Subjective quality-of-life predictors, for older adults with physical disabilities.

Objectives: To study changes in quality of life (QOL) and to explore predictors of QOL of community-dwelling older adults with physical disabilities. Design: A 2-yr longitudinal study involved a convenience sample of 49 people with physical disabilities aged 60-94 yrs. QOL was estimated twice at a 2-yr interval with the Quality of Life Index, which includes four domains: health and functioning, socioeconomic, psychological/spiritual, and family. The potential predictors evaluated at baseline were health condition, activity, participation (level and satisfaction), personal factors, and environmental factors (obstacles and facilitators). Results: No change over time in QOL mean score was observed 4 1; SD: 2.5; 95% confidence interval: -1.1 to 0.30; P = 0.25). However, about half the participants had a clinically significant change (either increase or decrease). Greater satisfaction with participation in social roles and fewer obstacles in the physical environment were identified as the best predictors (R-2 = 0.27; P = 0.001) of better QOL. Greater participation in daily activities, fewer obstacles in the physical and greater satisfaction with participation in social roles were environment, found to be the best predictors (R-2 = 0.49; P < 0.001) of high health and functioning QOL. Finally, increased QOL score over the 2-yr period was best predicted by initial lower socioeconomic QOL and activity level perceived as unstable (R-2 = 0.27; P = 0.001). Conclusions: QOL is partially explained by participation and environmental factors. These factors may be positively modified and thus may warrant special attention in health interventions. Identified predictors of OOL changes over time need to be considered in intervention studies.