ArticleQuality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation2026
Assessing the dimensionality of the EQ-HWB-25 alongside EQ-5D-5L, QOL-ACC and ASCOT in an older adult population.
Article in Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeSeveral instruments assess different aspects of quality of life (QoL), the EQ-HWB is developed to capture broader health and wellbeing constructs. Established QoL measures such as the EQ-5D-5L, QOL-ACC, and ASCOT are widely used in older populations. Analysing dimensionality across these instruments can provide insight into the constructs they cover and their conceptual relationships. This study aimed to examine the dimensionality of the EQ-HWB both on its own and alongside pooled items from these measures, to identify its underlying structure and the extent of item overlap.
methodsAnalysis was conducted using data from 453 participants aged 65 years and above who completed all four instruments. Exploratory Factor Analysis (EFA) was conducted to identify the underlying factor structure. Factors were selected based on eigenvalues greater than one and scree plots. A correlation cut-off of 0.32 was applied to determine item loading on a given factor. Both oblique and orthogonal rotations were explored. EFA was conducted separately for the EQ-HWB and each instrument, as well as for the pooled items from all instruments.
resultsEFAs conducted separately for the EQ-HWB, and each instrument resulted in a 4-factor structure. However, EFA of all pooled items showed that the 5-factor structure provided a better model fit. The five factors identified were: emotional functioning, self-care and usual activities, leisure and enjoyment, cognition and senses, and pain.
conclusionThis study provides evidence on the dimensions of QoL captured by a select pool of health focused and broader QoL instruments in an older adult population. The results enhance understanding of the conceptual coverage of the EQ-HWB relative to other QoL measures.
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