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This paper presents findings from a national survey of quality of life (QoL) in older age. The main aim of the analyses was to examine the definitions of quality of life given by people aged 65 or more years and the underlying reasons. Open-ended questions were used to elicit their perceptions of QoL. These were followed by structured measures of self-rated QoL overall, and of domains of QoL commonly reported in the literature. The main things said by the respondents to give their lives quality were categorised into 'themes'. These were: social relationships; social roles and activities; leisure activities enjoyed alone; health; psychological outlook and wellbeing; home and neighbourhood; financial circumstances; and independence. The reasons people gave to explain why these things were important to their QoL focused on: the freedom to do the things they wanted to do without restriction (whether in the home or socially); pleasure, enjoyment and satisfaction with life; mental harmony; social attachment and having access to companionship, intimacy, love, social contact and involvement, help; social roles; and feeling secure. This paper also presents data that demonstrates the ability of theoretically informed, structured survey indicators of QoL to predict respondents' self-rated overall QoL. Logistic regression analyses showed that most of these indicators were strong, independent predictors of self-ratings of QoL, although those that were not significant in the model did not fully incorporate lay reasons of QoL in their measurement scales. In conclusion, the indicators which were not significant in the model did not fully incorporate lay values in their measurement properties. It is also likely that those indicators that were significant could have been improved. KEY WORDS--quality of life, ageing, social support, social roles, health, wellbeing.

Chronological age can be an unsatisfactory method of discriminating between older people. The lay concept of how old people actually feel may be more useful. The aim of the analyses reported in this paper was to investigate indicators of age-identity (or subjective age) among a national random sample of people aged 65 of more years living at home in Britain. Information was initially collected by home interview and a follow-up postal questionnaire 12-18 months later. The age that respondents felt was a more sensitive indicator than chronological age of many indicators of the respondents' health, psychological and social characteristics. Multiple regression analysis showed that baseline health and functional status, and reported changes in these at follow-up, explained 20.4 per cent of the variance in self-perceived age. Adding baseline mental health (anxiety/depression), feelings and fears about ageing at follow-up explained a further 0.8 per cent of the variance, making the total variance explained 21.2 per cent. It is concluded that measures of physical health and functional status and their interactions influenced age-identity. Mental health status and psychological perceptions made a small but significant additional contribution. KEY WORDS--age-identity, subjective age, self-perceived age, attitudes to ageing, ageing

This study examines the prevalence of loneliness amongst older people in Great Britain, and makes comparisons with the findings of studies undertaken during the last five decades. In addition, the risk factors for loneliness are examined using a conceptual model of vulnerability and protective factors derived from a model of depression. Loneliness was measured using a self-rating scale, and measures of socio-demographic status and health/social resources were included. Interviews were undertaken with 999 people aged 65 or more years living in their own homes, and the sample was broadly representative of the population in 2001. Among them the prevalence of 'severe loneliness' was seven per cent, indicating little change over five decades. Six independent vulnerability factors for loneliness were identified: marital status, increases in loneliness over the previous decade, increases in time alone over the previous decade; elevated mental morbidity; poor current health; and poorer health in old age than expected. Advanced age and possession of post-basic education were independently protective of loneliness. From this evidence we propose that there are three loneliness pathways in later life: continuation of a long-established attribute, late-onset loneliness, and decreasing loneliness. Confirmation of the different trajectories suggests that policies and interventions should reflect the variability of loneliness in later life, for undifferentiated responses may be neither appropriate nor effective. KEY WORDS--loneliness, social exclusion.

This paper report results from a national survey of quality of life (QoL), based on 999 people aged 65 or more years living in private households in Britain. The study produced both qualitative and quantitative interview data. The 999 survey respondents were interviewed in their own homes with a semi-structured survey instrument, and 80 were followed-up in greater depth at one and two years after the baseline interview. The material from the in-depth interviews is presented here. The main QoL themes that emerged were: having good social relationships, help and support; living in a home and neighbourhood that is perceived to give pleasure, feels safe, is neighbourly and has access to local facilities and services including transport; engaging in hobbies and leisure activities (solo) as well as maintaining social activities and retaining a role in society; having a positive psychological outlook and acceptance of circumstances which cannot be changed; having good health and mobility; and having enough money to meet basic needs, to participate in society, to enjoy life and to retain one's independence and control over life. The results have implications for public policy, and supplement the growing body of knowledge on the composition and measurement of quality of life in older age. KEY WORDS--quality of life, ageing, older people.

Describes associations with changes in functional ability among very elderly people who were interviewed first in 1987 when they were aged 85 and above, and followed up in 1990. Focus on persons with severe difficulties in Activities of Daily Living (ADL); Use of health and social services by elderly with chronic problems.

Relatively little is known about what has been termed cultural gerontology, or the experience of ageing among members of particular ethnic minority groups. One of the greatest gaps in current knowledge relates to the subjective health status and use of health services among elderly people in ethnic minorities, particularly those who are Jewish. The research results reported here are from a survey of elderly people in City and Hackney, London, of whom 16% were Jewish. They show that Jewish respondents were more likely than other elderly people to report problems with emotional well-being, with mental and physical health and with functional ability (tasks of daily living). Jewish respondents were also more likely to use services, particularly health services, than other respondents. The associations with service use generally remained after health status had been controlled for. [ABSTRACT FROM PUBLISHER]

There is some evidence in the literature of increased demand on health services by adults with psychiatric morbidity. Among people over retirement age these associations appear weaker. Results from three independent, but comparable, surveys of elderly people living in London and Essex are presented in relation to their use of health and social services. Psychiatric morbidity was found to be a poor predictor of service use. Level of functional ability and, in some cases, age were both stronger predictors of use of a selection of these services among the two samples from the urban area. Age was a stronger predictor of use of home help and meals on wheels services among the younger urban sample aged 65–85. The model had little explanatory power in relation to use of general practitioner services. The study also indicated that the semi-rural sample had better reported health status and functional ability than the samples in the urban area. Use of health and social services was also lower in the semi-rural areas. [ABSTRACT FROM PUBLISHER]

An observational study was carried out in order to measure the quality of life of elderly people in two different types of long-stay care (two NHS nursing homes and a hospital ward). This formed part of a wider evaluation study of these two forms of institutional care. Qualitative techniques provided insights into the behaviours, moods, interactions and atmospheres in the settings, which were difficult to measure using traditional survey approaches. The observational study showed that it is.essential not to rely solely on interview material, and assessments of mental and physical functioning, when evaluating long-stay care. Characteristics of ‘total institutions’ clearly emerged from the analyses of the hospital ward, although the inclusion of the hospital patients' Club in the study revealed that these need not be inevitable, and that both the ward and the homes could be improved if modelled on the more autonomous and flexible philosophy of the Club. [ABSTRACT FROM PUBLISHER]