What do middle-aged and older people consider important dimensions of quality of life in later adulthood? Insights from a vignette experiment in the Netherlands

Abstract Despite consensus that quality of life (QoL) in later adulthood is multi-dimensional, scholars’ perceptions of the dimensions the construct comprises differ. Under the premise that models and measures of QoL should correspond with lay perspectives to have relevance to the targeted population, we investigated the constituents of QoL in later adulthood as perceived by middle-aged and older laypersons. We fielded a factorial design vignette experiment among 2,544 respondents aged 50+ participating in the Dutch Longitudinal Internet studies for the Social Sciences panel to assess how 11 dimensions identified from four established QoL instruments designed for older people (WHOQOL-OLD, CASP-19, OPQOL, ICECAP-O) influence QoL evaluations. The study extends prior work on lay perspectives on QoL by combining the internal validity of an experiment with the external validity of a true population sample. All dimensions considered significantly impacted the QoL ratings in the expected direction. Enjoyment and social participation had a significantly larger contribution than the other dimensions. Models stratified by age group showed a strong degree of similarity, suggesting a high level of consensus across age groups about the constituents of QoL in later adulthood. The study highlights the necessity of capturing a broad range of dimensions when conceptualizing QoL in later adulthood. Our finding that dimensions that were omitted in selected established instruments still contributed substantially to QoL evaluations arguably implies that these instruments may have suboptimal content validity. The insights gained from this study are important for developing and evaluating policies aimed at improving QoL for the ageing population.