. K., & Muthén, B. O. (2011). MPlus user’s guide (6th ed.). Los Angeles: Muthén and Muthén.

    Google Scholar 

  67. Yu, C. Y. (2002). Evaluating cutoff criteria of model fit indices for latent variable models with binary and continuos outcomes (Vol. 30). Education, Ph.D. Los Angeles: University of California, Los Angeles.

  68. Hooper, D., Coughlan, J., & Mullen, M. (2008). Structural equation modelling: Guidelines for determining model fit structural equation modelling. Electronic Journal of Business Research Methods, 6(1), 53–60.

    Google Scholar 

  69. Bentler, P. M., & Bonett, D. G. (1980). Significance tests and goodness of fit in the analysis of covariance structures. Psychological Bulletin, 88(3), 588–606.

    Article  Google Scholar 

  70. Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Model A Multidisciplinary Journal, 6(1), 1–55.

    Article  Google Scholar 

  71. Steiger, J. H. (2007). Understanding the limitations of global fit assessment in structural equation modeling. Personality and Individual Differences, 42(5), 893–898.

    Article  Google Scholar 

  72. van de Schoot, R., Lugtig, P., & Hox, J. (2012). A checklist for testing measurement invariance. European Journal of Developmental Psychology, 9(4), 486–492.

    Article  Google Scholar 

  73. Asparouhov, T., & Muthén, B. O. (2010). Weighted least squares estimation with missing data. MplusTechnical Appendix, 1–10.

  74. Blane, D., Higgs, P., Hyde, M., & Wiggins, R. D. (2004). Life course influences on quality of life in early old age. Social Science and Medicine, 58(11), 2171–2179.

    Article  CAS  Google Scholar 

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Funding

TILDA is co-funded by the Government of Ireland through the Department of Health, by Atlantic Philanthropies, and by Irish Life PLC. The funders played no role in designing or conducting the study or in the collection, management, analysis, or interpretation of the data, nor did they have any input into the preparation, review, or approval of the manuscript.

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Correspondence to M. Ward.

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The study was conducted according to the guidelines set out in the 1964 Helsinki Declaration and its later amendments. Ethical approval for TILDA was granted by the Faculty of Health Sciences Research Ethics Committee of Trinity College Dublin.

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Informed consent was obtained from all individual participants included in the study.

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Ward, M., McGarrigle, C.A. & Kenny, R.A. More than health: quality of life trajectories among older adults—findings from The Irish Longitudinal Study of Ageing (TILDA). Qual Life Res 28, 429–439 (2019). https://doi.org/10.1007/s11136-018-1997-y

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