R e s e a r c h r e p o r t What is already known on this subject < Increasing numbers of older people, higher expectations for ‘a good life’, and demands for health and social care, have led to international interest in the enhancement, and measurement, of quality of life (QoL) in older age. < QoL is a subjective concept, yet most measures of QoL are based primarily or partly on ‘expert’ opinions. What this study adds < This study focuses on the testing of a new measure of QoL, the Older People’s QoL Questionnaire (OPQOL), which was derived entirely from the views of older people in Britain, cross-checked against theoretical models for comprehensive- ness. < The OPQOL performed well in three samples of older people in Britain, one of which comprised people from ethnic minority groups. It is of potential value in the outcome assessment of health and social interventions, which can have a multidimen- sional impact on people’s lives. economically disadvantaged than the wider population.15 Further research is needed to examine whether differences in QoL reﬂect real variations, methodology, and cultural variations in expecta- tions or in reporting. Ethnic minority groups in Britain live in a wide range of different communities, and their diversity may also have affected responses in some way. Hence, variations in QoL by ethnic group requires caution in interpretation. It should also be noted that the standard question for ethnic status used, largely reﬂected Britain’s New Commonwealth groups, and may not be appropriate for use in other countries. The OPQOL performed well in psychometric tests of reli- ability and validity. Multiple regression models supported its validity and underlying constructs. Despite the Ethnibus sample’s consistently worse QoL scores, compared with the other samples, the CASP-19 and WHOQOL- OLD did not meet all criteria for internal consistency (reliability) in the ethnically diverse Ethnibus sample. The CASP-19 and WHOQOL-OLD also had relatively large numbers of items that failed to meet the reliability criterion for item‑total scale corre- lations; they frequently failed correlation tests for validity in the Ethnibus sample. This may have been due to this sample’s ethnic diversity, or because the CASP-19 and WHOQOL-OLD were not sufﬁciently sensitive. Health and social care interventions can have a multifaceted impact on people’s lives. The OPQOL is of potential value in descriptive and evaluative research. This research supports the use of the OPQOL in older populations in Britain. It awaits testing in other countries, and with different ethnic minority population groups. The OPQOL is currently being tested with older people living in Italy; initial results for cultural equivalence and understanding are positive (personal communication, Dr Claudio Bilotta, University of Milan). Acknowledgements Thanks are due to ONS Omnibus Survey and Ethnibus staff for mounting the Quality of Life and Active Ageing modules, and processing the data. Material from the ONS Omnibus Survey, made available through ONS, has been used with the permission of the Controller of The Stationery Ofﬁce. I also thank Professor Steve Iliffe, Ms Kalpa Karachi, and Ethnifocus for organising focus groups to comment on the OPQOL questionnaire, members of the study advisory group, and Ms Corinne Ward for her administration of the QoL follow-up survey and data processing. Members of ONS Omnibus and Ethnibus who carried out the original analysis and collection of the data hold no responsibility for the further analysis and interpretation of them. Funding The study was funded by the UK cross-research council New Dynamics of Ageing Programme; we are grateful for their support: New Dynamics of Ageing Research Programme; grant reference number: RES-352-25-0001. The sponsors played no role in the design, execution, analysis, interpretation and writing of the study. Competing interests None. Ethics approval This study was conducted with the approval of the University College London Research Ethics Committee. Contributors AB was PI of the grant, managed the study, conducted the statistics and wrote the ﬁrst and ﬁnal draft of this paper in collaboration with PS, coapplicant and coauthor. Provenance and peer review Not commissioned; externally peer reviewed. REFERENCES World Health Organization. Active ageing. A policy framework. Geneva: WHO, 2002. http://www.who.int/hpr/ageing/ActiveAgeingPolicyFrame.pdf (accessed Apr 2010). Lawton MP. Competence, environmental press and adaptation of older people. In: Lawton MP, Windley PG, Byerts TO, eds. Aging and environment. Theoretical approaches. New York: Springer, 1982:33e59. Lawton MP. Environment and other determinants of well-being in older people. Gerontologist 1983;23:349e57. Lawton MP. The varieties of well-being. Exp Aging Res 1983;9:65e72. Lawton MP. Background. A multidimensional view of quality of life in frail elders. In: Birren JE, Lubben J, Rowe J, et al, eds. The concept and measurement of quality of life in the frail elderly. San Diego: Academic Press, 1991:4e27. Lawton MP. Quality of life and affect in later life. In: Magai C, McFadden SH, eds. Handbook of emotion, human development, and aging. San Diego: CA Academic Press, 1996. 327e48. Bowling A. Ageing well. Quality of life in old age. Maidenhead: Open University Press, 2005. Bowling A, Bannister D, Sutton S, et al. A multidimensional model of QoL in older age. Ageing Ment Health 2002;6:355e71. Bowling A, Gabriel Z. An integrational model of quality of life in older age. A comparison of analytic and lay models of quality of life. Soc Indic Res 2004;69:1e36. Gabriel Z, Bowling A. Perspectives on quality of life in older age: older people talking. Ageing Soc 2004;24:675e91. Hyde M, Wiggins RD, Higgs P, et al. A measure of quality of life in early old age: the theory, development and properties of a needs satisfaction model (CASP-19). Ageing Ment Health 2003;7:186e94. Power M, Harper A, Bullinger M. the WHO Quality of Life Group. The World health Organisation WHOQOL-100: tests of the universality of quality of life in 15 different cultural groups worldwide. Health Psychol 1999;18:495e505. Power M, Quinn K, Schmidt S, WHOQOL-OLD Group. Development of WHOQOL- OLD module. Qual Life Res 2005;14:2197e214. Hagerty MR, Cummins RA, Ferriss AL, et al. Quality of life indexes for national policy: review and agenda for research. Soc Indic Res 2001;55:1096. Nazroo J, Bajekal M, Blane D, et al. Ethnic inequalities. In:Walker A, Hennesy CH eds. Growing older. Quality of life in old age. Maidenhead: Open University Press, 2004:35e59. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 280 J Epidemiol Community Health 2011;65:273e280. doi:10.1136/jech.2009.087668