Whoqol-Old Final Manual

WHOQOL-OLD
MANUAL
WORLD HEALTH ORGANIZATION
EUROPEAN OFFICE (COPENHAGEN)
MAY 2006
The WHOQOL-OLD module – manual
This manual was written by Mick Power and Silke Schmidt on behalf of the
WHOQOL-OLD Group. The study was funded by the European Commission Fifth
Framework, QLRT-2000-00320, and was carried out under the auspices of the World
Health Organization Quality of Life Group (WHOQOL Group). The WHOQOL-Old
Group comprises a coordinating group and collaborating investigators in each of the
following field centres: Professor M. Power, K. Quinn, K. Laidlaw, H. Toner, Univer-
sity of Edinburgh, UK; Dr R. Lucas, Insititut Català de l’Envelliment, Barcelona, Spain;
Professor S. Skevington, Dr F McCrate, University of Bath, UK; Dr M. Amir*, Y. Ben
Ya’acov, Tal Narkiss-Guez, Department of Behavioural Sciences, Ben-Gurion Univer-
sity of the Negev, Israel; Professor L. Kullman, National Institut for Medical Rehabilita-
tion, Hungary; G. Bech-Anderson, Dr K. Martigny, Psychiatric Research Unit,
Copenhagen, Denmark; Professor Ji-Qian Fang, Dr Yuantao Hao, Sun Yat-sen
University of Medical Sciences, Guangzhou, China; Professor M.C. Angermeyer, Dr H.
Matschinger, I. Winkler, Department of Psychiatry, University of Leipzig, Germany;
A/Professor G. Hawthorne, Australian Centre for Posttraumatic Health, University of
Melbourne, Australia; Dr M. Kalfoss, Faculty of Nursing, Menighetssosterhjemmets
College, Oslo, Norway; Dr A. Leplege, INSERM, Paris, France; Dr E. Dragomirecka,
Prague Psychiatric Centre, Prague, Czech Republic; Dr M. Martin, Mr D. Bushnell,
Health Services Research Associates Inc, Seattle, U.S.A.; Dr M. Tazaki, Department of
Science, Science University of Tokyo, Tokyo, Japan; Professor M. Eiseman,
Department of Psychology, University of Tromsoe, Norway; B. Nygren, Department of
Nursing, Umea University, Sweden; Dr A. Molzahn, Faculty of Human and Social
Development, University of Victoria, Canada; Dr J. Ceremnych, Scientific Department
of Gerontology Problems, Institute of Experimental and Clinical Medicine, Vilnius,
Lithuania; Dr M. Fleck, Department de Psiquiatra e Medicina Legal, Porte Alegre, Bra-
zil; Professor, K.-F. Leung, Hong Kong Hospital Authority, Kowloon, Hong Kong; Pro-
fessor N. von Steinbüchel, Centre of Neurogerontopsychology, Clinic of Psychiatric
Geriatrics, Geneva University Hospital, Switzerland; Assoc Professor E. Eiser, Celal
Bayar University, Manisa, Turkey; Professor L. Schwartzmann, Department of Medical
Psychology, Uruguay; Dr R. Killian, Department of Psychiatry, University of Ulm, Ger-
many; Dr S. Schmidt, Holger Muehlan, University of Hamburg, Germany.
* We note with great sadness the death of Dr. Marianne Amir in January 2004.
Further information can be obtained from:
Professor Mick Power

Section of Clinical and Health Psychology
University of Edinburgh
Medical School
Teviot Place
Edinburgh EH8 9AG, UK.
Email: mjpower@staffmail.ed.ac.uk
2
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World Health Organization (WHO). This document may not be reviewed, abstracted,
quoted, reproduced, translated, referred to in bibliographical matter or cited, in part or in
whole, without the prior written permission of WHO. No part of this document may be
stored in a retrieval system or transmitted in any form by any means - electronic, me-
chanical or other - without the prior written permission of WHO.
3
Contents
Introduction . . . . . . . . 5
The WHOQOL-OLD project. . . . . . . 7
Development of the WHOQOL-OLD module . . . . 7
Overview . . . . . . . . 7
Initial development . . . . . . . 8
Pilot study . . . . . . . . 9
Field Trial . . . . . . . . 10
Summary of results of questionnaire development . . . 12
The final version of the WHOQOL-OLD module . . . 13
Description of the instrument . . . . . . 14
Scale structure . . . . . . . 14
Scoring . . . . . . . . 15
Psychometric properties . . . . . . . 18
Basic statistics . . . . . . . 18
Factor analyses . . . . . . . 19
Convergent validity . . . . . . . 20
Discriminant group validity . . . . . . 22
Interpretation . . . . . . . . 23
Administration – suggested uses . . . . . . 23
References . . . . . . . . 24
Appendix . . . . . . . . 25
AI Final set of items for WHOQOL-OLD Module . . . . 26
A II Method for converting individual raw scores to transformed scores . 27
A III SPSS syntax file . . . . . . . 29
A IV Reference data . . . . . . . 32
AV List of Centres . . . . . . . 47
A VI The WHOQOL-OLD final scale . . . . . 54
4
Introduction ∗
The initial development of the generic WHOQOL measures of quality of life occurred in
fifteen different centres worldwide (see Table 1) with over forty centres now involved
in the project. Two main generic instruments are the WHOQOL-100, which consists of
24 facets grouped into six domains, and the WHOQOL-BREF, which is a reduced 26-
item version with four domains. Domains represent a high-level of organisation such as
the Psychological, the Physical, and the Social. Facets are an intermediate level of orga-
nisation between domains and items, for example, the psychological domain include fa-
cets that focus on the self, body image, and positive and negative feelings, each of
which in turn is represented by a set of four specific items in the WHOQOL-100. In
addition to the WHOQOL as a generic measure of quality of life, there have been
various adaptations to the assessment of quality of life in special groups, e.g. older
adults. A failure to operationalise the concept of quality of life adequately for the ageing
population will endanger many claims, comparisons with other populations, welfare
proposals, and so on, because no acceptable or satisfactory measure will have been de-
veloped on which to base such developments or comparisons.
One of the first questions that arises in the generic assessment of quality of life is whe-
ther or not questionnaires that have been developed in younger adult populations can be
used equally validly for older populations. One or two informative studies have been
carried out; thus, Brazier and colleagues (Brazier et al. 1996) found that two commonly
used measures, the EuroQol and the SF-36 could be fairly satisfactorily used with older
adults, though a number of issues were noted. These issues included problems about
format of administration, consistency of response, and some floor effects on particular
sub-scales. The sample used by Brazier et al was a relatively healthy one compared to
some of the patient groups that one would also wish to assess (cf. Coast et al. 1998).
From the previously published data with the WHOQOL (The WHOQOL Group 1998),
a small proportion of respondents from each of the 15 Centres were 65 years or older.
Re-analysis of these preliminary data shows for almost all centres that older adults re-
port greater satisfaction on facets related to social support, relationships in general, fi-
nances, and certain aspects of the home environment, as well as reporting lower negati-
ve feelings. We obviously needed to replicate these analyses in the present study with
larger numbers. Nevertheless, they are in line with some of our own (Lam & Power
1991) and others (Stewart et al. 1996) findings that older adults often report more satis-
faction with relationships and report better psychological health than do younger adults,
contrary to many of the stereotypes of old age. A second question arises of whether or
not there are specific areas of quality of life that may be more important in older adults
(cf. Baltes & Baltes 1990) and that therefore should supplement a generic adult ques-
tionnaire in order to provide a broader-band and more valid general assessment. Drama-
tic examples of this problem exist even for younger adults simply through the compari-
son of established generic measures; for example, the WHOQOL instruments assess
∗
Note: Parts of the present manual are adapted from the main publication for the WHOQOL-OLD
module (Power, Quinn, Schmidt & The WHOQOL-OLD Group, 2005).
5
Spirituality and the Environment, domains that are absent from most other instruments.
Two facets (Sensory Problems, and Communication) that were originally included in
the pilot WHOQOL, but dropped because of psychometric problems in a primarily
younger adult population, are good examples of facets that may need to be added to an
older adults module.
Table 1 Centres included in development of the WHOQOL-OLD module
Centre Country Pilot study (n) Field trial (n)

Edinburgh Scotland 303 116
Bath England 331 145
Leipzig Germany 433 354
Barcelona Spain 302 271
Copenhagen Denmark 467 384
Paris France 130 164
Prague Czech Republic 350 325
Budapest Hungary 304 333
Oslo Norway 372 324
Victoria Canada 430 202
Melbourne Australia 364 376
Seattle USA 235 295
Beer-Sheva Israel 312 250
Tokyo Japan 410 188
Umea Sweden 315 455
Guangzhou China 478 -
Hong Kong China 319 -
Porto Alegre Brazil 339 328
Montevideo Uruguay 256 248
Izmir Turkey 345 327
Geneva Switzerland 161 139
Vilnius Lithuania 445 342
WHOQOL-OLD Group Overall 7401 5566
The main aim of the study therefore was to answer both of these questions in relation to
the WHOQOL: do the generic forms (the WHOQOL-100 and the WHOQOL-BREF)
perform well, on a range of criteria, with an older adult population? And, second, do ad-
ditional facets need to be added to the adult generic form in order to assess quality of li-
fe adequately in the older adult population? The study will also ask the question of whe-
ther it is possible to have a single cross-cultural Older Adults module or whether each
culture requires its own culture-specific module. Although it has been possible to gene-
rate a common younger adults version of the WHOQOL and this has been supported by
empirical analyses (The WHOQOL Group 1998-a, 1998-b), the possibility remains that
diverse attitudes across cultures towards older adults may require the production of dif-
ferent older adults modules. This possibility will be carefully tested across the different
centres. The feedback from the focus groups and the data analyses will also allow the
6
question of how well the existing WHOQOL-100 items, which have been selected for
use with younger adults, perform when used with older adults. That is, one of the key
objectives of the research will be to test the question of whether the existing WHO-
QOL-100 items only need to be supplemented with an additional module or whether
these generic items need to be altered in some way or another.
In summary, the overall aim of the WHOQOL-OLD Group was to adapt the younger
adults version of the WHOQOL for use with older adults and then test its use in a series
of cross-cultural field trials. This adaptation consisted of the development of a supple-
mentary module that can be added to the existing WHOQOL instruments. The end point
of the work however is the construction of an Older Adults WHOQOL module (WHO-
QOL-OLD). To date, the work of the WHOQOL-OLD Group is partly available in writ-
ten form in publications (Power, Quinn, Schmidt & The WHOQOL-OLD Group, 2005)
and oral presentation. The present publication represents a manual for the use of the
questionnaire and also describes briefly the development and testing of the WHOQOL-
OLD module.
The WHOQOL-OLD project
The WHOQOL-OLD project aims at developing and testing a quality of life assessment
for older people. It started in 1999, as scientific co-operation of several centres. The aim
of the project was to develop and test a generic measure of quality of life in older adults
for international/ cross-cultural use. The project was funded by the European Com-
mission Fifth Framework, QLRT-2000-00320, and was carried out under the auspices
of the World Health Organization Quality of Life Group (WHOQOL Group). The
questionnaire development was conducted according to the following multi-step proce-
dure: (a) the initial development of relevant quality of life questions (items) and their
translation: focus group work within the collaborating centres and iterative Delphi tech-
nique process between the collaborating centres for item generation; (b) the pilot testing
of the questionnaire with appropriate modification (refinement, item reduction); (c) the
field trial testing of the questionnaire; (d) the final analysis: statistical analysis, project
report and publication of the manual .
Development of the WHOQOL-OLD module
Overview
The WHOQOL-OLD Coordinating Field Centre produced a draft protocol based on the
previous WHOQOL Group experiences in conducting international collaborative re-
search for the development of the WHOQOL-100 and WHOQOL-BREF (The
WHOQOL Group 1998-a, 1998-b). Following initial protocol development, it was cir-
culated to each Field Centre for comment. It was iteratively revised using a Delphi tech-
nique until there was agreement among the participating Centres. In summary, the steps
for the development of the WHOQOL-OLD followed the published WHOQOL metho-
7
dology, which consisted of focus group work in collaborating centres, item generation,
pilot testing, refinement and item reduction, and then field trial testing of the instru-
ment, as described below. Prior to the focus group exercise the iterative Delphi process
was also used to identify gaps in the coverage of the WHOQOL-100 that might be rele-
vant for older adults, and any other issues about the use of the WHOQOL with older
adults. The proposed WHOQOL-OLD module underwent various steps of instrument
development in a simultaneous cross-cultural approach (see Power, Quinn, Schmidt &
The WHOQOL-OLD Group, 2005). After conducting focus groups and forming an
international item pool, only those items were selected that pertain to older people,
while age generic items were processed separately. Further steps included a translation
process following international guidelines (Guillemin et al. 1993) and the pilot testing
of the instrument (Bullinger et al. 2002). The field study analysis of the WHOQOL-
OLD module comprises additional psychometric evaluations of both the single items
and the scale structure. These analyses lead to the final version of the WHOQOL-OLD
module and are reported in detail elsewhere (Power, Quinn, Schmidt & The
WHOQOL-OLD Group, 2005).
Initial development
The protocol for conducting focus groups established a common framework for inter-
preting and assessing the data reported by each Centre. Once agreed, the protocol was
used in each Centre as the guide for planning and conducting focus groups for the pur-
pose of eliciting the quality of life concerns of older adults, and for reporting the data
back to the Edinburgh Coordinating Centre. The focus group discussions included four
parts: (a) a general unstructured discussion on the dimensions of quality of life that were
important for older adults; (b) a commentary on and assessment of the facets and items
from the WHOQOL-100 instrument; (c) feedback on additional facets and items that
had been previously suggested by Field Centres during the Delphi exercise described
above; and (d) the gathering of ideas from participants for additional areas of quality of
life or items that participants felt were not covered during discussion. Each Centre
agreed to conduct four focus groups with older adults (with approximately equal num-
bers 60 - 80 years and 80 + years, equal male and female, and equal well and ill parti-
cipants), one with their carers and one group with health professionals working with ol-
der adults (i.e. a minimum of six focus groups). Suggestions for additional facets and
items were translated into English as the working language; equivalent items were iden-
tified across the suggestions from each centre; and each centre was given feedback
about the proposed items. This process eventually led to the generation of a set of 40 pi-
lot items, which were grouped conceptually by the participating centres into six facets
(see below; Hawthorne et al. in prep.; Winkler et al. in press). In addition, the focus
group work suggested four supplementary items for existing WHOQOL-100 facets; na-
mely, two items for “Sexual Activity”, and one item each for “Thinking” and for “Ho-
me”.
8
Pilot study
Population
The pilot testing was carried out in 22 different WHOQOL centres from around the
world (see Table 2). Each centre was asked to test an opportunistic sample of a mini-
mum of 300 older adults, but within the following sampling frame: approximately equal
numbers of male and female, equal numbers aged 60 - 80 and aged > 80 years, and
equal numbers of ill and well.∗ The data presented in Table 2 provide summary descrip-
tions of the samples from each of the 22 centres in terms of sample size, age, gender,
and health status.
Table 2 General description (sample sizes, selected sociodemographic characteristics) of the

WHOQOL-OLD pilot study sample from each participating centre (N = 7401)
Centre Sample size Age Gender Health status

