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Quality of Life in Older People


Richard G. Stefanacci

, DO, MGH, MBA, Thomas Jefferson University, Jefferson College of Population Health

Reviewed/Revised May 2022 | Modified Sep 2022

Quality of life is often defined as the degree to which a person is healthy, comfortable, and able to participate in or enjoy life events. As such, it is highly personal. What one person views as quality of life could vary widely with another person's. For many people, quality of life often revolves around health and health care options, so people and their doctors should consider the impact on quality of life when making decisions about medical issues.

When discussing quality of life, older people, their caregivers, and their doctors should keep in mind that the best medical decisions vary from person to person and do not depend solely on age. During these discussions, people should avoid language and attitudes that suggest bias against older people (ageism). For example, people should not assume that someone at a particular age should not have certain medical care or not participate in certain activities simply because of their age. Ageism can lead to too much or too little care and negatively affect quality of life.

Health-Related Quality of Life

How health affects quality of life depends on the person. Health-related quality of life has multiple dimensions, including the following:

  • Preventing uncomfortable symptoms (such as pain, shortness of breath, nausea, or constipation)

  • Feeling emotionally healthy

  • Being able to do typical activities involved in daily life (such as bathing, dressing, and toileting)

  • Maintaining close interpersonal relationships with friends and family

  • Enjoying social activities

  • Feeling satisfied with the medical and financial aspects of health care

  • Having a healthy body image and sexuality (including intimate relationships)

Some of the factors that influence health-related quality of life, such as mental impairment, disability, chronic pain, dependency on caregivers, and social isolation, may be obvious to people and their doctors. For example, most people think avoiding or managing chronic pain is important to maintaining a high quality of life. Other factors connected to quality of life, such as the quality of close relationships, cultural influences, religion, spirituality, personal values, and previous experiences with health care, may not be as obvious.

Still other factors, such as social determinants of health (SDOH), influence quality of life. SDOH are the conditions in the places where people live, learn, work, and play that affect a wide range of health and quality of life risks and outcomes.

How some factors affect quality of life cannot necessarily be predicted. In addition, some factors that end up affecting quality of life cannot be anticipated.

Also, perspectives on quality of life can change with circumstances. For example, after the death of a spouse a person's quality of life may change, which may impact health care goals.

Communicating with Health Care Practitioners

People should talk to their doctors and other health care practitioners about their quality of life and how their health issues impact their life. People and their health care practitioners should work together to determine health care goals Defining goals People and their doctors must make many decisions about medical issues. People must decide whether and when to see a doctor. Doctors and other primary care practitioners (PCPs) must decide what... read more . Even people with mild dementia or cognitive impairment can make their goals and preferences known when health care practitioners use simple explanations and questions. Having family members present when discussing the goals of a person with cognitive impairment may be helpful.

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