Measuring quality of life in the frail elderly

This study was carried out to develop and test the Geriatric Quality of Life Questionnaire (GQLQ), a health-related qualify of life (HRQL) questionnaire designed for the frail elderly. One hundred patients were asked to identify areas of their daily lives affected by their health. The GQLQ, developed on the basis of the results, the Rand Physical and Emotional Function Questionnaires, and the Barthel Index, were administered serially to a group of 76 patients participating in a randomized trial of a Geriatric Day Hospital. Participants in all phases of the study were over 65 years of age, living in their own home but with sufficient functional status impairment to compromise their ability to live independently. The GQLQ includes 25 questions focusing on activities of daily living (ADL), symptoms, and emotional function. In the ADL and Symptom domains respondents define personal problem areas. The responsiveness coefficients of the GQLQ ADL and Symptom domains (0.26 and 0.30 respectively) were similar to those of the Rand Physical Function instrument and the Barthel Index (0.29 and 0.20). The responsiveness coefficient of the GQLQ Emotional Function domain (0.50) was similar to that of the Rand Emotional Function instrument (0.63). Correlations between the GQLQ ADL domain and the Barthel Index (0.41), and between GQLQ and the Rand Physical Function instrument (0.30), were similar to the correlation between the Barthel Index and Rand Physical Function (0.40). While the GQLQ captures important areas of health-related quality of life impairment for the frail elderly, we failed to show any advantages in either responsiveness or validity to existing, simpler measures. New, specific instruments should be tested in head-to-head comparisons with existing measures, particularly generic instruments, before dissemination.