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Individualized measurement of quality of life in older adults: development and pilot testing of a new tool

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Abstract

We describe theoretical background, development, and piloting of a measure for quality of life in older adults that specifically takes into account the subjective perspective. Although quality of life is usually subjectively assessed, normative thresholds for “the good life” are most often set by a third party. The new tool FLQM asks for respondents to name, rate, and weight those domains in life that are most important for their life-satisfaction solely from their own point of view. Construct validity was pilot-tested in two samples of elders (N 1 = 44; N 2 = 90). Correlations were in the medium range in both studies and support the questionnaire’s validity. There were no age or gender differences on total score. However, in Study 1 as well as in Study 2 older subjects named significantly fewer domains than did younger participants. Further, in Study 1 the overall number of distinct domains generated by the participants diminished with age—the “interindividual pool of domains” shrank. Implications of this age-associated narrowing of domainscope are discussed on a background of adaptation theories. Concluding, the new questionnaire seems apt to assess older peoples’ quality of life even in a physically very ill population, but needs further testing, especially regarding its reliability. This is currently being undertaken in a larger longitudinal sample to assure psychometric properties.

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Acknowledgments

Study 1 was conducted as part of a PhD thesis and funded by a scholarship from Robert Bosch Foundation, Germany. The first author wishes to express his gratitude to the Foundation for their generous support. He would further like to thank Prof. Clemens Tesch-Römer, PhD, for his advice and critical feedback in the course of Study 1. The project underlying Study 2 in this article is funded by the Federal Ministry of Education and Research under Grant Number 01ET0701. The authors would like to thank Christa Scheidt-Nave, MD; Judith Fuchs, PhD; Markus Busch, MD; and Andrea Ernert for critical feedback in all phases of the research undertaking. Also, they gratefully acknowledge the constructive feedback of two anonymous reviewers and the editor on the manuscript. The contents of this publication are solely the responsibility of the authors.

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Authors and Affiliations

  1. Charité–Universitätsmedizin Berlin, Berlin, Germany

    Martin Holzhausen, Adelheid Kuhlmey & Peter Martus

Authors
  1. Martin Holzhausen
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  2. Adelheid Kuhlmey
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  3. Peter Martus
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Corresponding author

Correspondence to Martin Holzhausen.

Additional information

Communicated by D.J.H. Deeg.

Appendix

Appendix

English translation of the FLQM

Step 1: What is important in your life?

Different people vary widely in what they find important in life. I would now like you to let me know what you consider essential to a good life. This question may take you into somewhat unfamiliar territory, but you are the only one who can answer it, since people differ considerably in their needs and desires.

When asked this question, many people give answers such as the following:

Contact with their family,

their own state of health, or

their mobility.

However, very different things can also play an important role:

One’s mental faculties (e.g., memory),

how one’s apartment is arranged,

the cultivation of friendships.

Other people value the following:

Being able to take an active part in life,

learning something new and developing one’s knowledge, or

pursuing one’s hobbies (e.g., making music or attending sport events).

Obviously there are many things that can be important for your life. So please take some time and think about it.

They do not necessarily have to be positive things—perhaps you also lack something important in your life or you cannot meet your needs in certain domains.

Please name around five life domains (you may also name four or six domains) that most strongly influence your overall level of satisfaction or dissatisfaction with life.

Step 2: How satisfied or dissatisfied are you with these domains?

Please have a closer look at every single one of these areas. How satisfied or dissatisfied are you with each life area in your present situation?

Please rate each domain on the 6-point scale you see below: A rating of 1 means you are so satisfied with this life domain that virtually nothing can be improved; a rating of 6 means you are so dissatisfied with this life domain that you can hardly imagine it being any worse.

Please indicate your satisfaction or dissatisfaction with each life domain by giving it a rating between 1 and 6. If you are equally satisfied with several or all domains, simply give them the same rating.

1

2

3

4

5

6

There is hardly anything to improve

Very satisfied

Satisfied

Rather dissatisfied

Very dissatisfied

It could hardly be worse

Step 3: How important are these domains to you?

Please take your time and have another close look at the individual life domains. They are probably not all equally important to you. Please indicate how important you consider each domain.

Here you see again a 6-point scale: A rating of 1 means this domain ranks among the most important things in your life; a rating of 6 means you find this domain unimportant compared to the other areas.

Please indicate the importance you attach to each life domain by giving it a rating between 1 and 6. If you find several or all domains equally important, simply give them the same rating.

1

2

3

4

5

6

Among the most important things in my life

Very important

Important

Somewhat important

Rather unimportant

Not important compared to the other domains

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Holzhausen, M., Kuhlmey, A. & Martus, P. Individualized measurement of quality of life in older adults: development and pilot testing of a new tool. Eur J Ageing 7, 201–211 (2010). https://doi.org/10.1007/s10433-010-0159-z

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