(Females) (“healthy”) *
n M ± SD % %
Edinburgh (Scotland) 303 73.3 ± 8.2 68.5 83.8
Bath (England) 331 74.3 ± 8.0 59.5 84.5
Leipzig (Germany) 433 72.3 ± 8.2 43.6 65.6
Barcelona (Spain) 302 74.5 ± 7.5 56.6 63.6
Copenhagen (Denmark) 467 71.3 ± 8.3 52.5 83.6
Paris (France) 130 73.3 ± 8.2 55.9 93.0
Prague (Czech Republic) 350 74.1 ± 8.2 50.3 62.0
Budapest (Hungary) 304 74.7 ± 8.1 65.1 41.1
Oslo (Norway) 372 73.5 ± 6.6 74.6 73.2
Victoria (Canada) 430 74.4 ± 8.6 73.0 89.3
Melbourne (Australia) 364 74.9 ± 7.9 55.1 82.0
Seattle (USA) 235 72.8 ± 7.6 63.4 57.9
Beer-Sheva (Israel) 312 73.0 ± 8.3 52.4 71.3
Tokyo (Japan) 410 70.8 ± 8.0 55.7 78.6
Umea (Sweden) 315 73.3 ± 6.6 54.6 74.2
Guangzhou (China) 478 73.6 ± 8.5 48.5 61.5
Hong Kong (China) 319 72.5 ± 6.9 63.7 64.4
Porto Alegre (Brazil) 339 73.4 ± 8.3 56.0 57.5
Montevideo (Uruguay) 256 71.6 ± 7.4 61.3 72.3
Izmir (Turkey) 345 70.3 ± 5.8 52.2 57.4
Geneva (Switzerland) 161 74.7 ± 8.3 75.8 90.6
Vilnius (Lithuania) 445 73.3 ± 9.4 52.4 54.8
Total 7401 73.1 ± 8.0 57.8 70.1
Note: * “Healthy” or “unhealthy” as subjectively defined.
∗
The only exceptions were the Geneva and Paris centres who shared the recruitment of French-spea-
king individuals between them.
9
This sample is the largest sample to date of older adults tested with the WHOQOL-100.
The “health status” category in Table 2 refers to subjective assessment of health state,
irrespective of objective health-related conditions; thus, 70.1 % of the sample describe
themselves as healthy. Interestingly, 92 % of people with one or more co-morbid condi-
tions still rate themselves as healthy despite the presence of the ‘objective’ co-morbid
conditions. As would be expected, the statistics indicate that there are some inter-centre
differences for these descriptive variables.
Measures
The purpose of the pilot testing was to collect data on the WHOQOL-OLD items for the
purpose of item testing and item reduction. The measures included in the pilot study
therefore were the WHOQOL-100 (The WHOQOL Group 1998-a), which is an establi-
shed measure of quality of life with proven reliability and validity; a set of 40 items for
the pilot WHOQOL-OLD module generated from the focus group work; a set of impor-
tance questions that asked about the importance of each WHOQOL-100 and WHO-
QOL-OLD facet for the respondent (The WHOQOL Group 1998-a); and a set of socio-
demographic and health-related questions about co-morbid conditions.
Methods
The basic approach of the statistical analyses was to combine the strengths of the “clas-
sical” and the modern (“probabilistic”) psychometric approaches for scale development.
Following the earlier WHOQOL analytic guidelines (The WHOQOL Group 1998-b)
analysis examined item response frequency distributions, missing values analysis, item
and facet score correlations and reliability analyses, in particular, the use of the Multi-
trait Analysis Program (MAP; Hays et al., 1988) to identify items loading on predicted
factors versus non-predicted factors, and exploratory and confirmatory factor analyses.
In addition, an Item Response Theory (IRT) approach that used the unidimensional
Rasch measurement model (Andrich 1988) as implemented in the RUMM program
(Andrich 2001) and in the WINMIRA program (von Davier, 2001) was also used. An
iterative approach was taken in which the larger initial set of items was reduced through
a combination of classical and IRT approaches; thus, the earlier focus group and Delphi
work from which the WHOQOL-OLD items had been derived also provided an initial
facet structure for the items which provided the starting point for the subsequent structu-
ral analyses of the module.
Field Trial
The Field Trial allowed the participating centres to carry out a variety of different types
of studies that ranged from epidemiological surveys to validity analyses to evaluation of
longitudinal trials. Each centre however included a core dataset that could be further
analysed to produce the final version of the WHOQOL-OLD module.
10
Population
The Field Trial analyses were conducted in a sample of N=5566 with data coming from
20 national centres (Guangzhou and Hong Kong not included). The sample size recrui-
ted in each centre varied between n = 116 (Edinburgh) and n = 455 (Umea; see Table
3).
Table 3 General description (sample sizes, selected sociodemographic characteristics) of the

WHOQOL-OLD Field Trial sample from each participating centre (N=5566)
Centre Sample size Age Gender Health status

(Females) (“healthy”) *
n M ± SD % %
Edinburgh (Scotland) 116 77.59 ± 10.47 67.2 % 82.1 %
Bath (England) 145 69.65 ± 7.10 62.8 % 91.6 %
Leipzig (Germany) 354 72.73 ± 8.65 46.7 % 63.4 %
Barcelona (Spain) 271 71.96 ± 7.44 59.4 % 67.4 %
Copenhagen (Denmark) 384 72.35 ± 8.29 49.9 % 81.7 %
Paris (France) 164 76.65 ± 8.39 47.0 % 65.8 %
Prague (Czech Republic) 325 71.36 ± 7.72 59.7 % 61.1 %
Budapest (Hungary) 333 73.80 ± 8.68 69.1 % 42.9 %
Oslo (Norway) 324 75.14 ± 8.01 52.7 % 88.2 %
Victoria (Canada) 202 72.93 ± 8.52 54.0 % 84.4 %
Melbourne (Australia) 376 75.63 ± 6.92 58.2 % 83.7 %
Seattle (USA) 295 72.00 ± 8.35 58.0 % 73.9 %
Beer-Sheva (Israel) 250 70.32 ± 7.58 66.1 % 81.3 %
Tokyo (Japan) 188 69.39 ± 5.70 53.5 % 60.7 %
Umea (Sweden) 455 72.74 ± 8.21 53.4 % 76.2 %
Guangzhou (China) * - - - -
Hong Kong (China) * - - - -
Porto Alegre (Brazil) 328 71.78 ± 7.74 67.4 % 82.3 %
Montevideo (Uruguay) 248 73.19 ± 7.08 72.6 % 78.0 %
Izmir (Turkey) 327 70.97 ± 5.31 52.3 % 45.3 %
Geneva (Switzerland) 139 74.34 ± 7.32 55.8 % 88.5 %
Vilnius (Lithuania) 342 68.66 ± 6.67 69.6 % 57.0 %
Total 5566 72.52 ± 8.01 58.5 % 71.5 %
Note: ∗ Guangzhou and Hong Kong not included.
The gender rates varied with particularly higher rates of females in the Edinburgh, Mon-
tevideo, Budapest, Vilnius, and Porto Alegre centres. Furthermore, health status also va-
ried, which was of course a function of the type of assessment, i.e. being either asses-
sed by the single item on health report or by conditions on a chronic condition checklist.
On the level of a single subjective health status item, Bath, Geneva, Oslo, Victoria and
Melbourne showed a high proportion of people that reported to be in good health on the
11
item (> 83 %), while Izmir, Budapest, and Vilnius had higher proportions of people
with ill health (> 40 %).
Measures
The core measures included in the Field Trial were the 26-item WHOQOL-BREF (The
WHOQOL Group 1998), the 33-item WHOQOL-OLD interim module, sociodemogra-
phic and health status questions. The WHOQOL-BREF was used in the Field Trial be-
cause its shortness allowed centres to include other measures according to local interests
and local availability of questionnaires.
Table 4 WHOQOL-OLD Field Trial measures by centre
Centres WHOQOL modules EAAQ GDS SF-12

-OLD -100 -BREF
Edinburgh (Scotland) * - * * * -
Bath (England) * - * * * -
Leipzig (Germany) * - * * * *
Barcelona (Spain) * - * * * *
Copenhagen (Denmark) * * * * * *
Paris (France) * - * * * *+
Prague (Czech Republic) * - * * * -
Budapest (Hungary) * - * * * -
Oslo (Norway) - - - - GDS-15 -
Victoria (Canada) * - * * * *
Melbourne (Australia) * - * * * (4 items only) *
Seattle (USA) * - * * GDS-15 -
Beer-Sheva (Israel) * - * * * *
Tokyo (Japan) * - * * *
Umea (Sweden) * - * * GDS-15 (plus 15) *
Guangzhou (China) - - - - - -
Hong Kong (China) - - - - - -
Porto Alegre (Brazil) * F241-4 * * * *
Montevideo (Uruguay) * - * * GDS-15 -
Izmir (Turkey) * - * * * -
Geneva (Switzerland) * - * * - -
Vilnius (Lithuania) * - * * * *
Centres (n) 18 1 18 18 14 (+4) 11
Note: + = Geneva only.
Summary of results of questionnaire development
The two studies presented here summarise the development of an add-on module for the
WHOQOL group of measures for use with older adults. The studies demonstrate the de-
velopment of the module following the WHOQOL methodology (The WHOQOL
12
Group 1998-a) in which a simultaneous approach to instrument development is employ-

ed (Bullinger et al. 1996). That is, the starting point for the WHOQOL methodology is
an intense qualitative phase of cross-cultural focus groups, which for the WHOQOL-
OLD were run in 22 centres throughout the world. The summary output from these fo-
cus groups was used to identify common themes and issues either absent from or poorly
covered in the WHOQOL-100; these themes and issues were used to generate a set of
pilot items for testing with older adults.
The focus group work together with the Delphi exercise with the WHOQOL experts had
suggested two possible approaches to the amendment of the WHOQOL-100 for use
with older adults. There were some themes that seemed to best form additional facets,
such as that of issues around Death and Dying, whereas there were other aspects or
items that seemed supplementary to existing facets within the WHOQOL-100 such as
for the Sexual Activity facet. However, the quantitative analyses suggested that the
supplementary items were best included as part of the add-on module rather than being
used to supplement or amend the scoring of an existing facet; the clearest demonstration
of this point was for the Sexual Activity facet, in which the supplementary items were
still problematic and added little to the existing facet. Instead, an additional set of items
that focussed on Intimacy rather than Sexual Activity was written and tested at the Field
Trial stage of the study and have now been included in the final version of the module
as a separate facet. In terms of psychometric performance, the items selected for the
WHOQOL-OLD module demonstrate good performance both on classical and modern
psychometric grounds. The approach taken here shows that both classical and modern
methods can be fruitfully combined in scale development. Although modern
psychometric methods such as the Rasch modelling approach taken here were primarily
developed for use with unidimensional ability scales, their careful use with attitude
scales provides a powerful methodology for the development of valid comparable
measures across key populations, especially from different cultures.
In the event, the actual module developed focussed primarily on psychosocial aspects
relevant to older adults. Although there are pertinent issues for example that arise in re-
lation to the personal environment, general agreement was found from the focus groups
that the existing scales of the WHOQOL-100 already covered the personal environment
sufficiently. Instead, the new facets covered “Sensory Functioning” in the Physical Do-
main, which had been originally included in the 236-item pilot version of the WHO-
QOL but then dropped because of considerable ceiling effects in younger adults; and
other new facets were related to the Psychological Domain (e.g. “Autonomy”) and to
the Social Domain (e.g. “Intimacy”).
The final version of the WHOQOL-OLD module
The final version of the module contained six facets of four items each; the comparisons
between the WHOQOL-100 and the WHOQOL-BREF used in the pilot and the field
trial studies, respectively, suggest that the Older Adults module can be used in addition
13
to either the WHOQOL-100 or the WHOQOL-BREF, whichever is the most appropria-

te for a study. The scoring of the module can then consist of a profile set of six facet
scores, or, as supported by the existence of a higher order factor in the confirmatory fac-
tor analyses (CFA; see below), there can be a single total score based on a summation of
all 24 items in the module.
Description of the instrument
In the following section the scale structure and the scoring procedures of the final ver-
sion of the WHOQOL-OLD module are described.
Scale structure
The WHOQOL-OLD module consists of 24 Likert-scaled items assigned to six facets:

“Sensory Abilities” (SAB), “Autonomy” (AUT), “Past, Present and Future Activities”
(PPF), “Social Participation” (SOP), “Death and Dying” (DAD) and “Intimacy” (INT).
Each of the facets has 4 items, thus for all facets the score of possible values can range
from 4 to 20, provided all items of a facet have been completed (see Table 5). The sco-
res of these six facets or the values of the 24 single items of the WHOQOL-OLD modu-
le can be combined to produce a general (“overall”) score for quality of life in older
adults, denoted as the WHOQOL-OLD module “total score”. As empirically supported
by analyses of the measurement model via structural equation modelling (see below),
quality of life is conceived as a higher-order factor, underlying the structure of the
WHOQOL-OLD module.
Table 5 Items included in the facets of the WHOQOL-OLD module
Abbr. ∑ items Items of facets Possible range of raw score

Facet
(Min, Max)
Sensory Abilities SAB 4 1 + 2 + 10 + 20 16 (4, 20)
Autonomy AUT 4 3 + 4 + 5 + 11 16 (4, 20)
Past, Present and Future Activities PPF 4 12 + 13 + 15 + 19 16 (4, 20)
Social Participation SOP 4 14 + 16 + 17 + 18 16 (4, 20)
Death and Dying DAD 4 6+7+8+9 16 (4, 20)
Intimacy INT 4 21 + 22 + 23 + 24 16 (4, 20)
Table 6 describes the main content areas of each facet of the WHOQOL-OLD module.
The “Sensory Abilities” facet assesses sensory functioning and the impact of loss of sen-
sory abilities on quality of life. The “Autonomy” facet refers to independence in old age
and thus describes the amount of being able to live autonomously and to take own
decisions. While the “Past, Present, and Future Activities” facet describes satisfaction
about achievements in life and at things looking forward to, the “Social Participation”
facet delineates participation in activities of daily living, especially in the community.
The “Death and Dying” facet is related to concerns, worries, and fears about death and
14
dying, while the “Intimacy” facet assesses being able to have personal and intimate
relationships.
Table 6 Concepts and contents of the facets included in the WHOQOL-OLD module
Facet Abbr. Concept / content

Sensory Abilities SAB Sensory functioning, impact of loss of sensory abilities on
quality of life
Autonomy AUT Independence in old age; being able or free to live
autonomously and to take own decisions
Past, Present and Future Activities PPF Satisfaction about achievements in life and at things to look
forward to
Social Participation SOP Participation in activities of daily living, especially in the
community
Death and Dying DAD Concerns, worries and fears about death and dying
Intimacy INT Being able to have personal and intimate relationships
Scoring
To score the questionnaire correctly, the following scoring list has to be administered
(see Table 7). Scoring the WHOQOL-OLD module involves the following steps:
(a) Basically high scores represent high quality of life, low scores represent low quality
of life;
(b) Sorting items into the appropriate scales. For positively worded items, the above
classification can be applied in which higher values represent a higher quality of life.
For negatively worded items, the score has to be recoded (see below);
(c) Recoding negatively worded items, that is, each item identified with a "*" in the
scoring list has to be recoded so that numeric values assigned are reversed: 1 = 5, 2 = 4,
3 = 3, 4 = 2, 5 = 1. By recoding, high scores in positively worded items reflect higher
quality of life. The unidirectional values can subsequently be added to yield the sum-
med scores according to the scoring list of the WHOQOL-OLD module (Table 7);
(d) Using the scoring list (see below) is also necessary for identifying which items be-
long to a facet. Items to be recoded (see step c) are marked with an "*";
(e) Summing the items belonging to a facet yields the raw facet score (RFS). Its range
lies between the lowest possible (number of items (n) x 1) and highest possible (number
of items (n) x 5) value of the respective facet. For the WHOQOL-OLD module, each of
the six facets comprises 4 items, thus the lowest possible and the highest possible raw
score value are equal across all facets (range 4 to 20);
(f) Comparing scores across facets is possible by directly comparing the raw facet sco-
res. Because every facet comprises of 4 items with the same scaling and scoring format,
no transformation of raw scores is needed (so long as all items per facet have been ans-
wered);
15
(g) If the raw facet score is divided by the number of items in the facet, the resulting
standardised (mean) facet score (SFS) can have any decimal value between 1 and 5. A
value of 1 represents the lowest possible quality of life rating and a value of 5 the
highest possible quality of life rating for the individual;
(h) Transferring a raw score to a transformed scale score (TFS) between 0 and 100 ma-
kes it possible to express the scale score in percent between the lowest (0) and highest
(100) possible value. To obtain the transformed facet score (0 - 100) the following
transformation rule can be applied: TFS = 6.25 x (RFS - 4). (i) Producing the total
score of the WHOQOL-OLD involves the addition of the facet scores of a person using
all items (instead of the facet items only) of the questionnaire (again paying attention to
the recoding procedure – see steps “b” and “c”). Items may be added to form a total raw
score (according to step “e”, but using all items), a total standardized (mean) score
(according to step “g”, but using all items) or a total transformed (0 - 100) score
(according to step “h”, but using all items);
(i) Accumulating the values of more than one person – e g. a special age group – simply
may be done by summarising the facet and/ or total scores of each individual in that
sample (on the level of raw, standardized/ mean or transformed scores) and dividing the
respective result through the number of participants to produce the mean score of the
respective group.
The above manual scoring approach can be made easier by using a scoring mask that
can be easily produced from the scoring list (see step “d”). In addition, the SPSS syntax
file (enclosed in Appendix AIII) can be used for the automatic computation of facet and
total scores. To work with them, individual data have to be inputted into the computer
and identified by variable names and labels, which are also suggested for the enclosed
program. When analysing the WHOQOL-OLD module, the facet scores and the total
score must be calculated according to the following scoring list (including item num-
bers for the WHOQOL-OLD module; see Table 7 following).
16
Table 7 Scoring list for the WHOQOL-OLD module
Sensory Abilities (SAB) old_01* old_02* old_10* old_20

