DOI: 10.1111/j.1741-6612.2007.00249.x
162 Australasian Journal on Ageing, Vol 26 No 4 December 2007, 162–167
© 2007 The Authors
Journal compilation © 2007 ACOTA
Blackwell Publishing Asia
Research
Measuring quality of life in older people: Reliability and validity of
WHOQOL-OLD
Nancye M Peel and Helen P Bartlett
Australasian Centre on Ageing, The University of Queensland,
Queensland, Australia
Alison L Marshall*
School of Human Movement Studies, The University of Queensland,
Queensland, Australia
Objectives: The World Health Organization (WHO) recently
developed a generic Quality of Life (QOL) measure, the
WHOQOL-OLD, specifically for use with older adults. This
pilot study aimed to test the psychometric properties of the
new measure to determine its suitability for evaluating
outcomes of healthy ageing interventions.
Methods: A random sample of 100 participants aged 65 years
and older, selected from a database of community research
volunteers, was invited to complete a mailed questionnaire
administered at two time points. The questionnaire included
the WHOQOL-OLD, a generic health-related QOL measure,
the SF-12, as well as psychological and physical well-being
measures and demographic data.
Results and conclusion: Overall, the WHOQOL-OLD
demonstrated good performance on tests of reliability and
validity and had features that made it a more suitable outcome
measure of QOL in older people compared with the frequently
used measure, the SF-12.
Key words: measurement scales, older age, quality of life,
reliability, validity.
Introduction
As a response to global trends towards ageing of populations,
policies aimed at enhancing the quality in the extended years
of life have become part of health and social agendas in many
countries [1]. Quality of Life (QOL) is therefore an important
outcome measure for evaluating programs designed to promote
healthy and active ageing [2].
The World Health Organization (WHO) defines QOL as ‘an
individual’s perception of their position in life in the context of
the culture and value systems in which they live and in relation
to their goals, expectations, standards and concerns’ [3]. While
there are many generic and disease-specific instruments to
measure QOL [4], few have been developed and formally
validated in populations of older people [5]. Generic instru-
ments suitable for use in younger adult populations may fail to
adequately address specific areas of QOL that may be more
important and appropriate for older people [6]. Recently an
add-on module for the WHO generic measures of QOL, the
WHOQOL-OLD, was specifically developed for use with
older adults [6].
This pilot study aimed to test the completion, reliability and
validity of the WHOQOL-OLD, to determine its suitability for
use in evaluating a physical activity intervention for sedentary
older people. In the absence of a gold standard for measuring
an abstract concept such as QOL [7], evidence of validity was
assessed by comparison with the 12-item Short-Form Health
Survey (SF-12). The SF-12 [8] has been used in Australian
population surveys [9,10] and is considered a reliable measure of
health-related QOL in older people [11]. Validity was also
assessed by comparison with global judgements of health,
measures of physical and mental well-being, and demographic
variables. The measures of well-being included vitality (assessed
using the Vitality Plus Scale [12]), anxiety and depression
(Goldberg Symptom Inventory [13]) and psychological
distress (Kessler 10 [14]).
Methods
Study design
For this prospective study, a sample size of 29–47 was considered
adequate to demonstrate a moderate to substantial correlation
(r) of 0.4 – 0.5 [15] on test–retest measures, using an alpha of
0.05 and power of 80%. Based on an anticipated response rate
of 70% and further loss to follow up of 20%, a sample of 100
was targeted for recruitment. The study was approved by the
University of Queensland Behavioural and Social Sciences
Ethical Review Committee.
A random sample of participants (N = 100) was selected from
the Australasian Centre on Ageing’s 50+ Registry (a pool of
more than 600 research volunteers). Those eligible for the
study were aged 65 years and over, English speaking and with
no serious morbidity that would prevent participation. Those
selected were invited to complete the mailed questionnaire at
two time points (T1 and T2). The maximum time between
questionnaire administrations was two weeks.
Measures
WHOQOL-OLD, a 24-item QOL measure, was developed by the
WHOQOL Group as an add-on module to their QOL measures
(WHOQOL-100 and WHOQOL-BREF), specifically for use
Correspondence to: Dr Nancye M. Peel, Australasian Centre on
Ageing, The University of Queensland. Email: n.peel@uq.edu.au
*Present address: Health Promotion, School of Public Health,
Queensland University of Technology, Victoria Park Road, Kelvin
Grove, Qld 4059, Australia.