Predicting change in quality of life from age 79 to 90 in the Lothian Birth Cohort 1921

PurposeQuality of life (QoL) decreases in very old age, and is strongly related to health outcomes and mortality. Understanding the predictors of QoL and change in QoL amongst the oldest old may suggest potential targets for intervention. This study investigated change in QoL from age 79 to 90years in a group of older adults in Scotland, and identified potential predictors of that change.MethodParticipants were members of the Lothian Birth Cohort 1921 who attended clinic visits at age 79 (n=554) and 90 (n=129). Measures at both time points included QoL (WHOQOL-BREF: four domains and two single items), anxiety and depression, objective health, functional ability, self-rated health, loneliness, and personality.ResultsMean QoL declined from age 79 to 90. Participants returning at 90 had scored significantly higher at 79 on most QoL measures, and exhibited better objective health and functional ability, and lower anxiety and depression than non-returners. Hierarchical multiple regression models accounted for 20.3-56.3% of the variance in QoL at age 90. Baseline QoL was the strongest predictor of domain scores (20.3-35.6% variance explained), suggesting that individual differences in QoL judgements remain largely stable. Additional predictors varied by the QoL domain and included self-rated health, loneliness, and functional and mood decline between age 79 and 90years.ConclusionsThis study has identified potential targets for interventions to improve QoL in the oldest old. Further research should address causal pathways between QoL and functional and mood decline, perceived health and loneliness.