(4 items)
Autonomy (AUT) old_03 old_04 old_05 old_11
(4 items)
Past, Present, and Future Abilities (PPF) old_12 old_13 old_15 old_19
(4 items)
Social Participation (SOP) old_14 old_16 old_17 old_18
(4 items)
Death and Dying (DAD) old_06* old_07* old_08* old_09*
(4 items)
Intimacy (INT) old_21 old_22 old_23 old_24
(4 items)
Total Score (OLD) old_01* old_02* old_03 old_04
(24 items) old_05 old_06* old_07* old_08*
old_09* old_10* old_11 old_12
old_13 old_14 old_15 old_16
Note: * Reverse-scored items.
17
Psychometric properties
The psychometric properties of the WHOQOL-OLD module are based on the results of
the WHOQOL-OLD Field Trial (see Table 8).
Scale description and internal consistency
Cronbach’s alpha as a measure of internal consistency reached satisfactory values with

an acceptable range from α =.72 to α =.88 for each facet score, while the total score dis-
played a consistency coefficient of α = .89 (see Table 8).
Table 8 Selected psychometric properties for the facets and total score of the WHOQOL-OLD
module (WHOQOL-OLD Field Trial sample; N = 5566)
M SD Floor Ceiling Skewness α

Facet
(1 - 5) (%) (%)
Sensory Abilities 3.90 .86 1.9 46.5 - .72 .84
Autonomy 3.69 .71 1.4 25.3 - .42 .72
Past, Present and Future Activities 3.57 .69 1.5 20.6 - .40 .74
Social Participation 3.64 .74 1.8 24.5 - .59 .79
Death and Dying 3.55 1.00 6.0 32.9 - .45 .84
Intimacy 3.49 .98 7.5 24.9 - .22 .88
Total Score (Overall) 3.62 .55 0.2 14.8 - .24 .89
The analyses of the intercorrelations between facet scores (see Table 9) indicate that all
scores show distinct correlations with each other suggesting a higher-order quality of li-
fe factor (see also section “Factorial validity”). The only exception is the “Death and
Dying” facet showing substantial lower association (r = .039 - .204).
Table 9 Intercorrelations between facets and total score of the WHOQOL-OLD module
(WHOQOL-OLD Field Trial; N = 5566)
Facet SAB AUT PPF SOP DAD INT QoL

Sensory Abilities
Autonomy .362
Past, Present and Future Activities .349 .628
Social Participation .399 .551 .669
Death and Dying .204 .136 .195 .197
Intimacy .201 .363 .501 .395 .039
Total Score (Overall) .623 .718 .798 .769 .493 .636
18
Factor Analyses
The final measurement model of the WHOQOL-OLD module, comprising six facets of
four items each, showed good fit statistics for confirmatory testing of the measurement
model (CFI = 0.939; RMSEA = .052; χ2 = 3759.4, df = 237). This model includes an
overall higher order factor onto which all first-order factors load; beside the intercorre-
lations of the facets, also the presence of this higher order factor would suggest that the
WHOQOL-OLD module could be scored to give a total score in addition to a profile of
scores across the six facets.
Table 10 Fit statistics of the final version of the WHOQOL-OLD module, separate samples for all
participating centres (WHOQOL-OLD Field Trial sample; N = 5566)
N χ2 Fit statistics
Centre ID CMIN df p CFI RMSEA (95%-CI)
Edinburgh 116 359.48 237 (.000) .912 .067 .053 - .081
Bath 145 368.862 237 (.000) .928 .062 .050 - .074
Leipzig 354 457.969 237 (.000) .934 .051 .044 - .058
Barcelona 271 418.845 237 (.000) .921 .053 .045 - .062
Copenhagen 384 577.115 237 (.000) .920 .061 .055 - .068
Paris 164 449.153 237 (.000) .841 .074 .064 - .085
Prague* 325 513.878 215 (.000) .915 .066 .058 - .073
Budapest 333 436.031 237 (.000) .933 .050 .043 - .058
Oslo 324 541.772 237 (.000) .907 .063 .056 - .070
Victoria 202 461.556 237 (.000) .914 .069 .059 - .078
Melbourne 376 607.468 237 (.000) .912 .065 .051 - .078
Seattle 295 565.131 237 (.000) .912 .069 .061 - .076
Beer-Sheva 250 499.541 237 (.000) .891 .067 .059 - .075
Tokyo 188 456.993 237 (.000) .892 .070 .061 - .080
Umea 455 641.720 237 (.000) .913 .061 .056 - .067
Brazil 328 447.439 237 (.000) .938 .052 .045 - .059
Uruguay 248 428.244 237 (.000) .920 .057 .048 - .066
Turkey 327 791.070 237 (.000) .866 .085 .078 - .091
Switzerland 139 394.792 237 (.000) .891 .069 .057 - .081
Lithuania 342 434.701 237 (.000) .933 .049 .047 - .052
Overall 5,566 3759.410 237 (.000) .939 .052 .052 - .068
Note: * Fit statistics for the Prague subsample are estimated excluding item f295 from the measurement model.
19
Convergent validity
In terms of convergent validity with other subjective health related measures, the WHO-
QOL-OLD module facet scores and the total score correlated significantly with several
self-reported indicators of subjective health dimensions. Correlations were checked for
the other modules from the WHOQOL Group (WHOQOL-BREF, WHOQOL-100), for
the two domain scores of the SF-12 (“Physical” and “Mental”), and for the GDS score.
It was found that the WHOQOL-OLD total score and each facet score displayed only
very low correlations (range of r = -.055 - .119) with the “Physical” and the “Mental”
facet scores of the SF-12 health assessment. These low correlations might reflect the
different conceptualisation of the measures. As expected, the correlations of the
WHOQOL-OLD total score and facet scores with the GDS measure are negatively
directed and indicate substantial associations between both measures, in particular for
the total score (r = - .545).
Table 11 Correlation coefficients (Pearson r) for total score and facet scores of the WHOQOL-
OLD module with several health status indicators (GDS, SF-12)
GDS SF-12 SF-12

Physical Mental
Sensory Abilities - .378 .032 .052
Autonomy - .383 - .031 .086
Past, Present and Future Activities - .456 - .090 .117
Social Participation - .446 .013 .091
Death and Dying - .291 - .048 .005

Intimacy - .273 - .055 .119
Total Score (Overall) - .545 - .037 .107
The WHOQOL-100 and the WHOQOL-BREF are both multidimensional generic ins-
truments to assess quality of life and have been developed by the WHOQOL Group.
Strong correlations were found between the total score of the WHOQOL-OLD module
and the overall score of the WHOQOL-100 (r = .665), and with all domains of the
WHOQOL-BREF (r = .604 - .741) and the WHOQOL-100 (r = .550 - .737), except for
the domain “Spirituality” (r = .360). High correlations between the total score of the
WHOQOL-OLD module and the WHOQOL-100 can be observed on the facet-level
especially for the association with the facets “Relationships” (r = .628), “Safety” (r =
.640), “Leisure Opportunities” (r = .701), and “Thinking.” (r = .733). Only low to
moderate correlation coefficients were found for the association between the “Death and
Dying” facet of the WHOQOL-OLD module and various facets of other quality of life
measures.
20
Table 12 Correlation coefficients (Pearson r) for the facet scores and the total score of WHOQOL-
OLD module with the domain and facet scores of the WHOQOL-BREF and the WHO-
QOL-100
WHOQOL-BREF SAB AUT PPF SOP DAD INT QoL

Physical Health .338 .442 .477 .535 .108 .316 .655
Psychological .362 .548 .633 .574 .146 .456 .741
Social Relationships .302 .408 .530 .491 .191 .505 .604
Environment .383 .578 .616 .538 .215 .393 .678
WHOQOL-100 Domains
Physical .411 .332 .427 .460 .335 .268 .550
Psychological .359 .532 .716 .659 .299 .506 .737
Independence .417 .422 .487 .558 .222 .335 .580
Social .229 .420 .597 .513 .196 .674 .653
Environment .366 .500 .636 .627 .254 .484 .683
Spiritual .150 .211 .423 .339 .112 .290 .360
WHOQOL-100 Facets
Physical • Pain .314 .262 .272 .319 .340 .177 .421
• Energy .471 .403 .487 .534 .227 .359 .594
• Sleep .206 .146 .271 .260 .250 .118 .326
Psychological • Positive Feelings .320 .572 .767 .682 .157 .604 .733
• Thinking, Memory .420 .381 .474 .416 .113 .285 .503
• Self Esteem .174 .420 .576 .509 .181 .410 .536
• Body Image .205 .228 .370 .321 .317 .257 .425
• Negative Feelings .237 .356 .481 .520 .356 .327 .565
Independence • Mobility .404 .394 .373 .462 .186 .220 .489
• Activities of daily Living .381 .416 .454 .560 .187 .314 .553
• Medication .228 .231 .293 .313 .194 .204 .344
• Work Capacity .402 .404 .523 .568 .155 .383 .577
• Relationships .257 .388 .603 .535 .236 .540 .628
• Support .126 .407 .512 .458 .150 .559 .549
• Sex .234 .239 .401 .315 .116 .576 .473
Environment • Safety .323 .447 .554 .464 .256 .497 .640
• Home Environment .195 .357 .450 .385 .067 .383 .454
• Financial Resources .076 .164 .257 .236 .187 .214 .301
• Services .136 .352 .413 .368 .125 .296 .393
• Information Opportunities .363 .426 .502 .504 .185 .325 .552
• Leisure Opportunities .364 .538 .613 .704 .188 .477 .701
• Environment .305 .279 .437 .444 .194 .334 .502
• Transport .283 .266 .344 .400 .177 .233 .400
• Spirituality .150 .211 .423 .339 .112 .290 .361
Overall .310 .460 .595 .568 .239 .466 .665
21
Discriminant Group Validity
Facet differences according to a range of subgroups are displayed in Figures 1 and 2. In

terms of age, there are lower quality of life scores on all facets in participants older than
80 years, except for the “Death and Dying” facet score where those aged 60 to 80 years
have significantly more concerns about dying (see Figure 1).
WHOQOL-OLD module facet scores (M, SD) by agegroup
5
4.1
4.5 3.71
3.75 3.59 3.71 3.47 3.7
4
3.61 3.54 3.58 3.62 3.6 3.66 3.56
3.5
57-79 years
3
80-100 years
2.5
2
1.5
1
SAB AUT PPF SOP DAD INT GEN
Figure 1 WHOQOL-OLD module facet scores (M, SD) by agegroup (WHOQOL-OLD Field Trial
sample, n = 5566)
Gender effects are comparatively small, and occur mainly for the “Death and Dying” fa-
cet with higher scores for males. The largest mean differences can be demonstrated for
the “healthy” vs. “unhealthy” self-report variable with individuals who report themsel-
ves to be healthy scoring significantly higher on all facets (see Figure 2).
WHOQOL-OLD module facet scores (M, SD) by health status
5
4.09
4.5
3.8 3.71 3.82 3.63 3.79 3.74
4
3.44 3.33 3.23 3.31
3.22
3.5 Healthy
3.3 3.27
3
2.5 Unhealthy
2
1.5
1
SAB AUT PPF SOP DAD INT GEN
Figure 2 WHOQOL-OLD module facet scores (M, SD) by health status (WHOQOL-OLD Field
Trial sample, n = 5566)
22
Interpretation
The values achieved on the individual facet scores of the WHOQOL-OLD module and
on the total score of the WHOQOL-OLD module represent an empirical assessment of
older adults quality of life from the respondent’s point of view. Until the data from re-
presentative national standard samples are available for the WHOQOL-OLD module,
the results of the WHOQOL-OLD Field Trial (N = 5566) should be used as preliminary
reference data for older people (60 years and above). For the reference values of the
WHOQOL-OLD facet scores and the WHOQOL-OLD total score, all scores have been
linearly transformed to a range of 0 to 100 (cf. Tables A4 – A9 in Appendix AIV). The
scores are shown together and separately for males and females and for different age
groups (below 80 years and greater than 80 years).
How to use the questionnaire
Upon completion, comprehensiveness of questionnaire completion should be checked

and the identification of the form should be noted. Use of the data for research purposes
is not recommended when more than 20% of the items are missing (see WHOQOL
Group, 1998-a, 1998-b). Data can be computer inputted for easy scoring (in research
projects) or can be scored by hand according to the scoring procedure described above.
The questionnaires are available in the different project languages. Translations into a
number of further languages are in preparation. Proposals for further language versions
should first be sent via the Edinburgh Co-ordinating Centre to the WHOQOL-OLD
Steering Group.
Administration – suggested uses
The WHOQOL-OLD module can be used in a wide variety of studies including cross-
cultural investigations, population epidemiology, health monitoring, service develop-
ment, and clinical intervention trials in which issues about quality of life are crucial.
The WHOQOL-OLD module will permit the assessment of the impact of service provi-
sion and of different health and social care structures on quality of life, especially in the
identification of the possible consequences of policies on quality of life for older adults
and a clearer understanding of investment areas to achieve best gains in quality of life.
A related issue is the estimation of the impact of physical and psychological interventi-
ons in a range of physical and psychiatric conditions related to old age. Cross-sectional
studies between different services or treatments and longitudinal studies of interventions
can be assessed with the WHOQOL-OLD. Moreover, the unique cross-cultural app-
roach to the development of the measure, means that comparisons can be made between
different cultures (Power et al., 1999). The exacting standards of instrument develop-
ment used for the WHOQOL-OLD mean that such comparisons run less risk of cultural
bias; the WHOQOL methodology (The WHOQOL Group 1998-b) provides a unique
approach to instrument development that provides for cross-cultural validity for the
assessment of quality of life across the adult lifespan.
23
References
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Andrich D (2001). RUMM2010: Rasch unidimensional measurement models. Perth: RUMM Laboratory.
Baltes PB, Baltes MM (eds) (1990). Successful aging: perspectives from the behavioral sciences. Cam-
bridge: Cambridge University Press.
Bullinger M, Power MJ, Aaronson NK, Cella DF, Anderson RT (1996). Creating and evaluating cross-
cultural instruments. In B Spilker B (ed), Quality of life and pharmacoeconomics in clinical trials
(2nd ed). Hagerstown, MD: Lippincott-Raven.
Brazier JE, Walters SJ, Nicholl JP, Kohler B (1996). Using the SF-36 and EuroQol on an elderly popula-
tion. Quality of Life Research, 5: 195 - 204.
Coast J, Peters TJ, Richards SH, Gunnell DJ (1998) Use of the EuroQol among elderly acute care Pa-
tients. Quality of Life Research, 7: 1 - 10.
Hawthorne G, Davidson N, Quinn K, McCrate F, Winkler I, Lucas R, Killian R, Molzahn A, WHOQOL-
OLD Group (in prep). Issues in conducting cross-cultural research: Implementation of an agreed inter-
national protocol designed by the WHOQOL Group for the conduct of focus groups eliciting the qua-
lity of life of older adults.
Hays RD, Hayashi T, Carson S, Ware JE (1988). User’s Guide for the Multitrait Analysis Program
(MAP). Santa Monica, CA: The RAND Corporation, N-2786-RC.
Lam DH, Power MJ (1996). Social support in a general practice elderly sample. International Journal of Ge-
riatric Psychiatry, 6: 89 - 93.
Power MJ, Bullinger M, Harper A, The WHOQOL Group (1999). The World Health Organization
WHOQOL-100: tests of the universality of quality of life in fifteen different cultural groups world-
wide. Health Psychology, 18: 495 - 505.
Stewart AL, Sherbourne CD, Brod M (1996). Measuring health-related quality of life in older and de-
mented populations. In B Spilker B (Ed), Quality of life and pharmacoeconomics in clinical trials
(2nd ed). Hagerstown, MD: Lippincott-Raven.
Von Davier M (2001). WINMIRA User Manual. Kiel: IPN (Institute for Science Education).
The WHOQOL Group (1998-a). Development of The World Health Organization WHOQOL-BREF qua-
lity of life assessment. Psychological Medicine, 28: 551 - 558.
The WHOQOL Group (1998-b). The World Health Organization quality of life assessment (WHOQOL):
development and general psychometric properties. Social Science & Medicine, 46: 1569 - 1585.
The WHOQOL-OLD Group (2005). Development of the WHOQOL-OLD module. Quality of Life Re-
search, 14, 2197-2214.
Winkler I, Killian R, Hawthorne G, Lucas R, McCrate F, Molzahn A, Quinn K, The WHOQOL-OLD
Group (in prep). Cross-cultural aspects of quality of life in old age: Results of an international focus
group study for the development of a WHOQOL module for people in old age: the WHOQOL-OLD.
24
Appendix
AI Final set of items for WHOQOL-OLD Module

