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Abstract: Promoting quality of life in older age is an internationally recognized priority, requiring valid measurement. We present a short version of the established Older People''s Quality of Life questionnaire (OPQOL-brief). The full OPQOL-35 was original in being developed from the perspectives of older people, assessed conceptually, and validated with a population sample using gold-standard psychometric assessment. The OPQOL-brief was also developed by asking older people to prioritize the most important items from the OPQOL-35, next assessed psychometrically with a population sample, and also statistically against the discarded 22 items. The aim was to assess the psychometric properties of the short, 13-item version of the OPQOL (OPQOL-brief), and to compare the performance of included and discarded items. The method was a national population survey of people aged 65+ living at home. The measures were OPQOL-brief, WHOQOL-QOL and CASP-19. The OPQOL-brief was found to be a highly reliable and valid, short measure of quality of life in older age. The OPQOL-brief is of value in assessment of interventions where a rigorously tested, short measure is required. The grounded development of the instrument is consistent with international policy emphasis on user involvement in shaping policy and research. [Copyright &y& Elsevier]

Abstract: The objective was to investigate associations between type of area, individuals’ perceptions of their neighbourhoods, and indicators of social and physical functioning. Social functioning was measured using numbers of social activities and frequency of social contacts in the past month. Physical functioning was measured with Townsend''s Activities of Daily Living scale. The study was a British cross-sectional population survey of people aged 65 plus living at home. Multilevel analyses indicated that respondents who lived in affluent areas were less likely to have low levels of social activity independently of individual demographic and socio-economic characteristics. Individuals’ perceptions of the area as neighbourly and having good facilities were also independently associated with lower likelihood of low social activities. Affluence of the area and perceived neighbourhood were associated with physical functioning, although these associations disappeared once adjustment was made for individuals’ characteristics. Both objective and more subjective measures of the neighbourhood independently contributed to our understanding of the determinants of social and physical functioning in older age. The unique value of this paper is its inclusion of the influence of perceived neighbourhood on the social and physical functioning of an older population, which are key components of active ageing. [Copyright &y& Elsevier]

The concept of quality of life is elusive and this paper reports on a study that has tried to deconstruct the concept in order to better understand what older people say quality of life means to them. The focus here is on the transport dimension where quality of life is broken down into mobility patterns, locality and social networks. The paper first sets the scene with a summary of secondary data and it then systematically presents data from interviews carried out with 1000 older people as part of the British Office for National Statistics Omnibus Surveys in Britain under the three headings mentioned above. A substantial amount of diversity and variation is found in the data by quality of life ratings and the expectations of the respondents. It is argued that both the active (travel related) and passive (locality and social networks) elements need to be brought together so that the quality of life for the elderly can be better understood. [Copyright &y& Elsevier]

A current popular theme in medicine concerns whether and how patients should be involved in treatment choice. Assuming patient involvement is desirable, how should one go about eliciting preferences? A variety of quantitative and qualitative methods exist that may be used for this purpose, one of which is the repertory grid method. This method involves eliciting constructs (reasons) for preferences through comparing sets of three options. This method allows the structured elicitation of the reasons behind individual preferences, but also, when used with generalised procrustes analysis (GPA), allows aggregation of individual data to reveal general preference patterns. In this study the repertory grid method was used to examine patient preferences for angina treatments with the goal of, first, gaining some understanding of general patterns of patient preference, and second, examining the likely utility of the technique in this setting. A sample of 21 patients with mild and stable angina from two general practices in Norfolk, UK was interviewed using the repertory grid method to elicit the constructs underlying their preferences amongst seven angina treatments (including `no treatment'). Individualised questionnaires were then produced and sent to the patients for self- completion, which required rating the extent to which each construct was relevant for each treatment (scored on visual analogue rating scales). Analysis of the ratings, using GPA, showed that the constructs clustered around two dimensions: 'some treatment' versus 'no treatment', and drug treatment versus surgical treatment. While some treatment was generally preferred to no treatment, individuals varied in preference for drug treatments or surgical treatments. Although the latter were generally perceived as 'effective' they were also perceived, for example, as 'invasive', 'frightening', related to 'negative experiences', and being more appropriate for when symptoms are severe ('proportionate'). We consider the implications of these results for involving patients in choosing amongst treatments. [ABSTRACT FROM AUTHOR]