1. Older People’s Quality of Life Surveys A. Bowling et al. QoL C. Victor et al. Loneliness S Ebrahim et al. (MRC) Disability

2. Aims of studies Measure QoL in people aged 65+ in Britain, Measure QoL in people aged 65+ in Britain, Develop & test new measure (OPQOL) in: Develop & test new measure (OPQOL) in: 3 national face-to-face interview surveys of people aged 65+ in Britain: 999 r/s: 1999-2000, followed up 2007-8 999 r/s: 1999-2000, followed up 2007-8 586 r/s: 2007-8 586 r/s: 2007-8 400 ethnically diverse people 2007-8 400 ethnically diverse people 2007-8

3. Main QoL themes 1999-2000 Social & family relationships Social & family relationships Social roles & activities Social roles & activities Health & functional ability Health & functional ability Home & neighbourhood Home & neighbourhood Psychological well-being & outlook Psychological well-being & outlook Income Income Independence, control over one’s life Independence, control over one’s life ▼ Under-pinned the OPQOL 2007-8 surveys Under-pinned the OPQOL 2007-8 surveys + religion, culture (2) prioritised by 4 ethnically diverse focus groups

4. ‘Social relationships’: 81% said these gave quality to life: ‘ for companionship’ ‘to do things with’ ‘to take me out’ ‘to make life bearable’ ‘to know there is someone there willing to help me’ ‘to look after me’ ‘for ‘confidence’. ….Oh, and my little cat. I talk to her a lot, she’s just like a little child. She doesn’t like being left alone, I love her to bits. Now and again I give her a little kiss.’

5. Good neighbours & family – ‘Four doors down the man called me to give me broad beans. When I did not put my washing line up he came round to see if there was any problem. The lady two doors down does my eye drops three times a week. They are all very good.’ ‘The quality of my life now is my family - my children and grandchildren. My life surrounds them. I go at weekends, they visit every week. Sometimes I have the younger grandchild staying overnight….. I’m there if they need me. ‘

6. Good friends Emphasised in relation to providing company (e.g. mixing, conversation, self-esteem) - as opposed to providing practical help, which was a role identified mainly for relatives and neighbours.

7. Poor social relationships took quality away from live for 12%: Due to difficulties maintaining contacts or good relationships, often because of: geographical distance families ‘too busy’ to visit family feuds (‘If only we could be friends with our children.’) Ill health/difficulties getting out

8. Older people’s Quality of Life Questionnaire item 2007-8 11. I have someone who gives me love and affection Echinus ONS O/S QoL follow-up % % % Strongly agree 10 50 45 Agree 45 38 35 Neither agree nor disagree --- 5 13 Disagree 43 5 6 Strongly disagree 2 2 1

9. OPQOL items: health and desire for companionship 2007-8 8. ‘I am healthy enough to get out & about’ Strongly disagree/ Neither Agree/ Disagree Strongly agree % % % 10. ‘I would like more Companionship/ contact with other people’ Strongly agree/Agree 48 21 19*** Neither 32 57 43 Strongly disagree/Disagree 20 22 39

10. QOL & social support All surveys (1999-2000; 2007-8): The more supporters people had, the greater their chances of rating their QoL as good rather than not good. Other predictors of QoL were health and physical functioning, and self-efficacy (feeling ‘can do’).

11. QoL baseline survey. Adjusted (age, sex, NS-SEC) odds of rating: QoL as ‘good’ (1 referent) vs. ’not good’ (0) among: older people with severe physical disability O.R. (95% CI) P Health compared to others same age Excellent to good 4.05 (1.89 to 8.70) ** vs. Fair -Poor Self efficacy/control over important things in life A lot of control 5.36 (2.03 to 14.18) ** Some control 2.98 (1.24 to 7.18) * Little /no control Reference category Social support N Number of supporters (1 to 5) 1.64 (1.14 to 2.34) ** Age and Ageing, 36:310-315.

12. Odds ratios of predictors of perceived QoL (‘good’ vs. ’not good’ QoL) OPQOL scores Referent 1 (all p<0.001) ONS sample (65+) QoL follow-up sample (74+) O.R. (95% CI) O.R. (95% CI) Follow-up: Unable to walk 400 yards without help or at all vs. rest 0.128 (0.070 – 0.236) 0.443 (0.312-0.631) Actual number of supporters who would help in a personal crisis 1.159 (1.062 – 1.265) 1.183 (1.070 – 1.308) Baseline: Self-efficacy High vs. rest N/A 3.449 (1.681 – 7.078) 1