A II Method for converting individual raw scores to transformed scores
A III SPSS syntax file
A IV Reference data
AV List of Centres
A VI The WHOQOL-OLD final scale
25
AI Final set of items for WHOQOL-OLD Module
Table A1 Final set of items for the WHOQOL-OLD module
Facet I Sensory Abilities (OLD-SAB)
OLD-01 Impairments to senses affect daily life

OLD-02 Loss of sensory abilities affect participation in activities
OLD-10 Problems with sensory functioning affect ability to interact
OLD-20 Rate sensory functioning
Facet II Autonomy (OLD-AUT)
OLD-03 Freedom to make own decisions

OLD-04 Feel in control of your future
OLD-05 People around you are respectful of your freedom
OLD-11 Able to do things you’d like
Facet III Past, Present and Future Activities (OLD-PPF)
OLD-12 Satisfied with opportunities to continue achieving

OLD-13 Received the recognition you deserve in life
OLD-15 Satisfied with what you’ve achieved in life
OLD-19 Happy with things to look forward to
Facet IV Social Participation (OLD-SOP)
OLD-14 Have enough to do each day

OLD-16 Satisfied with the way you use your time
OLD-17 Satisfied with level of activity
OLD-18 Satisfied with opportunity to participate in community
Facet V Death and Dying (OLD-DAD)
OLD-06 Concerned about the way you will die

OLD-07 Afraid of not being able to control death
OLD-08 Scared of dying
OLD-09 Fear pain before death
Facet VI Intimacy (OLD-INT)
OLD-21 Feel a sense of companionship in life

OLD-22 Experience love in your life
OLD-23 Opportunities to love
OLD-24 Opportunities to be loved
26
A II Method for converting individual raw scores to transformed scores
Table A2 Method for converting individual raw scores to transformed scores (WHOQOL-OLD
total score)
RTS STS TTS RTS STS TTS RTS STS TTS

24 - 120 1-5 0 - 100 24 - 120 1-5 0 - 100 24 - 120 1-5 0 - 100
24 1.00 .00 57 2.38 34.38 90 3.75 68.75
25 1.04 1.04 58 2.42 35.42 91 3.79 69.79
26 1.08 2.08 59 2.46 36.46 92 3.83 70.83
27 1.13 3.13 60 2.50 37.50 93 3.88 71.88
28 1.17 4.17 61 2.54 38.54 94 3.92 72.92
29 1.21 5.21 62 2.58 39.58 95 3.96 73.96
30 1.25 6.25 63 2.63 40.63 96 4.00 75.00
31 1.29 7.29 64 2.67 41.67 97 4.04 76.04
32 1.33 8.33 65 2.71 42.71 98 4.08 77.08
33 1.38 9.38 66 2.75 43.75 99 4.13 78.13
34 1.42 10.42 67 2.79 44.79 100 4.17 79.17
35 1.46 11.46 68 2.83 45.83 101 4.21 80.21
36 1.50 12.50 69 2.88 46.88 102 4.25 81.25
37 1.54 13.54 70 2.92 47.92 103 4.29 82.29
38 1.58 14.58 71 2.96 48.96 104 4.33 83.33
39 1.63 15.63 72 3.00 50.00 105 4.38 84.38
40 1.67 16.67 73 3.04 51.04 106 4.42 85.42
41 1.71 17.71 74 3.08 52.08 107 4.46 86.46
42 1.75 18.75 75 3.13 53.13 108 4.50 87.50
43 1.79 19.79 76 3.17 54.17 109 4.54 88.54
44 1.83 20.83 77 3.21 55.21 110 4.58 89.58
45 1.88 21.88 78 3.25 56.25 111 4.63 90.63
46 1.92 22.92 79 3.29 57.29 112 4.67 91.67
47 1.96 23.96 80 3.33 58.33 113 4.71 92.71
48 2.00 25.00 81 3.38 59.38 114 4.75 93.75
49 2.04 26.04 82 3.42 60.42 115 4.79 94.79
50 2.08 27.08 83 3.46 61.46 116 4.83 95.83
51 2.13 28.13 84 3.50 62.50 117 4.88 96.88
52 2.17 29.17 85 3.54 63.54 118 4.92 97.92
53 2.21 30.21 86 3.58 64.58 119 4.96 98.96
54 2.25 31.25 87 3.63 65.63 120 5.00 100.00
55 2.29 32.29 88 3.67 66.67
56 2.33 33.33 89 3.71 67.71
Note: RTS = raw total score (range 24 – 120); STS = standardized (mean) total score (range 1 – 5); TTS
= transformed total score (range 0 – 100).
27
Table A3 Method for converting individual raw scores to transformed scores (WHOQOL-OLD
facet scores)
RFS SFS TFS RFS SFS TFS RFS SFS TFS

4 - 20 1-5 0 - 100 4 - 20 1-5 0 - 100 4 - 20 1-5 0 - 100
4 1.00 0 10 2.50 37.50 16 4.00 75.00
5 1.25 6.25 11 2.75 43.75 17 4.25 81.25
6 1.50 12.50 12 3.00 50.00 18 4.50 87.50
7 1.75 18.75 13 3.25 56.25 19 4.75 93.75
8 2.00 25.00 14 3.50 62.50 20 5.00 100.00
9 2.25 31.25 15 3.75 68.75
Note: RFS = raw facet score (range 24 – 120); SFS = standardized (mean) facet score (range 1 – 5);
TFS = transformed facet score (range 0 – 100).
28
A III SPSS syntax file
The attached SPSS syntax file automatically checks and recodes data and computes raw
(sum), standardized (mean) and transformed (0 - 100) scores for each of the six facets
and the total score of the WHOQOL-OLD module.
An electronic version of the SPSS syntax file that just calculates summary scores may
be obtained from Professor Mick Power, Section of Clinical and Health Psychology,
Edinburgh University, Medical School, Teviot Place, Edinburgh EH8 9AG, United
Kingdom (UK). Email: mjpower@staffmail.ed.ac.uk
*-----------------------------------------------------------------------------------------------------------------------------.
*Name: WHOQOL_OLD.sps.
*Function: Prepare 6 scales and one total score for the 24 items of the WHOQOL-OLD.
*Syntax is prepared for unrecoded data-sets.
*Name of the recoded item stays the same as for the original item.
*-Missing values are initially coded as “9”----------------------------------------------------------------------------
------------------------------------------------.
RECODE

(9=SYSMIS) .
EXECUTE.
*-----------------------------------------------------------------------------------------------------------------------------.
*Reverse coding of the WHOQOL-OLD*
*-----------------------------------------------------------------------------------------------------------------------------.
RECODE
old_01 old_02 old_06

(1=5) (2=4) (3=3) (4=2) (5=1).
EXECUTE.
29
*-----------------------------------------------------------------------------------------------------------------------------.
*Scale "sensory abilities" with 4 items.
*Possible range of untransformed data: 16 (lowest and highest possible value: 4,20).
*Scale will be calculated when at least 4 items of the scale have been answered.
*-----------------------------------------------------------------------------------------------------------------------------.
COMPUTE old_sa_s = (SUM.4(old_01,old_02,old_10,old_20)).

COMPUTE old_sa_m = (MEAN.4(old_01,old_02,old_10,old_20)).
COMPUTE old_sa_t = 100 * (MEAN.4(old_01,old_02,old_10,old_20)-1)/4.
VARIABLE LABEL old_sa_s 'Sensory-Abilities_sum'.

VARIABLE LABEL old_sa_m 'Sensory-Abilities_mean'.
VARIABLE LABEL old_sa_t 'Sensory-Abilities_transformed_(0-100)'.
EXECUTE.
*-----------------------------------------------------------------------------------------------------------------------------.
*Scale "autonomy" with 4 items.
*-----------------------------------------------------------------------------------------------------------------------------.
COMPUTE old_au_s = (SUM.4(old_03,old_04,old_05,old_11)).

COMPUTE old_au_m = (MEAN.4(old_03,old_04,old_05,old_11)).
COMPUTE old_au_t = 100 * (MEAN.4(old_03,old_04,old_05,old_11)-1)/4.
VARIABLE LABEL old_au_s 'Autonomy_sum'.

VARIABLE LABEL old_au_m 'Autonomy_mean'.
VARIABLE LABEL old_au_t 'Autonomy_transformed_(0-100)'.
EXECUTE.
*-----------------------------------------------------------------------------------------------------------------------------.
*Scale "past, present and future activities" with 4 items.
*-----------------------------------------------------------------------------------------------------------------------------.
COMPUTE old_pp_s = (SUM.4(old_12,old_13,old_15,old_19)).

COMPUTE old_pp_m = (MEAN.4(old_12,old_13,old_15,old_19)).
COMPUTE old_pp_t = 100 * (MEAN.4(old_12,old_13,old_15,old_19)-1)/4.
VARIABLE LABEL old_pp_s 'Past-Present-and-Future-Activities_sum'.

VARIABLE LABEL old_pp_m 'Past-Present-and-Future-Activities_mean'.
VARIABLE LABEL old_pp_t 'Past-Present-and-Future-Activities_transformed_(0-100)'.
EXECUTE.
*-----------------------------------------------------------------------------------------------------------------------------.
*Scale "social participation" with 4 items.
*-----------------------------------------------------------------------------------------------------------------------------.
COMPUTE old_sp_s = (SUM.4(old_14,old_16,old_17,old_18)).

COMPUTE old_sp_m = (MEAN.4(old_14,old_16,old_17,old_18)).
COMPUTE old_sp_t = 100 * (MEAN.4(old_14,old_16,old_17,old_18)-1)/4..
VARIABLE LABEL old_sp_s 'Social-Participation_sum'.

VARIABLE LABEL old_sp_m 'Social-Participation_mean'.
VARIABLE LABEL old_sp_t 'Social-Participation_transformed_(0-100)'.
EXECUTE.
30
*-----------------------------------------------------------------------------------------------------------------------------.
*Scale "death and dying" with 4 items.
*-----------------------------------------------------------------------------------------------------------------------------.
COMPUTE old_dd_s = (SUM.4(old_06,old_07,old_08,old_09)).

COMPUTE old_dd_m = (MEAN.4(old_06,old_07,old_08,old_09)).
COMPUTE old_dd_t = 100 * (MEAN.4(old_06,old_07,old_08,old_09)-1)/4.
VARIABLE LABEL old_dd_s 'Death-and-Dying_sum'.

VARIABLE LABEL old_dd_m 'Death-and-Dying_mean'.
VARIABLE LABEL old_dd_t 'Death-and-Dying_transformed_(0-100)'.
EXECUTE.
*-----------------------------------------------------------------------------------------------------------------------------.
*Scale "intimacy" with 4 items.
*-----------------------------------------------------------------------------------------------------------------------------.
COMPUTE old_in_s = (SUM.4(old_21,old_22,old_23,old_24)).

COMPUTE old_in_m = (MEAN.4(old_21,old_22,old_23,old_24)).
COMPUTE old_in_t = 100 * (MEAN.4(old_21,old_22,old_23,old_24)-1)/4.
VARIABLE LABEL old_in_s 'Intimacy_sum'.

VARIABLE LABEL old_in_m 'Intimacy_mean'.
VARIABLE LABEL old_in_t 'Intimacy_transformed_(0-100)'.
EXECUTE.
*-----------------------------------------------------------------------------------------------------------------------------.
*Scale "total score" with 24 items.
*-----------------------------------------------------------------------------------------------------------------------------.
COMPUTE old_to_s = SUM.24(old_01,old_02,old_03,old_04,old_05,old_06,

old_07,old_08,old_09,old_10,old_11,old_12,old_13,
old_21,old_22,old_23,old_24)).
COMPUTE old_to_m = (MEAN.24(old_01,old_02,old_03,old_04,old_05,old_06,
old_21,old_22,old_23,old_24)).
COMPUTE old_to_t = 100 * (MEAN.24(old_01,old_02,old_03,old_04,old_05,
old_06, old_07,old_08,old_09,old_10,old_11,old_12,
old_20,old_21,old_22,old_23,old_24)-1)/4.
VARIABLE LABEL old_to_s 'Total-Score_sum'.

VARIABLE LABEL old_to_m 'Total-Score_mean'.
VARIABLE LABEL old_to_t 'Total-Score_transformed_(0-100)'.
EXECUTE.
*-----------------------------------------------------------------------------------------------------------------------------.
31
A IV Reference data
Table A4-I Reference data for the summed score (raw value) of the final 4-item “Sensory Abilities”
facet (OLD-SAB) of the WHOQOL-OLD module (Field Trial sample; N total = 5566)
Table A4-II Reference data for the transformed raw score (range 0 - 100) of the final 4-item “Sensory
Abilities” facet (OLD-SAB) of the WHOQOL-OLD module (Field Trial sample; N total =
5566)
Table A5-I Reference data for the summed score (raw value) of the final 4-item “Autonomy” facet
(OLD-AUT) of the WHOQOL-OLD module (Field Trial sample; N total = 5566)
Table A5-II Reference data for the transformed raw score (range 0 - 100) of the final 4-item
“Autonomy” facet (OLD-AUT) of the WHOQOL-OLD module (Field Trial sample; N total =
5566)
Table A6-I Reference data for the summed score (raw value) of the final 4-item “Past, Present, and
Future Activities” (OLD-PPF) facet of the WHOQOL-OLD module (Field Trial sample; N
total = 5566)
Table A6-II Reference data for the transformed raw score (range 0 - 100) of the final 4-item “Past, Pre-
sent, and Future Activities” (OLD-PPF) facet of the WHOQOL-OLD module (Field Trial
sample; N total = 5566)
Table A7-I Reference data for the summed score (raw value) of the final 4-item “Social Participation”
(OLD-SOP) facet of the WHOQOL-OLD module (Field Trial sample; N total = 5566)
Table A7-II Reference data for the transformed raw score (range 0 - 100) of the final 4-item “Social
Participation” (OLD-SOP) facet of the WHOQOL-OLD module (Field Trial sample; N total
= 5566)
Table A8-I Reference data for the summed score (raw value) of the final 4-item “Death amd Dying”
(OLD-DAD) facet of the WHOQOL-OLD module (Field Trial sample; N total = 5566)
Table A8-II Reference data for the transformed raw score (range 0 - 100) of the final 4-item “Death
amd Dying” (OLD-DAD) facet of the WHOQOL-OLD module (Field Trial sample; N total =
5566)
Table A9-I Reference data for the summed score (raw value) of the final 4-item “Intimacy” facet
(OLD-INT) of the WHOQOL-OLD module (Field Trial sample; N total = 5566)
Table A9-II Reference data for the transformed raw score (range 0 - 100) of the final 4-item “Intimacy”
facet (OLD-INT) of the WHOQOL-OLD module (Field Trial sample; N total = 5566)
Table A10-I Reference data for the summed score (raw value) of the final summary/ total score (OLD-
TO) of the WHOQOL-OLD module (Field Trial sample; N total = 5566)
Table A10-II Reference data for the transformed raw score (range 0 - 100) of the final summary/ total
score (OLD-TO) of the WHOQOL-OLD module (Field Trial sample; N total = 5566)
32
Table A4-I Reference data for the summed score (raw value) of the final 4-item “Sensory Abilities” facet (OLD-SAB) of the WHOQOL-OLD module (Field
Trial sample; N total = 5566)
Male Female < 80 80 ≤ Total

