HRQOL

[Guest guest]

Hi,

HRQOL declines with age. This is a central, inescapable consequence of the increased life span and consequent increased prevalence of chronic disease and the effects of senescent changes in many physiologic systems. These changes affect HRQOL; for example, pain in arthritic joints leads to circumscription of choice in daily activities; lower-extremity weakness means difficulty climbing stairs or standing up long enough to prepare a meal; and slowing of psychomotor skills may mean inability to drive safely. Older people adjust their daily lives to accommodate these decrements and in this way preserve HRQOL.

Still, cross-sectional studies show major declines in health-related QOL with increasing age. For example, mean health-related QOL scores for the U.S. population (with 1.0 optimal health and 0.0 death) ranged from 0.90 to 0.94 for people under age thirty, 0.81–0.90 for people age thirty-five–sixty, 0.70–0.79 for people aged sixty–eighty, and 0.51–0.63 for people over age eighty (kson, et al.). By this formulation, a medical intervention that improved health-related QOL from 0.74 to 0.81 would therefore be equivalent to a reduction in age, in this case from seventy–seventy-five to fifty-five–sixty. Thus, clinical trials for medical interventions and therapeutics have increasingly turned to health-related

QOL as an outcome to capture the broad effects of treatment.

In contrast to health-related QOL, environmental or non-health-related QOL may remain high throughout life or even improve with greater age. With retirement, for example, older people have more leisure time; and with children gone, houses paid for, and successful investments, they may have more disposable income. As a result, older people have

more opportunities to develop interests and create satisfying environments. Better health care and effective disease management also play a major role in fostering QOL in late life. These factors counterbalance declines in health-related QOL and may be responsible for the great resiliency older people show in the face of declining health.

Dr. Smita

[Guest guest]

HRQOL

 Hi,

HRQOL declines with age. This is a central, inescapable consequence of the

increased life span and consequent increased prevalence of chronic disease and

the effects of senescent changes in many physiologic systems. These changes

affect HRQOL; for example, pain in arthritic joints leads to circumscription of

choice in daily activities; lower-extremity weakness means difficulty climbing

stairs or standing up long enough to prepare a meal; and slowing of psychomotor

skills may mean inability to drive safely. Older people adjust their daily lives

to accommodate these decrements and in this way preserve HRQOL.

Still, cross-sectional studies show major declines in health-related QOL with

increasing age. For example, mean health-related QOL scores for the U.S.

population (with 1.0 optimal health and 0.0 death) ranged from 0.90 to 0.94 for

people under age thirty, 0.81–0.90 for people age thirty-five–sixty,

0.70–0.79 for people aged sixty–eighty, and 0.51–0.63 for people over age

eighty (kson, et al.). By this formulation, a medical intervention that

improved health-related QOL from 0.74 to 0.81 would therefore be equivalent to a

reduction in age, in this case from seventy–seventy-five to

fifty-five–sixty. Thus, clinical trials for medical interventions and

therapeutics have increasingly turned to health-related QOL as an outcome to

capture the broad effects of treatment.

In contrast to health-related QOL, environmental or non-health-related QOL may

remain high throughout life or even improve with greater age. With retirement,

for example, older people have more leisure time; and with children gone, houses

paid for, and successful investments, they may have more disposable income. As a

result, older people have more opportunities to develop interests and create

satisfying environments. Better health care and effective disease management

also play a major role in fostering QOL in late life. These factors

counterbalance declines in health-related QOL and may be responsible for the

great resiliency older people show in the face of declining health.

Dr. Smita