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Published in: Quality of Life Research 8/2019

Open Access 01-08-2019 | Review

Quality of life is substantially worse for community-dwelling older people living with frailty: systematic review and meta-analysis

Authors: Thomas F. Crocker, Lesley Brown, Andrew Clegg, Katherine Farley, Matthew Franklin, Samantha Simpkins, John Young

Published in: Quality of Life Research | Issue 8/2019

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Abstract

Purpose

Frailty is an important predictor of adverse health events in older people, and improving quality of life (QOL) is increasingly recognised as a focus for services in this population. This systematic review synthesised evidence of the relationship between frailty and QOL in community-dwelling older people, with an emphasis on how this relationship varied across QOL domains.

Methods

We conducted a systematic review with meta-analysis. We searched five databases for reports of QOL in older people with frailty and included studies based on pre-defined criteria. We conducted meta-analyses comparing “frail” and “not frail” groups for each QOL scale where data were available. We compared pooled results to distribution-based and known-group differences to enhance interpretation. We summarised reported cross-sectional and longitudinal analyses.

Results

Twenty-two studies (24,419 participants) were included. There were medium or larger standardised mean differences for 24 of 31 QOL scales between frail and not frail groups, with worse QOL for frail groups. These scales encompassed constructs of health-related quality of life as well as psychological and subjective well-being. There were similar findings from mean difference meta-analyses and within-study analyses.

Conclusions

The association between frailty and lower QOL across a range of constructs is clear and often substantial. Future research should establish whether causal mechanisms link the constructs, which aspects of QOL are most important to older people with frailty, and investigate their tractability. Services focused on measuring and improving QOL for older people with frailty should be introduced.
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Literature
2.
go back to reference Galloway, S., Bell, D., Hamilton, C., & Scullion, A. (2006). Well-being and quality of life: Measuring the benefits of culture and sport-a literature review and thinkpiece. Edinburgh: Scottish Executive: Social Research). Galloway, S., Bell, D., Hamilton, C., & Scullion, A. (2006). Well-being and quality of life: Measuring the benefits of culture and sport-a literature review and thinkpiece. Edinburgh: Scottish Executive: Social Research).
3.
go back to reference Andelman, R., Board, R., Carman, L. L., Cummins, R. A., Ferriss, A., Friedman, P., et al. (1998). Quality of life definition and terminology: A discussion document from the International Society for Quality of Life Studies: The International Society for Quality-of-Life Studies (ISQOLS). Andelman, R., Board, R., Carman, L. L., Cummins, R. A., Ferriss, A., Friedman, P., et al. (1998). Quality of life definition and terminology: A discussion document from the International Society for Quality of Life Studies: The International Society for Quality-of-Life Studies (ISQOLS).
5.
go back to reference World Health Organization. (2015). World report on ageing and health. Geneva: World Health Organization. World Health Organization. (2015). World report on ageing and health. Geneva: World Health Organization.
8.
go back to reference Arnold, S. B. (1991). Measurement of quality of life in the frail elderly. In J. Birren, J. Lubben, J. Rowe & D. Deutchman (Eds.), The concept and measurement of quality of life in the frail elderly (pp. 50–73). London: Academic Press.CrossRef Arnold, S. B. (1991). Measurement of quality of life in the frail elderly. In J. Birren, J. Lubben, J. Rowe & D. Deutchman (Eds.), The concept and measurement of quality of life in the frail elderly (pp. 50–73). London: Academic Press.CrossRef
21.
go back to reference . Review Manager (RevMan) (2014). (5.3 ed.). Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration. . Review Manager (RevMan) (2014). (5.3 ed.). Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration.
24.
28.
45.
go back to reference Bilotta, C., Bowling, A., Nicolini, P., Casè, A., Pina, G., Rossi, S. V., et al. (2011). Older People’s Quality of Life (OPQOL) scores and adverse health outcomes at a one-year follow-up. A prospective cohort study on older outpatients living in the community in Italy. Health & Quality of Life Outcomes. https://doi.org/10.1186/1477-7525-9-72.CrossRef Bilotta, C., Bowling, A., Nicolini, P., Casè, A., Pina, G., Rossi, S. V., et al. (2011). Older People’s Quality of Life (OPQOL) scores and adverse health outcomes at a one-year follow-up. A prospective cohort study on older outpatients living in the community in Italy. Health & Quality of Life Outcomes. https://​doi.​org/​10.​1186/​1477-7525-9-72.CrossRef
52.
go back to reference Rao, S., Wallace, L., Theou, O., & Rockwood, K. (2017). Is it better to be happy or not depressed? Depression mediates the effect of psychological well-being on adverse health outcomes in older adults. International Journal of Geriatric Psychiatry, 32(9), 1000–1008. https://doi.org/10.1002/gps.4559.CrossRefPubMed Rao, S., Wallace, L., Theou, O., & Rockwood, K. (2017). Is it better to be happy or not depressed? Depression mediates the effect of psychological well-being on adverse health outcomes in older adults. International Journal of Geriatric Psychiatry, 32(9), 1000–1008. https://​doi.​org/​10.​1002/​gps.​4559.CrossRefPubMed
56.
go back to reference Espinoza, S. E., & Fried, L. P. (2007). Risk factors for frailty in the older adult. Clinical Geriatrics, 15(6), 37–44. Espinoza, S. E., & Fried, L. P. (2007). Risk factors for frailty in the older adult. Clinical Geriatrics, 15(6), 37–44.
63.
go back to reference Rippon, S., & Hopkins, T. (2015). Head, hands and heart: asset-based approaches in health care. A review of the conceptual evidence and case studies of asset-based approaches in. In Health, care and wellbeing. London: The Health Foundation. Rippon, S., & Hopkins, T. (2015). Head, hands and heart: asset-based approaches in health care. A review of the conceptual evidence and case studies of asset-based approaches in. In Health, care and wellbeing. London: The Health Foundation.
Metadata
Title
Quality of life is substantially worse for community-dwelling older people living with frailty: systematic review and meta-analysis
Authors
Thomas F. Crocker
Lesley Brown
Andrew Clegg
Katherine Farley
Matthew Franklin
Samantha Simpkins
John Young
Publication date
01-08-2019
Publisher
Springer International Publishing
Published in
Quality of Life Research / Issue 8/2019
Print ISSN: 0962-9343
Electronic ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-019-02149-1

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