Centre ID M SD N M SD N M SD N M SD N M SD N
Edinburgh 15.78 3.40 36 15.25 4.13 72 16.44 3.46 57 14.30 4.12 50 15.43 3.90 108
Bath 16.62 3.02 52 17.16 2.90 90 17.17 2.84 122 15.47 3.56 17 16.96 2.94 142
Leipzig 15.16 3.39 185 15.52 3.41 157 16.02 3.06 249 13.45 3.55 93 15.33 3.39 343
Barcelona 14.94 3.22 108 15.05 3.14 150 15.22 3.12 213 13.93 3.27 44 15.00 3.17 258
Copenhagen 16.19 3.10 175 16.69 2.87 178 16.88 2.69 272 14.80 3.45 71 16.45 2.98 358
Paris 13.99 3.32 74 13.60 3.85 65 13.80 3.72 80 13.81 3.40 59 13.81 3.57 139
Prague 14.21 3.86 129 14.34 3.77 191 14.89 3.54 266 11.31 3.63 54 14.29 3.80 320
Budapest 14.83 3.56 100 14.17 3.65 219 14.63 3.52 230 13.72 3.85 89 14.38 3.63 319
Oslo 15.73 2.94 142 17.05 2.82 155 17.15 2.54 183 15.28 3.17 113 16.42 2.94 299
Victoria 16.76 2.92 85 16.82 2.65 99 17.31 2.43 135 15.35 3.16 46 16.79 2.77 184
Melbourne 15.43 3.52 148 16.94 2.90 205 16.82 2.97 241 15.33 3.52 111 16.32 3.25 363
Seattle 16.23 3.33 120 16.46 3.50 167 16.97 3.05 235 13.62 3.68 52 16.36 3.42 287
Beer-Sheva 15.45 3.18 80 16.21 3.10 153 15.95 3.13 196 15.97 3.08 34 15.92 3.18 240
Tokyo 15.81 2.72 85 15.56 3.71 93 15.65 3.33 151 14.17 3.49 6 15.68 3.27 178
Umea 15.14 3.21 208 16.07 3.31 237 16.14 3.00 340 13.99 3.65 105 15.64 3.29 445
Brazil 16.45 2.66 106 16.20 3.32 220 16.57 3.02 265 15.03 3.25 61 16.28 3.12 326
Uruguay 16.40 3.08 68 17.31 2.64 167 16.91 2.96 129 15.63 2.93 30 17.04 2.80 235
Turkey 13.22 3.77 156 12.58 4.11 171 13.17 3.83 304 9.17 3.75 23 12.89 3.96 327
Switzerland 16.39 3.05 57 17.59 2.36 76 17.49 2.35 94 16.02 3.29 40 17.05 2.73 134
Lithuania 15.57 2.93 100 15.27 3.03 226 15.58 2.85 301 12.76 3.54 25 15.37 3.00 326
Overall 15.39 3.37 2214 15.75 3.51 3091 15.92 3.31 4063 14.28 3.70 1123 15.60 3.46 5331
33
Table A4-II Reference data for the transformed raw score (range 0 - 100) of the final 4-item “Sensory Abilities” facet (OLD-SAB) of the WHOQOL-OLD
module (Field Trial sample; N total = 5566)

Edinburgh 73.61 21.24 36 70.31 25.84 72 77.74 21.62 57 64.37 25.73 50 71.41 24.35 108
Bath 78.85 18.86 52 82.22 18.12 90 82.33 17.73 122 71.69 22.22 17 80.99 18.40 142
Leipzig 69.73 21.17 185 72.01 21.31 157 75.15 19.14 249 59.07 22.20 93 70.81 21.21 343
Barcelona 68.34 20.12 108 69.04 19.64 150 70.13 19.48 213 62.07 20.46 44 68.75 19.80 258
Copenhagen 76.18 19.34 175 79.28 17.94 178 80.47 16.82 272 67.52 21.59 71 77.81 18.64 358
Paris 62.42 20.78 74 60.00 24.07 65 61.25 23.22 80 61.33 21.26 59 61.29 22.33 139
Prague 63.81 24.11 129 64.63 23.55 191 68.07 22.15 266 45.72 22.71 54 64.30 23.74 320
Budapest 67.69 22.26 100 63.56 22.80 219 66.44 21.98 230 60.74 24.04 89 64.85 22.68 319
Oslo 73.28 18.40 142 81.57 17.62 155 82.17 15.89 183 70.52 19.83 113 77.63 18.39 299
Victoria 79.78 18.26 85 80.11 16.59 99 83.19 15.18 135 70.92 19.73 46 79.96 17.34 184
Melbourne 71.45 21.98 148 80.88 18.11 205 80.13 18.56 241 70.83 21.98 111 77.01 20.33 363
Seattle 76.46 20.81 120 77.84 21.86 167 81.06 19.09 235 60.10 23.03 52 77.26 21.40 287
Beer-Sheva 71.56 19.89 80 76.31 19.35 153 74.71 19.55 196 74.82 19.25 34 74.51 19.89 240
Tokyo 73.82 17.02 85 72.24 23.21 93 72.81 20.82 151 63.54 21.80 6 73.00 20.45 178
Umea 69.62 20.07 208 75.45 20.66 237 75.90 18.77 340 62.44 22.79 105 72.72 20.57 445
Brazil 77.83 16.64 106 76.22 20.75 220 78.54 18.90 265 68.95 20.28 61 76.74 19.50 326
Uruguay 77.48 19.26 68 83.16 16.52 167 80.72 18.49 129 72.71 18.31 30 81.52 17.50 235
Turkey 57.65 23.54 156 53.65 25.67 171 57.32 23.95 304 32.34 23.43 23 55.56 24.72 327
Switzerland 77.41 19.07 57 84.95 14.73 76 84.31 14.66 94 75.16 20.58 40 81.58 17.09 134
Lithuania 72.31 18.34 100 70.46 18.95 226 72.38 17.84 301 54.75 22.12 25 71.03 18.76 326
Overall 71.16 21.08 2214 73.45 21.94 3091 74.51 20.68 4063 64.25 23.14 1123 72.52 21.61 5331
34
Table A5-I Reference data for the summed score (raw value) of the final 4-item “Autonomy” (OLD-AUT) facet of the WHOQOL-OLD module (Field Trial

Edinburgh 14.39 2.72 36 14.81 3.01 74 15.55 3.06 58 13.65 2.41 51 14.67 2.91 110
Bath 15.48 2.28 52 15.65 2.15 89 15.68 2.21 121 15.06 2.13 18 15.59 2.19 141
Leipzig 14.87 2.32 187 14.94 2.97 156 15.15 2.56 250 14.23 2.71 93 14.90 2.63 343
Barcelona 13.76 2.69 107 13.17 2.86 150 13.48 2.80 214 13.05 2.85 42 13.41 2.80 257
Copenhagen 15.64 2.56 180 15.62 2.62 182 15.79 2.65 280 15.10 2.38 72 15.61 2.59 367
Paris 12.74 2.91 77 12.76 3.34 63 12.93 3.16 90 12.42 3.00 50 12.75 3.10 140
Prague 14.80 3.07 129 14.47 3.15 193 14.82 3.00 268 13.52 3.47 54 14.60 3.12 322
Budapest 13.83 2.90 102 13.75 2.73 226 13.93 2.70 238 13.37 2.97 90 13.78 2.78 328
Oslo 14.38 2.97 144 14.86 2.89 159 14.95 2.77 183 14.17 3.12 119 14.63 2.92 307
Victoria 16.40 2.58 92 16.26 2.47 105 16.48 2.48 139 15.93 2.65 54 16.32 2.51 197
Melbourne 15.17 2.41 144 15.72 2.37 209 15.60 2.41 243 15.35 2.38 110 15.49 2.42 363
Seattle 15.43 2.90 122 15.66 2.81 164 15.94 2.74 234 13.87 2.69 52 15.56 2.84 286
Beer-Sheva 15.14 2.26 81 15.31 2.35 153 15.41 2.25 196 14.37 2.40 35 15.24 2.34 242
Tokyo 14.95 2.53 86 14.18 2.97 94 14.58 2.68 153 13.00 3.52 6 14.55 2.79 180
Umea 14.61 2.21 209 14.55 2.52 237 14.83 2.23 341 13.75 2.66 105 14.58 2.38 446
Brazil 14.75 2.14 107 14.90 2.92 220 14.87 2.73 266 14.77 2.51 61 14.85 2.69 327
Uruguay 12.90 3.09 67 15.17 2.82 174 14.02 3.12 130 13.43 3.48 28 14.54 3.06 241
Turkey 13.66 2.42 156 13.79 2.82 171 13.74 2.69 304 13.61 1.92 23 13.73 2.64 327
Switzerland 16.16 2.23 55 16.38 2.71 77 16.41 2.56 91 15.95 2.46 42 16.26 2.53 133
Lithuania 12.62 2.65 101 12.49 2.74 228 12.62 2.70 305 11.46 2.70 24 12.53 2.71 329
Overall 14.61 2.75 2234 14.65 2.93 3124 14.74 2.84 4104 14.17 2.89 1129 14.64 2.86 5386
35
Table A5-II Reference data for the transformed raw score (range 0 - 100) of the final 4-item “Autonomy” (OLD-AUT) facet of the WHOQOL-OLD module
(Field Trial sample; N total = 5566)

Edinburgh 64.93 16.99 36 67.57 18.78 74 72.20 19.10 58 60.29 15.04 51 66.70 18.18 110
Bath 71.75 14.25 52 72.82 13.43 89 72.99 13.82 121 69.10 13.30 18 72.43 13.69 141
Leipzig 67.91 14.49 187 68.35 18.55 156 69.68 16.01 250 63.91 16.92 93 68.11 16.44 343
Barcelona 60.98 16.80 107 57.29 17.86 150 59.26 17.48 214 56.55 17.78 42 58.83 17.49 257
Copenhagen 72.74 16.02 180 72.60 16.39 182 73.66 16.55 280 69.36 14.88 72 72.56 16.18 367
Paris 54.63 18.20 77 54.76 20.90 63 55.83 19.74 90 52.63 18.78 50 54.69 19.39 140
Prague 67.49 19.17 129 65.45 19.67 193 67.63 18.74 268 59.49 21.71 54 66.27 19.47 322
Budapest 61.46 18.11 102 60.95 17.07 226 62.08 16.85 238 58.54 18.54 90 61.11 17.37 328
Oslo 64.89 18.54 144 67.89 18.09 159 68.44 17.34 183 63.55 19.48 119 66.45 18.27 307
Victoria 77.51 16.10 92 76.61 15.43 105 78.01 15.48 139 74.54 16.55 54 77.03 15.72 197
Melbourne 69.79 15.06 144 73.24 14.83 209 72.51 15.09 243 70.91 14.87 110 71.83 15.13 363
Seattle 71.41 18.13 122 72.87 17.53 164 74.60 17.15 234 61.66 16.79 52 72.25 17.77 286
Beer-Sheva 69.60 14.14 81 70.67 14.70 153 71.33 14.08 196 64.82 15.01 35 70.27 14.61 242
Tokyo 68.46 15.81 86 63.63 18.56 94 66.14 16.78 153 56.25 22.01 6 65.94 17.42 180
Umea 66.30 13.84 209 65.93 15.73 237 67.69 13.92 341 60.95 16.62 105 66.10 14.86 446
Brazil 67.17 13.36 107 68.12 18.24 220 67.93 17.06 266 67.32 15.66 61 67.81 16.79 327
Uruguay 55.60 19.31 67 69.79 17.61 174 62.60 19.47 130 58.93 21.75 28 65.85 19.15 241
Turkey 60.38 15.14 156 61.18 17.65 171 60.86 16.78 304 60.05 12.03 23 60.80 16.48 327
Switzerland 76.02 13.96 55 77.35 16.97 77 77.54 15.97 91 74.70 15.37 42 76.64 15.78 133
Lithuania 53.90 16.53 101 53.07 17.13 228 53.85 16.84 305 46.61 16.89 24 53.32 16.93 329
Overall 66.31 17.16 2234 66.57 18.33 3124 67.13 17.75 4104 63.54 18.06 1129 66.47 17.85 5386
36
Table A6-I Reference data for the summed score (raw value) of the final 4-item “Past, Present and Future Activities” (OLD-PPF) facet of the WHOQOL-
OLD module (Field Trial sample; N total = 5566)

Edinburgh 14.19 3.19 37 14.51 2.62 74 14.81 3.12 59 13.84 2.27 51 14.41 2.81 111
Bath 15.31 2.30 51 14.91 2.11 90 15.12 2.17 120 14.56 2.41 18 15.06 2.18 141
Leipzig 14.83 2.20 183 14.46 2.52 162 14.70 2.37 253 14.52 2.34 92 14.65 2.36 346
Barcelona 13.96 2.85 106 13.81 3.06 155 13.93 2.91 216 13.48 3.24 44 13.87 2.97 261
Copenhagen 14.65 2.79 185 14.43 2.55 182 14.73 2.57 284 13.85 3.03 73 14.53 2.68 372
Paris 13.05 2.65 78 13.06 2.86 62 13.27 2.87 86 12.72 2.49 54 13.06 2.73 140
Prague 13.96 2.40 130 13.66 2.57 192 13.91 2.41 268 13.13 2.86 54 13.78 2.50 322
Budapest 13.50 2.80 101 13.25 2.75 224 13.36 2.73 236 13.25 2.87 89 13.33 2.76 325
Oslo 14.56 2.25 144 14.68 2.25 156 14.75 2.34 182 14.44 2.10 117 14.62 2.24 304
Victoria 16.02 2.77 90 15.93 2.62 104 16.04 2.70 139 15.71 2.58 51 15.97 2.68 194
Melbourne 14.89 2.65 148 15.22 2.59 210 15.38 2.59 246 14.58 2.55 111 15.10 2.63 368
Seattle 15.47 2.80 122 15.49 2.78 168 15.80 2.74 236 14.11 2.59 54 15.48 2.78 290
Beer-Sheva 14.20 2.63 81 13.99 2.56 153 14.06 2.54 196 14.14 2.82 35 14.06 2.62 242
Tokyo 13.73 2.42 86 13.08 2.47 95 13.42 2.42 154 12.83 1.72 6 13.39 2.46 181
Umea 14.71 2.22 210 14.63 2.31 234 14.94 2.21 338 13.81 2.21 106 14.67 2.26 444
Brazil 14.87 2.35 107 15.33 2.60 221 15.18 2.57 267 15.21 2.35 61 15.18 2.53 328
Uruguay 13.05 3.03 60 15.28 2.55 169 14.00 2.94 120 14.23 3.76 26 14.70 2.85 229
Turkey 13.35 2.66 156 13.23 2.97 171 13.36 2.82 304 12.39 2.73 23 13.29 2.82 327
Switzerland 15.25 2.07 57 15.71 2.67 75 15.49 2.54 93 15.53 2.16 40 15.50 2.42 133
Lithuania 12.14 2.63 101 11.52 2.69 223 11.72 2.69 302 11.64 2.59 22 11.72 2.68 324
Overall 14.33 2.69 2233 14.25 2.83 3120 14.32 2.80 4099 14.06 2.69 1127 14.29 2.78 5382
37
Table A6-II Reference data for the transformed raw score (range 0 - 100) of the final 4-item “Past, Present and Future Activities” (OLD-PPF) facet of the
WHOQOL-OLD module (Field Trial sample; N total = 5566)

