Measurement of the Quality of Life of Elderly People and Construction of Summary QOL Indices

日本社会正在迅速老龄化。1999年，65岁以上人口占总人口的17%，这一比例还将继续增加。如何保持或提高老年人的生活质量是一个亟待解决的问题。我们的目标是衡量生活质量，并制定综合指标来表示它。本文通过分析某病房的临床资料，探讨老年痴呆患者生活质量的表征结构。客观的生活质量是根据临床资料来确定的，这些资料反映了患者在病房的日常生活态度和行为方式。我们设计了三组测量项目，它们被认为是彼此密切相关的。第一组包括关于生活质量的9个项目，第二组是关于日常生活活动（ADL）的9个项目，第三组是评估痴呆量表智力水平的单一项目。对数据进行多变量分析，得到19个项目的空间结构和聚类结构。从医学的角度对结果进行了解释，并对项目的相关结构提出了新的发现。在此基础上，我们构建了一些评价生活质量的指标，为评价、非医疗护理和医学研究提供依据。此外，治疗方法的评估与生活质量的研究密切相关。最后，我们讨论了本研究的意义和局限性，并检验了本研究的效度和信度。

The Japanese society is aging rapidly. People of ages over 65 years shares 17 percent of the total population in 1999 and the share will increase. It is a serious problem how to keep or improve the quality of life (QOL) of elderly people. We aim to measure the QOL and develop composite indices to represent it.For the purpose we investigate structures to represent the QOL of old demented patients by analyzing clinical data obtained in a ward. We deal with the objective QOL on the basis of clinical data which indicate the attitudes and ways of behavior in their daily life in the ward. We design three sets of measurement items which are considered closely related to one other. The first set consists of nine items about QOL, the second of nine items about the activities of daily living (ADL), and the third of a single item to assess the intellectual level on a dementia scale.Multivariate analysis is performed for the data, and thus the spatial and the cluster structures of the nineteen items are obtained. The results are interpreted from a medical point of view, and new findings are presented on the correlated structure of the items. On the basis of those findings, we construct some indices to comprehend the QOL, which will serve for assessment, non-medical care and medical study. Furthermore, evaluation of therapeutic approaches are provided in a close connection with the QOL research. Lastly, we discuss the significance and the limitations of our findings, and examine the validity and the reliability of our study.