It could be worselot's worse!' why healthrelated quality of life is better in older compared with younger individuals with heart failure

Debra K. Moser, Seongkum Heo, Kyoung Suk Lee, Muna Hammash, Barbara Riegel, Terry A. Lennie, Cynthia Arslanian-Engoren, Gia Mudd-Martin, Nancy Albert, John Watkins

Research output: Contribution to journalArticlepeer-review

52 Scopus citations


Background: health-related quality of life (HRQOL) is markedly impaired in patients with heart failure (HF). Despite worse prognosis and physical status, older patients have better HRQOL than younger patients. Objective: to determine reasons for differences in HRQOL in older compared with younger HF patients. Methods: a mixed methods approach was used. HRQOL was assessed using the Minnesota Living with HF Questionnaire and compared among HF patients (n = 603) in four age groups (≤53, 54-62, 63-70 and ≥71 years). Socio-demographic/clinical and psychological factors related to HRQOL were determined in four groups using multiple regressions. Patients (n = 20) described their views of HRQOL during semi-structured interviews. Results: HRQOL was worse in the youngest group, and best in the two oldest groups. The youngest group reported higher levels of depression and anxiety than the oldest group. Anxiety, depression and functional capacity predicted HRQOL in all age groups. Qualitatively, patients in all age groups acknowledged the negative impact of HF on HRQOL; nonetheless older patients reported that their HRQOL exceeded their expectations for their age. Younger patients bemoaned the loss of activities and roles, and reported their HRQOL as poor. Conclusions: better HRQOL among older HF patients is the result, in part, of better psychosocial status. The major factor driving better HRQOL among older patients is a change with advancing age in expectations about what constitutes good HRQOL.

Original languageEnglish
Article numberaft078
Pages (from-to)626-632
Number of pages7
JournalAge and Ageing
Issue number5
StatePublished - Sep 2013

Bibliographical note

Funding Information:
This work was supported by the National Institutes of Health, National Institute of Nursing Research (R01 NR008567 to D.K.M., P20NR010679 to D.K.M). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Nursing Research or the National Institutes of Health. Financial sponsors played no role in the design, execution, analysis and interpretation of data or writing of the study.


  • Anxiety
  • Depression
  • Health-related quality of life
  • Older adults
  • Older people

ASJC Scopus subject areas

  • Aging
  • Geriatrics and Gerontology


Dive into the research topics of 'It could be worselot's worse!' why healthrelated quality of life is better in older compared with younger individuals with heart failure'. Together they form a unique fingerprint.

Cite this