Edinburgh 63.68 19.92 37 65.71 16.36 74 67.58 19.51 59 61.52 14.16 51 65.03 17.56 111
Bath 70.71 14.39 51 68.19 13.20 90 69.48 13.56 120 65.97 15.04 18 69.10 13.65 141
Leipzig 67.69 13.74 183 65.35 15.76 162 66.90 14.82 253 65.76 14.61 92 66.55 14.76 346
Barcelona 62.26 17.80 106 61.29 19.11 155 62.07 18.17 216 59.23 20.24 44 61.69 18.56 261
Copenhagen 66.55 17.45 185 65.21 15.94 182 67.08 16.05 284 61.56 18.91 73 65.83 16.75 372
Paris 56.57 16.55 78 56.65 17.89 62 57.92 17.95 86 54.51 15.57 54 56.61 17.09 140
Prague 62.26 15.02 130 60.35 16.06 192 61.94 15.08 268 57.06 17.85 54 61.12 15.65 322
Budapest 59.34 17.47 101 57.81 17.18 224 58.47 17.04 236 57.79 17.91 89 58.29 17.25 325
Oslo 66.02 14.06 144 66.75 14.07 156 67.17 14.60 182 65.28 13.14 117 66.37 14.02 304
Victoria 75.14 17.33 90 74.58 16.37 104 75.22 16.86 139 73.16 16.12 51 74.84 16.78 194
Melbourne 68.07 16.56 148 70.15 16.20 210 71.14 16.20 246 66.10 15.91 111 69.40 16.46 368
Seattle 71.67 17.50 122 71.84 17.37 168 73.73 17.10 236 63.19 16.18 54 71.77 17.39 290
Beer-Sheva 63.73 16.43 81 62.42 16.00 153 62.88 15.87 196 63.39 17.62 35 62.86 16.38 242
Tokyo 60.83 15.14 86 56.78 15.41 95 58.89 15.15 154 55.21 10.77 6 58.70 15.37 181
Umea 66.96 13.85 210 66.43 14.41 234 68.36 13.83 338 61.32 13.83 106 66.68 14.14 444
Brazil 67.93 14.70 107 70.84 16.23 221 69.85 16.04 267 70.08 14.71 61 69.89 15.78 328
Uruguay 56.56 18.96 60 70.53 15.92 169 62.50 18.39 120 63.94 23.47 26 66.87 17.82 229
Turkey 58.45 16.60 156 57.68 18.58 171 58.47 17.64 304 52.45 17.04 23 58.05 17.64 327
Switzerland 70.29 12.95 57 73.17 16.69 75 71.84 15.87 93 72.03 13.50 40 71.90 15.15 133
Lithuania 50.87 16.42 101 47.03 16.79 223 48.26 16.81 302 47.73 16.20 22 48.23 16.74 324
Overall 64.59 16.82 2233 64.06 17.71 3120 64.49 17.50 4099 62.90 16.80 1127 64.29 17.36 5382
38
Table A7-I Reference data for the summed score (raw value) of the final 4-item “Social Participation” facet (OLD-SOP) of the WHOQOL-OLD module

Edinburgh 13.76 3.29 37 14.08 3.44 74 14.88 3.47 59 12.88 2.98 51 13.97 3.38 111
Bath 15.60 2.16 53 15.75 2.62 89 15.77 2.51 121 14.89 1.84 18 15.70 2.45 142
Leipzig 15.23 2.65 183 15.39 2.54 161 15.64 2.44 252 14.38 2.79 92 15.29 2.60 345
Barcelona 14.51 2.90 109 14.84 2.51 153 14.83 2.66 217 14.05 2.69 44 14.71 2.68 262
Copenhagen 14.81 3.09 185 14.47 3.22 180 14.87 3.18 283 13.58 3.03 72 14.61 3.19 370
Paris 12.65 3.08 79 12.10 3.55 61 12.71 3.39 86 11.93 3.11 54 12.41 3.30 140
Prague 14.26 2.75 131 13.83 3.04 193 14.44 2.61 270 11.83 3.45 54 14.00 2.93 324
Budapest 14.22 2.98 100 14.14 2.84 224 14.31 2.70 236 13.78 3.30 88 14.16 2.88 324
Oslo 14.83 2.64 148 15.13 2.44 163 15.36 2.43 186 14.48 2.58 124 15.00 2.55 315
Victoria 15.81 2.93 91 15.80 2.92 107 15.91 2.77 138 15.45 3.25 56 15.81 2.91 198
Melbourne 15.08 2.92 147 15.52 2.84 211 15.59 2.75 244 14.92 2.95 113 15.34 2.86 368
Seattle 15.33 3.06 123 15.61 2.79 166 15.73 2.79 235 14.44 3.17 54 15.49 2.90 289
Beer-Sheva 14.37 3.04 81 14.73 2.99 157 14.62 2.96 200 14.71 3.17 35 14.60 3.05 246
Tokyo 13.73 2.32 86 13.46 2.65 95 13.71 2.49 154 12.83 2.64 6 13.59 2.50 181
Umea 14.72 2.47 208 14.59 2.66 234 15.02 2.40 337 13.46 2.74 105 14.65 2.57 442
Brazil 14.46 2.52 107 15.00 2.99 221 14.88 2.81 267 14.59 3.04 61 14.83 2.85 328
Uruguay 13.30 3.18 61 15.20 2.60 170 13.98 2.94 124 14.36 3.29 25 14.70 2.89 231
Turkey 12.46 2.72 156 13.01 3.36 171 12.82 2.94 304 11.83 4.57 23 12.75 3.08 327
Switzerland 15.47 2.15 59 16.04 2.56 74 15.65 2.50 93 16.05 2.17 41 15.77 2.40 134
Lithuania 14.12 2.48 99 13.70 2.86 230 13.89 2.72 305 13.08 3.08 24 13.83 2.75 329
Overall 14.48 2.89 2243 14.63 2.98 3134 14.71 2.88 4111 14.00 3.14 1140 14.57 2.95 5406
39
Table A7-II Reference data for the transformed raw score (range 0 - 100) of the final 4-item “Social Participation” facet (OLD-SOP) of the WHOQOL-OLD

Edinburgh 60.98 20.54 37 63.01 21.52 74 68.01 21.68 59 55.51 18.65 51 62.33 21.13 111
Bath 72.52 13.50 53 73.46 16.35 89 73.55 15.68 121 68.06 11.52 18 73.11 15.31 142
Leipzig 70.22 16.54 183 71.16 15.89 161 72.77 15.26 252 64.88 17.43 92 70.58 16.26 345
Barcelona 65.71 18.11 109 67.77 15.69 153 67.68 16.65 217 62.78 16.83 44 66.91 16.74 262
Copenhagen 67.53 19.29 185 65.45 20.13 180 67.95 19.89 283 59.90 18.96 72 66.30 19.91 370
Paris 54.03 19.28 79 50.61 22.21 61 54.43 21.18 86 49.54 19.46 54 52.54 20.60 140
Prague 64.12 17.17 131 61.43 18.99 193 65.23 16.31 270 48.96 21.57 54 62.52 18.30 324
Budapest 63.87 18.63 100 63.36 17.74 224 64.41 16.86 236 61.15 20.64 88 63.52 17.99 324
Oslo 67.69 16.50 148 69.59 15.25 163 71.00 15.22 186 65.47 16.11 124 68.73 15.93 315
Victoria 73.83 18.30 91 73.77 18.22 107 74.41 17.30 138 71.54 20.33 56 73.80 18.21 198
Melbourne 69.26 18.28 147 72.01 17.73 211 72.46 17.16 244 68.25 18.41 113 70.89 17.85 368
Seattle 70.78 19.11 123 72.59 17.42 166 73.32 17.44 235 65.28 19.83 54 71.82 18.15 289
Beer-Sheva 64.81 18.99 81 67.08 18.69 157 66.34 18.53 200 66.96 19.80 35 66.23 19.05 246
Tokyo 60.83 14.52 86 59.14 16.56 95 60.67 15.57 154 55.21 16.50 6 59.94 15.60 181
Umea 67.01 15.43 208 66.19 16.64 234 68.90 15.00 337 59.11 17.14 105 66.57 16.07 442
Brazil 65.36 15.77 107 68.78 18.70 221 68.00 17.59 267 66.19 19.00 61 67.66 17.84 328
Uruguay 58.09 19.87 61 70.00 16.27 170 62.35 18.37 124 64.75 20.56 25 66.86 18.03 231
Turkey 52.84 17.01 156 56.32 21.02 171 55.10 18.36 304 48.91 28.56 23 54.66 19.26 327
Switzerland 71.72 13.45 59 75.25 16.01 74 72.78 15.60 93 75.30 13.55 41 73.55 15.00 134
Lithuania 63.26 15.47 99 60.65 17.87 230 61.80 17.01 305 56.77 19.23 24 61.44 17.20 329
Overall 65.53 18.09 2243 66.47 18.65 3134 66.93 17.98 4111 62.52 19.63 1140 66.07 18.45 5406
40
Table A8-I Reference data for the summed score (raw value) of the final 4-item “Death and Dying” facet (OLD-DAD) of the WHOQOL-OLD module (Field

Edinburgh 15.11 2.77 37 15.59 3.20 75 15.08 3.24 59 15.83 2.84 52 15.43 3.06 112
Bath 15.69 3.24 54 14.49 3.50 90 14.85 3.50 123 15.22 3.25 18 14.94 3.44 144
Leipzig 13.87 4.02 187 12.03 4.08 162 12.87 4.20 255 13.41 3.97 94 13.01 4.14 349
Barcelona 13.40 3.65 104 12.69 3.75 149 12.79 3.72 210 14.05 3.59 42 12.98 3.72 253
Copenhagen 14.70 3.21 183 13.45 3.77 179 13.97 3.50 280 14.39 3.76 71 14.08 3.57 367
Paris 15.47 3.31 79 14.17 4.26 69 15.23 3.96 90 14.29 3.56 58 14.86 3.83 148
Prague - - - - - - - - - - - - - - -
Budapest 15.42 3.50 103 15.01 4.06 227 14.94 3.86 238 15.64 3.94 92 15.14 3.89 330
Oslo 14.68 3.23 141 14.08 3.80 158 14.08 3.59 181 14.82 3.45 117 14.34 3.55 303
Victoria 16.21 3.36 92 15.47 3.33 105 15.81 3.54 140 15.92 2.81 53 15.81 3.36 197
Melbourne 15.48 3.25 149 14.76 3.59 206 14.76 3.51 243 15.75 3.30 111 15.08 3.49 365
Seattle 16.67 2.98 124 15.51 3.64 165 15.91 3.32 236 16.43 3.84 53 16.01 3.42 289
Beer-Sheva 13.27 4.13 79 11.86 4.02 159 12.20 4.12 200 13.03 4.10 35 12.25 4.10 246
Tokyo 13.01 3.87 86 12.76 4.17 97 13.14 3.95 155 11.33 2.73 6 12.88 4.02 183
Umea 15.64 3.45 211 15.03 3.59 237 15.13 3.45 341 15.92 3.76 107 15.32 3.54 448
Brazil 14.52 3.80 106 14.20 4.16 221 14.32 4.13 267 14.23 3.67 60 14.30 4.04 327
Uruguay 16.90 4.13 60 13.51 4.87 168 15.17 4.83 117 16.25 4.53 28 14.40 4.91 228
Turkey 11.38 4.00 156 10.75 3.75 171 11.25 3.86 304 8.43 3.15 23 11.05 3.88 327
Switzerland 14.56 3.73 55 13.13 3.71 76 13.83 3.67 89 13.52 4.01 42 13.73 3.77 131
Lithuania 15.46 3.30 97 13.95 3.56 224 14.36 3.49 298 15.09 4.21 23 14.41 3.55 321
Overall 14.71 3.79 2103 13.82 4.07 2938 14.06 3.97 3826 14.82 3.87 1085 14.19 3.98 5068
41
Table A8-II Reference data for the transformed raw score (range 0 - 100) of the final 4-item “Death and Dying” facet (OLD-DAD) of the WHOQOL-OLD

Edinburgh 69.43 17.29 37 72.42 19.98 75 69.28 20.28 59 73.92 17.75 52 71.43 19.11 112
Bath 73.03 20.24 54 65.56 21.88 90 67.78 21.87 123 70.14 20.29 18 68.36 21.51 144
Leipzig 61.66 25.11 187 50.19 25.51 162 55.42 26.28 255 58.84 24.82 94 56.34 25.90 349
Barcelona 58.77 22.82 104 54.32 23.45 149 54.94 23.24 210 62.80 22.43 42 56.15 23.25 253
Copenhagen 66.87 20.07 183 59.04 23.59 179 62.30 21.90 280 64.96 23.49 71 62.99 22.30 367
Paris 71.68 20.70 79 63.59 26.65 69 70.21 24.77 90 64.33 22.27 58 67.91 23.92 148
Prague - - - - - - - - - - - - - - -
Budapest 71.36 21.91 103 68.81 25.36 227 68.38 24.15 238 72.76 24.63 92 69.60 24.33 330
Oslo 66.76 20.19 141 62.97 23.73 158 62.98 22.46 181 67.63 21.57 117 64.62 22.17 303
Victoria 76.29 20.98 92 71.67 20.84 105 73.84 22.13 140 74.53 17.59 53 73.83 20.98 197
Melbourne 71.77 20.29 149 67.23 22.44 206 67.26 21.96 243 73.42 20.65 111 69.26 21.78 365
Seattle 79.18 18.63 124 71.93 22.74 165 74.44 20.72 236 77.71 23.97 53 75.04 21.35 289
Beer-Sheva 57.91 25.78 79 49.14 25.10 159 51.25 25.74 200 56.43 25.61 35 51.58 25.62 246
Tokyo 56.32 24.17 86 54.77 26.03 97 57.14 24.70 155 45.83 17.08 6 55.50 25.12 183
Umea 72.78 21.57 211 68.96 22.47 237 69.59 21.55 341 74.47 23.51 107 70.76 22.11 448
Brazil 65.74 23.77 106 63.74 26.00 221 64.49 25.82 267 63.96 22.91 60 64.39 25.28 327
Uruguay 80.62 25.83 60 59.45 30.45 168 69.82 30.16 117 76.56 28.34 28 65.02 30.71 228
Turkey 46.15 25.01 156 42.18 23.46 171 45.31 24.15 304 27.72 19.66 23 44.07 24.26 327
Switzerland 66.02 23.32 55 57.07 23.17 76 61.45 22.95 89 59.52 25.05 42 60.83 23.56 131
Lithuania 71.65 20.63 97 62.19 22.25 224 64.72 21.84 298 69.29 26.31 23 65.05 22.17 321
Overall 66.91 23.67 2103 61.39 25.44 2938 62.87 24.80 3826 67.63 24.20 1085 63.66 24.89 5068
42
Table A9-I Reference data for the summed score (raw value) of the final 4-item “Intimacy” facet (OLD-INT) of the WHOQOL-OLD module (Field Trial

Centre ID Mean SD N Mean SD N Mean SD N Mean SD N Mean SD N
Edinburgh 12.68 4.00 34 11.99 4.59 67 12.84 4.98 56 11.43 3.48 44 12.22 4.39 101
Bath 14.90 3.73 51 14.78 4.17 89 14.98 3.97 120 13.65 4.44 17 14.82 4.00 140
Leipzig 15.67 3.31 181 14.82 3.39 152 15.47 3.39 245 14.75 3.27 88 15.27 3.37 334
Barcelona 14.35 3.81 108 13.52 4.10 139 14.01 3.95 211 13.00 4.19 35 13.88 3.99 247
Copenhagen 13.72 4.05 181 14.17 3.66 175 14.19 3.79 275 13.17 4.07 71 13.94 3.86 361
Paris 13.70 2.98 76 13.07 3.53 58 13.45 3.21 85 13.39 3.31 49 13.43 3.24 134
Prague 14.24 2.92 131 14.38 3.33 189 14.44 2.95 268 13.73 4.09 52 14.32 3.16 320
Budapest 13.84 3.97 97 10.70 4.61 187 12.27 4.68 213 10.27 4.21 71 11.77 4.64 284
Oslo 15.74 2.52 145 15.71 2.54 157 15.87 2.51 182 15.50 2.56 119 15.72 2.54 304
Victoria 15.38 3.76 89 14.18 4.68 99 14.87 4.14 138 14.35 4.79 46 14.75 4.30 188
Melbourne 14.30 3.93 148 13.41 4.19 197 14.08 4.11 240 13.17 4.11 104 13.81 4.11 353
Seattle 15.49 3.81 123 14.05 4.53 169 15.05 4.28 238 12.91 3.94 54 14.66 4.30 292
Beer-Sheva 14.55 3.09 78 13.86 4.18 152 14.23 3.87 195 13.47 3.51 32 14.06 3.84 237
Tokyo 13.20 2.39 85 11.84 2.97 94 12.45 2.77 153 11.67 2.25 6 12.49 2.79 179
Umea 13.84 3.22 203 13.13 3.76 215 13.93 3.35 324 11.91 3.65 94 13.48 3.52 418
Brazil 15.82 2.76 107 14.62 3.78 219 14.98 3.56 266 15.13 3.36 60 15.01 3.52 326
Uruguay 12.52 3.68 62 16.45 3.18 170 14.90 3.77 125 12.89 4.60 28 15.40 3.75 232
Turkey 14.28 2.58 156 14.80 2.74 171 14.60 2.65 304 13.91 2.92 23 14.55 2.68 327
Switzerland 14.62 3.14 55 13.80 3.51 69 13.92 3.47 87 14.71 3.01 38 14.16 3.35 125
Lithuania 12.20 3.19 93 9.45 4.03 219 10.37 3.99 290 9.00 3.99 22 10.27 4.00 312
Overall 14.38 3.49 2203 13.62 4.18 2987 14.04 3.89 4015 13.35 4.00 1053 13.94 3.92 5214
43
Table A9-II Reference data for the transformed raw score (range 0 - 100) of the final 4-item “Intimacy” facet (OLD-INT) of the WHOQOL-OLD module

