In the medico-psychological context, the term “Quality of Life” only exists since approximately 25 years. Yet, the well-being of patients has always been a focus of medical actions. The question “how are you” addresses many aspects of what we consider today by the term “quality of life” or more precisely, health-related quality of life (HRQOL). A nominal definition of such a complex construct seems impossible. Yet, there is consensus concerning the different dimensions of an operational definition: widely accepted components of quality of life are physical, psychological and social factors, which are assessed on the subjective as well as on the behavioral level via self- or observer rating. Some authors add facets as for example spiritual, mental, environmental and ethical aspects. Especially in gerontology and psychogeriatrics these dimensions play an important role.
This presentation will give an insight in concepts and operationalizations of HRQOL in the psychogeriatrics. Answers to questions as “what, why, how, in and by whom HRQOL should be measured” will be addressed. Theoretical considerations, measurement models and different fields of application will be outlined, in particular, the characteristics of HRQOL assessment in the aging population with and without dementia. HRQOL measures are used for either monitoring illness or assessing a populations’ health state, or as an outcome measure in clinical trials or other interventions.
In the past, in elderly populations - with or without cognitive impairment - only proxy measures of objective pathology, e.g., limitations in activities of daily living or cognitive impairment have been used to indicate quality of life. Yet, for older people, an assessment of health status and HRQOL may be a particularly relevant possibility for doctors and patients to decide whether an intervention is beneficial, as opposed to only improving a particular set of symptoms or prolonging life, however with less quality. Some authors question the reliability of HRQOL self-rating of persons with dementia. This presentation and the one of M. Brod and C. Selai will show that this endeavour is valid. International and national (for the French-speaking area) aspects of the more recent developments in generic and disease-specific questionnaires, such as the WHO QOL-OLD, the MLDL, the DQOL and AD-QOL will be considered.
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