• Anne van der Vorst, ZijlstraG A RixtGARDepartment of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200, MD, Maastricht, the Netherlands., Nico De Witte, Ruth G M Vogel, ScholsJos M G AJMGADepartment of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200, MD, Maastricht, the Netherlands.Department of Family Medicine, Care and Public Health Research Instit, KempenGertrudis I J MGIJMDepartment of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200, MD, Maastricht, the Netherlands., and D-SCOPE Consortium.
• Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200, MD, Maastricht, the Netherlands. a.vandervorst@maastrichtuniversity.nl.
• BMC Geriatr. 2017 Oct 26; 17 (1): 251.

BackgroundMost research on multidimensional frailty focuses on deficits and risks of adverse outcomes. However, although some frail older people report a low quality of life (QoL), others still report a relatively high QoL. More knowledge about these discrepancies might give new insight into developing frailty prevention strategies. Therefore, this mixed-method study aimed (a) to identify characteristics related to QoL among frail older people; and (b) to explain discrepancies between higher and lower levels of QoL, with a specific interest in identifying strengths frail older people with a higher QoL still have.MethodsSemi-structured interviews were held with community-dwelling, frail older people with higher (n = 16) and lower levels of QoL (n = 18). Frailty was assessed with the Comprehensive Frailty Assessment Instrument, which measures environmental, physical, psychological, and social frailty. Other quantitative measures included socio-demographic characteristics, overall QoL, meaning in life, and mastery. The qualitative part focused on the meaning and maintenance of QoL (among other factors), despite being frail. Possible explanations for discrepancies in QoL were explored.ResultsFrail older people with a higher QoL were older, had lower levels of psychological frailty, and reported higher meaning in life compared to those with a lower QoL. Outcomes of qualitative analysis showed that participants in the high QoL subgroup adapted more effectively to difficulties, had more things in prospect, performed more activities, and were more satisfied with their social network compared to the low QoL subgroup.ConclusionThis exploratory study suggests possibilities to promote and improve QoL by strengthening specific resources among frail older people.

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