Centre ID Mean SD N Mean SD N Mean SD N Mean SD N Mean SD N
Edinburgh 54.23 24.99 34 49.91 28.71 67 55.25 31.10 56 46.45 21.75 44 51.36 27.47 101
Bath 68.14 23.29 51 67.35 26.09 89 68.65 24.84 120 60.29 27.77 17 67.63 25.03 140
Leipzig 72.96 20.68 181 67.60 21.21 152 71.71 21.19 245 67.19 20.44 88 70.45 21.06 334
Barcelona 64.70 23.82 108 59.49 25.62 139 62.56 24.67 211 56.25 26.17 35 61.77 24.94 247
Copenhagen 60.74 25.31 181 63.57 22.88 175 63.66 23.70 275 57.31 25.42 71 62.12 24.14 361
Paris 60.61 18.65 76 56.68 22.09 58 59.04 20.08 85 58.67 20.68 49 58.91 20.23 134
Prague 64.03 18.28 131 64.85 20.79 189 65.23 18.42 268 60.82 25.55 52 64.51 19.78 320
Budapest 61.47 24.78 97 41.84 28.80 187 51.67 29.23 213 39.17 26.30 71 48.55 28.99 284
Oslo 73.41 15.74 145 73.17 15.89 157 74.18 15.68 182 71.90 16.00 119 73.25 15.88 304
Victoria 71.14 23.47 89 63.64 29.28 99 67.93 25.89 138 64.67 29.94 46 67.19 26.88 188
Melbourne 64.40 24.56 148 58.82 26.17 197 63.02 25.67 240 57.33 25.71 104 61.33 25.66 353
Seattle 71.80 23.82 123 62.83 28.33 169 69.09 26.76 238 55.67 24.62 54 66.61 26.85 292
Beer-Sheva 65.95 19.31 78 61.64 26.11 152 63.94 24.17 195 59.18 21.94 32 62.87 24.00 237
Tokyo 57.50 14.97 85 49.00 18.59 94 52.82 17.32 153 47.92 14.07 6 53.04 17.44 179
Umea 61.51 20.15 203 57.06 23.48 215 62.06 20.97 324 49.47 22.83 94 59.23 22.01 418
Brazil 73.89 17.27 107 66.35 23.63 219 68.66 22.27 266 69.58 20.98 60 68.83 22.01 326
Uruguay 53.23 22.99 62 77.79 19.90 170 68.15 23.58 125 55.58 28.73 28 71.23 23.41 232
Turkey 64.22 16.14 156 67.47 17.14 171 66.22 16.59 304 61.96 18.26 23 65.92 16.72 327
Switzerland 66.36 19.64 55 61.23 21.93 69 62.00 21.72 87 66.94 18.83 38 63.50 20.93 125
Lithuania 51.28 19.93 93 34.05 25.17 219 39.78 24.92 290 31.25 24.93 22 39.18 24.98 312
Overall 64.89 21.79 2203 60.12 26.11 2987 62.78 24.30 4015 58.46 24.97 1053 62.15 24.48 5214
44
Table A10-I Reference data for the summed score (raw value) of the final summary/ total score (OLD-TO) of the WHOQOL-OLD module (Field Trial samp-
le; N total = 5566)

Edinburgh 85.22 13.53 32 85.97 14.06 64 89.36 15.39 53 80.98 10.05 42 85.72 13.82 96
Bath 93.87 10.42 48 92.48 10.81 85 93.49 10.72 115 88.81 9.68 16 92.98 10.65 133
Leipzig 89.90 11.04 173 87.30 12.20 144 89.84 11.11 235 85.49 12.55 82 88.72 11.64 317
Barcelona 84.53 11.68 99 83.56 11.38 113 84.25 11.51 185 82.00 11.63 26 84.01 11.51 212
Copenhagen 90.30 12.90 157 88.89 12.42 162 90.56 12.78 251 85.55 11.49 58 89.52 12.77 324
Paris 81.52 10.16 54 77.68 14.19 40 81.26 13.30 58 77.67 9.70 36 79.88 12.12 94
Prague - - - - - - - - - - - - - - -
Budapest 85.52 12.29 92 81.72 13.11 173 84.06 12.81 198 80.03 12.93 67 83.04 12.94 265
Oslo 90.20 11.28 125 91.81 10.39 139 92.49 10.64 169 88.64 10.70 94 90.98 10.87 265
Victoria 96.67 12.79 82 94.42 12.31 90 96.34 12.13 130 92.59 13.18 39 95.49 12.55 172
Melbourne 89.89 12.91 132 91.67 11.88 184 92.13 12.29 218 88.62 12.04 97 91.00 12.35 324
Seattle 94.39 13.95 118 92.71 13.66 157 95.24 13.38 226 85.08 12.66 49 93.43 13.79 275
Beer-Sheva 87.03 11.74 72 86.65 13.11 137 86.81 12.42 177 87.24 13.03 29 86.53 12.79 215
Tokyo 84.48 10.83 84 81.23 13.26 91 83.18 12.03 149 75.83 10.32 6 82.79 12.23 175
Umea 88.74 10.88 198 88.53 12.00 203 90.16 10.63 315 83.06 12.61 86 88.63 11.45 401
Brazil 90.87 9.71 105 90.18 12.83 217 90.77 11.98 263 88.78 11.48 59 90.41 11.89 322
Uruguay 84.04 11.22 47 94.16 10.90 133 89.52 12.32 95 87.55 12.89 20 91.52 11.82 180
Turkey 78.35 12.00 156 78.16 12.83 171 78.92 12.11 304 69.35 13.29 23 78.25 12.42 327
Switzerland 91.77 9.67 47 93.12 10.72 66 93.05 10.32 80 91.36 10.21 33 92.56 10.27 113
Lithuania 82.10 11.46 80 76.89 11.97 180 78.79 11.98 242 74.50 12.42 18 78.49 12.04 260
Overall 88.02 12.56 1901 87.24 13.45 2549 88.10 13.09 3463 85.07 12.72 880 87.57 13.10 4470
45
Table A10-II Reference data for the transformed raw score (range 0 - 100) of the final summary/ total score (OLD-TO) of the WHOQOL-OLD module (Field

Edinburgh 63.77 14.09 32 64.55 14.65 64 68.08 16.03 53 59.35 10.47 42 64.29 14.40 96
Bath 72.79 10.85 48 71.34 11.26 85 72.38 11.17 115 67.51 10.09 16 71.86 11.09 133
Leipzig 68.64 11.50 173 65.94 12.71 144 68.59 11.57 235 64.05 13.08 82 67.41 12.12 317
Barcelona 63.05 12.17 99 62.04 11.85 113 62.76 11.99 185 60.42 12.12 26 62.51 11.99 212
Copenhagen 69.06 13.44 157 67.59 12.94 162 69.33 13.31 251 64.12 11.97 58 68.25 13.30 324
Paris 59.92 10.58 54 55.91 14.78 40 59.64 13.86 58 55.90 10.11 36 58.21 12.63 94
Prague - - - - - - - - - - - - - - -
Budapest 64.09 12.80 92 60.13 13.66 173 62.56 13.35 198 58.36 13.46 67 61.50 13.48 265
Oslo 68.96 11.75 125 70.64 10.82 139 71.34 11.08 169 67.33 11.15 94 69.77 11.33 265
Victoria 75.70 13.32 82 73.36 12.82 90 75.35 12.64 130 71.45 13.73 39 74.47 13.07 172
Melbourne 68.64 13.44 132 70.49 12.38 184 70.97 12.80 218 67.31 12.55 97 69.79 12.86 324
Seattle 73.32 14.54 118 71.57 14.23 157 74.21 13.93 226 63.63 13.19 49 72.32 14.36 275
Beer-Sheva 65.65 12.23 72 65.26 13.66 137 65.42 12.94 177 65.88 13.58 29 65.14 13.32 215
Tokyo 63.00 11.28 84 59.62 13.82 91 61.65 12.53 149 53.99 10.75 6 61.24 12.74 175
Umea 67.44 11.33 198 67.22 12.50 203 68.91 11.07 315 61.52 13.14 86 67.33 11.92 401
Brazil 69.65 10.11 105 68.94 13.37 217 69.55 12.48 263 67.48 11.96 59 69.17 12.39 322
Uruguay 62.54 11.69 47 73.08 11.35 133 68.25 12.83 95 66.20 13.43 20 70.33 12.32 180
Turkey 56.62 12.50 156 56.41 13.37 171 57.21 12.62 304 47.24 13.84 23 56.51 12.94 327
Switzerland 70.59 10.07 47 72.00 11.16 66 71.93 10.75 80 70.17 10.63 33 71.41 10.70 113
Lithuania 60.52 11.94 80 55.09 12.47 180 57.07 12.48 242 52.60 12.94 18 56.76 12.54 260
Overall 66.69 13.08 1901 65.88 14.01 2549 66.77 13.64 3463 63.61 13.25 880 66.22 13.64 4470
46
Appendix V PARTICIPATING CENTRES

No Title Name Address Telephone Fax
Email
1 Prof. Michael Power Section of Clinical and Health 44-131 651 3943 44-131 651 3971 mjpower@staffmail.ed.ac.uk
Psychology
University of Edinburgh, Medical School,
Teviot Place,
Edinburgh, EH8 9AG, UK
Ms. Kathryn Quinn
Mr Ken Laidlaw 44-131 651 3947 K.Laidlaw@ed.ac.uk

Dr. Hugh Toner 44-1334 652611 HughToner@fife-pct.scot.nhs.uk
Dr. Clare Atherton
Ms. Christine Watson
2 Prof. Suzanne Skevington WHO Field Centre for the Study of 44-1225-826826 44-1225-826381 S.M.Skevington@bath.ac.uk
Quality of Life
Department of Psychology
University of Bath
Claverton Down
Bath BA2 7AY
UK
Ms. Farah McCrate 44-1225-826826 pssfrm@bath.ac.uk
3 Dr. Reinhold Killian Department of Psychiatry 11 49-8221-962861 49-8221-9628160 reinhold.kilian@bkh-guenzburg.de

University of Ulm
BKH-Gunzburg
Ludwig-Heilmeyer Str. 2
89312 Gunzburg
Ms. Ines Winkler Klinik und Poliklinik fur Psychiatrie 49 341 972 4532 49-341-972-4539 wini@medizin.uni-leipzig.de
Mr Herbert Matschinger Johannisallee 20
Universitaet Leipzig
03417 Leipzig
Germany
47

Email
4. Dr. Ramona Lucas Institut Catala de L’Envelliment 34-93 4335030 34-93-433-5006 rlucas@envelliment.org
Sant Antoni Maria Claret, 171
08041 Barcelona
Dr. Rosa Monteserín EAP Sardenya 34 93 567 43 80 / / 567 43 95 direct rmonteserin@eapsardenya.net
Nadal Sardenya 466. 08025 Barcelona. 567 43 95 direct
Spain
Dr. Salvi Junca
Mr Oscar Garcia
5. Dr Klaus Martiny WHO Collaborating Centre 45 48 29 32 52 45-48-26-38-77 kmar@fa.dk

Psychiatric Research Unit
Fredericksborg General Hospital
DK-3400 Hillerod
Denmark
Prof. Per Bech 45 48 29 32 53 pebe@fa.dk
Ms. Gabriele Bech- 45 48 29 32 52 gabean@fa.dk
Andersen
6. Dr. Alain LePlege INSERM 33-1-49591978 33-1-45-21-2075 Alain.Leplege@wanadoo.fr

82 rue de General Leclerc
94276 Le Kremlin – Bicetre
France
7. Dr Eva Dragomirecka Prague Psychiatric Center 420-2-66-003142 420-2-66-003143 dragomirecka@pcp.lf3.cuni.cz

Psychiatric Demography unit
Ustavni 91
181 03 Praha 8 -Bohnice
Czech Republic
Ms. Pavla Selepova 420-2-66-003142 selepova@pcp.lf3.cuni.cz
8. Prof. Lajos Kullmann National institute for Medical 36-1-2008830 36-1-392-5044 kullmlaj@elender.hu
Rehabilitation kullmlaj@hu.inter.net
PO Box 1 l.kullmann@rehabint.hu
1528 Budapest 123
Hungary
Dr. Tibor Troznai 36-1-3612804
Dr. Cecilia Varju
48
Appendix V (cont.) PARTICIPATING CENTRES

Email
9. Dr. Mary Kalfoss Faculty of Nursing 47 22 98 63 41 47 22 98 63 50 Mary.Kalfoss@diakonova.no

Diakonova University mary.kalfoss@c2i.net
Linstowgate 5
0166 Oslo
Norway
Ms. Ann-Christine Fritzsonn 47 22 98 63 21 47 22 98 63 50 anne-
christine.fritzsonn@diakonova.no
Ms. Liv Halvorsrud 47 22 98 63 09 47 22 98 63 50 Liv.Halvorsrud@diakonova.no
Dr. Mardon Breimoen 47 22 98 63 36 47 22 98 63 50 Mardon.breimoen@diakonova.no
Mr Svein Alve 47 22 45 35 57 47 22 45 36 00 svein.alve@oks.hioslo.no
10. Prof. Anita Molzahn Faculty of Human and Social 250-721-7958 250-721-6231 amolzahn@uvic.ca
Development
University of Victoria
3800 Finnerty Road
Victoria V8W 2Y2
British Columbia
Canada
Ms. Janice Robinson 250-721-8050 janmarco@shaw.ca
11. Assoc. Graeme Hawthorne Australian Centre for Posttraumatic 61-39496-4931 61-39596-2830 graemeh@unimelb.edu.au
Prof. Health
Department of Psychiatry
University of Melbourne
Locked Bag 1
West Heidleberg
Victoria 3081 Australia
Prof. Helen Herrman St Vincent's Mental Health Service 613-9288-4751 613-9288-4802 HERRMAHE@svhm.org.au
The University of Melbourne
Department of Psychiatry
PO Box 2900, Fitzroy, Victoria 3065
Australia
49

Email
12. Mr Don Bushnell Health Services Research Associates 425-775-6565 Ext 425 775 6734 bushnell@hrainc.net
Inc. 206
6505 216th St SW, Suite 105
Mountlake Terrace
WA 98043 USA
Ms. Mona Martin 425-775-6565 Ext martin@hrainc.net
202
13. Dr. Gary Diamond Department of Behavioural Science 972-8-6472083 982-76-472932 gdiamond@bgumail.bgu.ac.il
Mr Yoram Ben Ya’acov and Social Work yoramb@bgumail.bgu.ac.il
Mrs Tal Narkiss-Guez Ben-Gurion Univeristy of the Negev tnarkiss@bgumail.bgu.ac.il
84105 Beer-Sheva
Israel
14. Dr Miyako Tazaki Department of Science 81-3-3260-4272 (ext. 81-3-3260-0322 tazaki@rs.kagu.sut.ac.jp

Science University of Tokyo 2373)
1-3, Kagurqzaka, Shinjuku-ku
162-8601 Tokyo, Japan
Dr Yoshinoro Ebihara Keiogiyuku University 81-3-3353-1211 ebby@mars.dti.ne.jp
Ms. Miwa Fujii Kwansai University 81-798-54-6847 81-798-51-0955 mfujii@kwansei.ac.jp
Ms. Emiko Hasegawa Seigakuin University 81-48-725-6191 81-48-781-6891 e_hasegawa@seigakuin-
univ.ac.jp
Dr Keiko Hatada Onomichi Hospital 81-95-856-1111 81-95-856-4755 K.HATADA.13@c8mnx.ne.jp
15. Dr Gudjon Magnusson Director 45-3917-1492 45-3917-1851 GMA@who.dk

Division of Technical Support 1
Reducing Disease Burden
WHO Regional Office for Europe
Scherfigsvej 8
2100 Copenhagen
Denmark
50

