COSMIN database

Quality of life in older people: a structured review of generic self-assessed health instruments

Haywood, K. L., Garratt, A. M., and Fitzpatrick, R.
OBJECTIVE: To review evidence relating to the measurement properties of multi-item generic patient or self-assessed measures of health in older people.

METHODS: Systematic literature searches to identify instruments. Pre-defined criteria relating to reliability, validity and responsiveness.

RESULTS: 122 articles relating to 15 instruments met the inclusion criteria. The most extensive evidence was found for the SF-36, COOP Charts, EQ-5D, Nottingham Health Profile (NHP) and SIP. Four instruments have evidence of both internal consistency and test-retest reliability--NHP, SF-12, SF-20, SF-36. Four instruments lack evidence of reliability--HSQ-12, IHQL, QWB, SQL. Most instruments were assessed for validity through comparisons with other instruments, global judgements of health, or clinical and socio-demographic variables. Five instruments lack evidence of responsiveness--GQL, HSQ-12, IHQL, QLI and QWB.

CONCLUSION: There is good evidence for reliability, validity and responsiveness for the SF-36, EQ-5D and NHP. There is more limited evidence for the COOP, SF-12 and SIP. The SF-36 is recommended where a detailed and broad ranging assessment of health is required, particularly in community dwelling older people with limited morbidity. The EQ-5D is recommended where a more succinct assessment is required, particularly where a substantial change in health is expected. Instrument content should be assessed for relevance before application. The concurrent evaluation of generic instruments in older people is recommended.
Qual Life Res
0962-9343 (Print)
Publication year:
General health perceptions / HRQoL:
Health-related quality of life
Adults (18-65)
Seniors (65+)
Certain infections and parasitic diseases and related symptoms
Diseases of and symptoms related to the blood and blood-forming organs and certain disorders involving the immune mechanism
Diseases of and symptoms related to the circulatory system
Diseases of and symptoms related to the digestive system
Diseases of and symptoms related to the ear and mastoid process
Diseases of and symptoms related to the eye and adnexa
Diseases of and symptoms related to the genitourinary system
Diseases of and symptoms related to the musculoskeletal system and connective tissue
Diseases of and symptoms related to the nervous system
Diseases of and symptoms related to the respiratory system
Diseases of and symptoms related to the skin and subcutaneous tissue
Endocrine, nutritional and metabolic diseases and related symptoms
External causes of morbidity and mortality
Injury, poisoning and certain other consequences of external causes
Mental and behavioural disorders and related symptoms
Neoplasms and related symptoms
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
PRO / non-PRO:
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
AQoL - Assessment of Quality of Life
COOP charts - Dartmouth COOP Functional Health Assessment Charts
COOP/WONCA charts - COOP/WONCA Functional Healh assessment charts   
EQ-5D - EuroQoL-5 Dimensions   
FSQ - Functional Status Questionnaire
GQL - Goteborg Quality of Life instrument
HSQ-12 - Health Status Questionnaire 12
IHQL - Index for Health-related Quality of Life
NHP - Nottingham Health Profile   
QLI - Quality of Life Index [alias: Ferrans and Powers Quality of Life Index]
QWB - Quality of Well-Being Scale
SF-12 - 12-item Short Form Health Survey [alias: RAND-12]
SF-20 - MOS short-form general health survey 20 item
SF-36 - 36-item Short Form Health Survey [alias: RAND-36][alias: Medical Outcomes Study (MOS) SF-36]]    |  | also see:
SIP - Sickness Impact Profile   
SQL - Spitzer Quality of Life index