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岁以上的老年人占总人口的17%，而且这一比例还将继续上升。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。本研究旨在探讨老年痴呆症患者的生活质量及其综合指标，并通过对老年痴呆症患者临床资料的分析，探讨老年痴呆症患者生活质量的综合指标。我们根据反映病人在病房中的日常生活态度和行为方式的临床资料，对病人的客观生活质量进行了研究。我们设计了三套被认为是密切相关的测量项目。第一组包括9个关于生活质量的项目，第二组包括9个关于日常生活活动能力的项目，第三组包括痴呆量表中的一个评估智力水平的项目，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。结果从医学的角度进行解释，并提出了新的发现的项目的相关结构。在此基础上，我们构建了一些衡量生命质量的指标，为评估、非医疗护理和医学研究提供参考。此外，治疗方法的评价与生活质量研究密切相关。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.