Email
16. Prof. Martin Eisemann Dept of Psychology 0047 77646279 0047 77645610 martine@psyk.uit.no
University of Tromsoe
N-9037 Tromsoe
Norway
Mr Bjorn Nygren Department of Nursing 46-90-786-5292 bjorn.nygren@nurs.umu.se

Umea University
SE-90187
Umea
Sweden
17. Prof. Ji-Qian Fang Department of Medical Statistics 86-20-873-30671 86-29-873-31605 fangjq@gzsums.edu.cn
School of Public Health
Sun Yat-Sen University of Medical
Science
74 Zhongshan Road II
510080 Guangzhou
China
Mr Hao Yuan-tao 86-20-873-30671 86-29-873-30446 yuantao_hao@hotmail.com
18. Dr. Jelena Ceremnych Scientific Department of Gerontology 370-2-628636 370-5-2123073 cereb@ktl.mii.lt
Problems
Institute of Experimental and Clinical
Medicine
Zygimantu 9
LT-2600 Vilnius
Lithuania
Prof. Algirdas Venalis
Ms. Natalija Daniliuk 370-5-2777726 370-5-2777745 natalijad@mail.lt
Ass.Prof. Vidmantas Alekna
Dr. Vaineta Valeikiene
51
Appendix V ADDITIONAL CENTRES

. Email
1. Prof. Kwok Fai Leung Hong Kong Project Team on 852-29586166 852-29586719 kfleung@ha.org.hk
Chinese Version of WHOQOL
Hong Kong Hospital Authority
C/O Dept of Occupational
Therapy
Queen Elizabeth Hospital
30 Gascoigne Road
Kowloon. Hong Kong
Prof. David Phillips 852-29586166 phillips@LN.edu.hk
Dr. Alfred Chan 852-29586166 ssmchan@1n.edu.hk
Dr. Cindy Lam 852-29586166 clklam@hku.hk
2. Dr. Marcelo Fleck Dept de Psiquiatria E 51-3316-8413 51-3330-8965 mfleck.voy@zaz.com.br

Medicina Legal
Universidade Federale Do Rio
Grande Do Sul
Rua Ramiro Barcelas, 2350 4
Andar Cedex
90035-003-Porte Alegre-RS
Brazil
Dr. Eduardo Chachamovich 51-3316-8413 echacha@ez-poa.com.br
Ms. Clarissa Trentini 51-3316-8413 CLARISSATRENTINI@aol.com
Dra. Neusa Sica de Rocha 51-3316-8413 neusa@sitesul.com.br
3. Professor Nicole von Steinbüchel Centre of +41 22 305 50 00 +41 22 305 50 44 Nicole.vonSteinbuchel@hcuge.ch
Neurogerontolopsychology nicole.vonsteinbuchel@pse.unige.ch
Clinic of Geriatric Psychiatriy,
University Hospitals of
Geneva, Belle-Idée
2 Chemin du Petit-Bel-Air,
1225 Chêne-Bourg
Switzerland
Ms Kerstin Weber +41 22 305 50 00 Kerstin.Weber@hcuge.ch
Ms Catia Beni +41 705 90 85 Catia.Beni@pse.unige.ch
Ms Parissa De Montenach +41 705 90 85 dparissa@yahoo.fr
52
Appendix V (contd.) ADDITIONAL CENTRES

. Email
4. Assoc. Erhan Eser Celal Bayar Univ. Tip Fak. 90-236-239-1319 90-236-237-6449 eseres@ttnet.net.tr
Prof. Halk Sagligi AD. Istasyon
Mevkii
45050, Manisa
Turkey
Assoc. Caner Fidaner 90-236-239-1319 fidaner@superonline.com
Prof.
Dr. Sultan Eser 90-236-239-1319 sultaneser@hotmail.com
5. Dr. Laura Schwartzmann Department of Medical 698-2622-2683 698-2622-2683 laura@mednet.org.uy

Psychology
Calabria 3969
Montevideo CP 11300
Uruguay
Ms Bettina Caporale 698-2622-2683 caporaleb@yahoo.com
Ms Adriana Suárez 698-2622-2683 routrade@internet.com.uy
6. Dr. Silke Schmidt Department of Medical 40-42803-6206 40-42803-4940 sischmid@uke.uni-hamburg.de

Psychology
Hamburg-Eppendorf Hospital
Martinistrasse 52
20246 Hamburg
Germany
53
Appendix VI
WHOQOL-OLD
Instructions
This questionnaire asks for your thoughts and feelings about certain aspects of your
quality of life and addresses issues that may be important to you as an older member of
society.
Please answer all the questions. If you are unsure about which response to give to a
question, please choose the one that appears most appropriate. This can often be your first
response.
Please keep in mind your standards, hopes, pleasures and concerns. We ask that you think
about your life in the last two weeks.
For example, thinking about the last two weeks, a question might ask:
How much do you worry about what the future might hold?
Not at all A little A moderate Very much An extreme

1 2 amount 4 amount
3 5
You should circle the number that best fits how much you have worried about the future
over the last two weeks. So you would circle the number 4 if you worried about your
future “Very much”, or circle number 1 if you have worried “Not at all” about your future.
Please read each question, assess your feelings, and circle the number on the scale for each
question that gives the best answer for you.
Thank you for your help
54
The following questions ask about how much you have experienced certain things in the last
two weeks, for example, freedom of choice and feelings of control in your life. If you have
experienced these things an extreme amount circle the number next to “An extreme
amount”. If you have not experienced these things at all, circle the number next to “Not at
all”. You should circle one of the numbers in between if you wish to indicate your answer
lies somewhere between “Not at all” and “Extremely”. Questions refer to the last two
weeks.
1. (F25.1) To what extent do impairments to your senses (e.g. hearing,

vision, taste, smell, touch) affect your daily life?
1 2 amount 4 amount
3 5
2. (F25.3) To what extent does loss of for example, hearing, vision, taste,
smell or touch affect your ability to participate in activities?
1 2 amount 4 amount
3 5
3. (F26.1) How much freedom do you have to make your own decisions?
1 2 amount 4 amount
3 5
4. (F26.2) To what extent do you feel in control of your future?

Not at all Slightly Moderately Very Extremely
1 2 3 4 5
5. (F26.4) How much do you feel that the people around you are respectful
of your freedom?
1 2 3 4 5
6. (F29.2) How concerned are you about the way in which you will die?
1 2 amount 4 amount
3 5
55
7. (F29.3) How much are you afraid of not being able to control your death?
1 2 3 4 5
8. (F29.4) How scared are you of dying?

1 2 3 4 5
9. (F29.5) How much do you fear being in pain before you die?
1 2 amount 4 amount
3 5
The following questions ask about how completely you experience or were able to do certain
things in the last two weeks, for example getting out as much as you would like to. If you
have been able to do these things completely, circle the number next to “Completely”. If
you have not been able to do these things at all, circle the number next to “Not at all”. You
should circle one of the numbers in between if you wish to indicate your answer lies
somewhere between “Not at all” and “Completely”. Questions refer to the last two weeks.
10. (F25.4) To what extent do problems with your sensory functioning (e.g.
hearing, vision, taste, smell, touch) affect your ability to interact with others?
Not at all A little Moderately Mostly Completely
1 2 3 4 5
11. (F26.3) To what extent are you able to do the things you’d like to do?
1 2 3 4 5
12. (F27.3) To what extent are you satisfied with your opportunities to
continue achieving in life?
1 2 3 4 5
56
13. (F27.4) How much do you feel that you have received the recognition you
deserve in life?
1 2 3 4 5
14. (F28.4) To what extent do you feel that you have enough to do each day?
1 2 3 4 5
The following questions ask you to say how satisfied, happy or good you have felt about
various aspects of your life over the last two weeks . For example, about your participation
in community life or your achievements in life. Decide how satisfied or dissatisfied you are
with each aspect of your life and circle the number that best fits how you feel about this.
Questions refer to the last two weeks.
15. (F27.5) How satisfied are you with what you have achieved in life?
Very dissatisfied Dissatisfied Neither satisfied Satisfied Very satisfied
1 2 nor dissatisfied 4 5
3
16. (F28.1) How satisfied are you with the way you use your time?
3
17. (F28.2) How satisfied are you with your level of activity?
3
18. (F28.7) How satisfied are you with your opportunity to participate in
community activities?
3
57
19. (F27.1) How happy are you with the things you are able to look forward
to?
Very unhappy Unhappy Neither happy Happy Very happy
1 2 nor unhappy 4 5
3
20. (F25.2) How would you rate your sensory functioning (e.g. hearing, vision,
taste, smell, touch)?
Very poor Poor Neither poor nor Good Very good
1 2 good 4 5
3
The following questions refer to any intimate relationships that you may have. Please consider
these questions with reference to a close partner or other close person with whom you can
share intimacy more than with any other person in your life.
21. (F30.2) To what extent do you feel a sense of companionship in your life?
1 2 amount 4 amount
3 5
22. (F30.3) To what extent do you experience love in your life?

1 2 amount 4 amount
3 5
23. (F30.4) To what extent do you have opportunities to love?

1 2 3 4 5
24. (F30.7) To what extent do you have opportunities to be loved?

1 2 3 4 5
Do you have any comments about the questionnaire?
THANK YOU FOR YOUR HELP
58
WHOQOL-OLD (BREF FORMAT)
Instructions
This questionnaire asks for your thoughts and feelings about certain aspects of your quality of life and
addresses issues that may be important to you as an older member of society.
Please answer all the questions. If you are unsure about which response to give to a question, please
choose the one that appears most appropriate. This can often be your first response.
Please keep in mind your standards, hopes, pleasures and concerns. We ask that you think about your
life in the last two weeks.
For example, thinking about the last two weeks, a question might ask:
How much do you worry about what the future might hold?

amount amount
1 2 3 4 5
You should circle the number that best fits how much you have worried about the future over the last
two weeks. So you would circle the number 4 if you worried about your future “Very much”, or circle
number 1 if you have worried “Not at all” about your future. Please read each question, assess your
feelings, and circle the number on the scale for each question that gives the best answer for you.
Thank you for your help

The following questions ask about how much you have experienced certain things in the last two weeks.

amount amount
1 To what extent do impairments to your 1 2 3 4 5
(F25.1) senses (e.g. hearing, vision, taste, smell,
touch) affect your daily life?
2 To what extent does loss of, for example, 1 2 3 4 5
(F25.3) hearing, vision, taste, smell or touch affect
your ability to participate in activities?
3 How much freedom do you have to make 1 2 3 4 5
(F26.1) your own decisions?
Not at all Slightly Moderately Very much Extremely

4 To what extent do you feel in control of 1 2 3 4 5
(F26.2) your future?
5 How much do you feel that the people 1 2 3 4 5
(F26.4) around you are respectful of your freedom?

amount amount
6 How concerned are you about the way in 1 2 3 4 5
(F29.2) which you will die?
Not at all Slightly Moderately Very much Extremely

7 How much are you afraid of not being able 1 2 3 4 5
(F29.3) to control your death?
8 How scared are you of dying? 1 2 3 4 5
(F29.4)

amount amount
9 How much do you fear being in pain before 1 2 3 4 5
(F29.5) you die?
The following questions ask about how completely you experience or were able to do certain things in the last two weeks.

10 To what extent do problems with your 1 2 3 4 5
(F25.4) sensory functioning (e.g. hearing, vision,
taste, smell, touch) affect your ability to
interact with others?
11 To what extent are you able to do the things 1 2 3 4 5
(F26.3) you’d like to do?
12 To what extent are you satisfied with your 1 2 3 4 5
(F27.3) opportunities to continue achieving in life?
13 How much do you feel that you have 1 2 3 4 5
(F27.4) received the recognition you deserve in life?
14 To what extent do you feel that you have 1 2 3 4 5
(F28.4) enough to do each day?
The following questions ask you to say how satisfied, happy or good you have felt about various aspects of your life over the last
two weeks.
Very Dissatisfied Neither Satisfied Very

dissatisfied satisfied nor satisfied
dissatisfied
15 How satisfied are you with what you have 1 2 3 4 5
(F27.5) achieved in life?
16 How satisfied are you with the way you use 1 2 3 4 5
(F28.1) your time?
17 How satisfied are you with your level of 1 2 3 4 5
(F28.2) activity?
18 How satisfied are you with your opportunity 1 2 3 4 5
(F28.7) to participate in community activities?
Very Unhappy Neither Happy Very happy

unhappy happy nor
unhappy
19 How happy are you with the things you are 1 2 3 4 5
(F27.1) able to look forward to?
Very poor Poor Neither poor Good Very good

nor good
20 How would you rate your sensory 1 2 3 4 5
(F25.2) functioning (e.g. hearing, vision, taste,
smell, touch)?
The following question refer to any intimate relationships that you may have. Please consider these questions with reference to a
close partner or other close person with whom you can share intimacy more than with any other person in your life.

amount amount
21 To what extent do you feel a sense of 1 2 3 4 5
(F30.2) companionship in your life?
22 To what extent do you experience love in
(F30.3) your life?

23 To what extent do you have opportunities to 1 2 3 4 5
(F30.4) love?
24 To what extent do you have opportunities to
(F30.7) be loved?
Do you have any comments about the questionnaire?
THANK YOU FOR YOUR HELP

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WHOQOL-OLD

WORLD HEALTH ORGANIZATION

EUROPEAN OFFICE (COPENHAGEN)

Further information can be obtained from:

Professor Mick Power

Table 1 Centres included in development of the WHOQOL-OLD module

Centre Country Pilot study (n) Field trial (n)

The WHOQOL-OLD project

Development of the WHOQOL-OLD module

Table 2 General description (sample sizes, selected sociodemographic characteristics) of the

Centre Sample size Age Gender Health status

Table 3 General description (sample sizes, selected sociodemographic characteristics) of the

Centre Sample size Age Gender Health status

Table 4 WHOQOL-OLD Field Trial measures by centre

Centres WHOQOL modules EAAQ GDS SF-12

Summary of results of questionnaire development

Group 1998-a) in which a simultaneous approach to instrument development is employ-

The final version of the WHOQOL-OLD module

to either the WHOQOL-100 or the WHOQOL-BREF, whichever is the most appropria-

Description of the instrument

The WHOQOL-OLD module consists of 24 Likert-scaled items assigned to six facets:

Table 5 Items included in the facets of the WHOQOL-OLD module

Abbr. ∑ items Items of facets Possible range of raw score

Facet Abbr. Concept / content

Table 7 Scoring list for the WHOQOL-OLD module

Sensory Abilities (SAB) old_01* old_02* old_10* old_20

Note: * Reverse-scored items.

Scale description and internal consistency

Cronbach’s alpha as a measure of internal consistency reached satisfactory values with

M SD Floor Ceiling Skewness α

Facet SAB AUT PPF SOP DAD INT QoL

GDS SF-12 SF-12

Death and Dying - .291 - .048 .005

WHOQOL-BREF SAB AUT PPF SOP DAD INT QoL

Discriminant Group Validity

Facet differences according to a range of subgroups are displayed in Figures 1 and 2. In

WHOQOL-OLD module facet scores (M, SD) by agegroup

WHOQOL-OLD module facet scores (M, SD) by health status

How to use the questionnaire

Upon completion, comprehensiveness of questionnaire completion should be checked

Administration – suggested uses

AI Final set of items for WHOQOL-OLD Module

AI Final set of items for WHOQOL-OLD Module

Table A1 Final set of items for the WHOQOL-OLD module

Facet I Sensory Abilities (OLD-SAB)

OLD-01 Impairments to senses affect daily life

Facet II Autonomy (OLD-AUT)

OLD-03 Freedom to make own decisions

Facet III Past, Present and Future Activities (OLD-PPF)

OLD-12 Satisfied with opportunities to continue achieving

Facet IV Social Participation (OLD-SOP)

OLD-14 Have enough to do each day

Facet V Death and Dying (OLD-DAD)

OLD-06 Concerned about the way you will die

Facet VI Intimacy (OLD-INT)

OLD-21 Feel a sense of companionship in life

A II Method for converting individual raw scores to transformed scores

RTS STS TTS RTS STS TTS RTS STS TTS

RFS SFS TFS RFS SFS TFS RFS SFS TFS

A III SPSS syntax file

old_01 old_02 old_03 old_04

old_01 old_02 old_06

COMPUTE old_sa_s = (SUM.4(old_01,old_02,old_10,old_20)).