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

A range of terms (including quality of life, health-related quality of life and health status) describe a broad set of aspects of self-reported health that can be captured by questionnaires and related instruments. Health in older people particularly requires attention to broader aspects of the impact of health on physical, social and psychological function. A structured review was performed to assess how well such issues are measured by available instruments. A total of 45 instruments were identified that have received some degree of evaluation to establish their use in assessing the health of older individuals. Two types of instruments were included in the review: generic and older-people-specific instruments. The SF-36 has by far the largest evidence base to support its use in older people. The OMFAQ has the best evidence base amongst older-people-specific instruments. Many instruments have only minimal evidence of measurement properties. Concepts such as quality of life are still defined and used in a variety of ways, and major questions must be addressed before uniform practice emerges in this important area of health policy.