Older women prioritize quality of life over living longer, study shows

Women over 50 are putting quality of life ahead of living longer - according to research from the University of East Anglia (UEA) and University College London (UCL).

A survey of more than 6,000 over 50s reveals that older women are taking a 'life's for living' approach, placing more value on quality of life than adding extra years.

Men on the other hand, were found to be more likely to prioritize living longer.

The results are part of a wider analysis of older people's views on healthcare and ageing, published today.

The study also found that women are more likely more likely to challenge doctors than their male counterparts. But older people overall are increasingly willing to leave medical decisions in the hands of professionals.

How the research happened

Researchers analyzed responses from more than 6,000 over 50s as part of the English Longitudinal Study of Ageing (ELSA) - a longstanding survey led by UCL with fieldwork by the National Centre for Social Research.

They explored six key areas - risk-taking, future planning, quality versus length of life, body function versus appearance, willingness to try experimental treatments, and whether treatment decisions should be left to doctors.

One of the study's most notable findings was the divide between men and women.

The healthcare gender divide

Women were significantly more likely to prioritize quality of life over length of life and less likely to want doctors to make healthcare decisions on their behalf. They were also more cautious about risks and less willing to try experimental treatments.

Men, meanwhile, were more likely to hand decision-making power to medical professionals and were less likely to put quality of life ahead of simply living longer."

Prof. Nicholas Steel, UEA's Norwich Medical School

Age played a major role

"People aged 75 and over were more likely to avoid risks, reject experimental treatments and leave healthcare decisions to their doctor than those in their 50s and early 60s," said Prof Steel.

"We also found that older participants were more likely to prioritize how well their body functions rather than how it looks.

"But perhaps the most surprising finding was just how varied people's views were," he added.

No one-size-fits-all

Their wider findings suggest that when it comes to healthcare, there is no such thing as a "typical" older patient.

Instead, people hold strikingly different views on everything from taking risks and trying experimental treatments to whether they would rather enjoy a better quality of life or simply live for longer.

Responses were spread across the full range of options for many of the questions asked, showing there is no one-size-fits-all approach to healthcare preferences.

The research comes amid a growing push for "shared decision-making" in the NHS, which encourages doctors and patients to work together when choosing treatments.

Prof Paola Zaninotto, Professor of Statistics & Epidemiology at UCL, co-author of the study and Deputy Director of ELSA, said: "One of the clearest messages from this study is that there is no such thing as a 'typical' older person when it comes to healthcare preferences.

"While we found some broad differences by age, sex and education, people's views varied enormously. That is why it is so important for healthcare professionals to have conversations with patients about what matters most to them, rather than making assumptions."

The power of education

The team also found that those with fewer educational opportunities were more likely to leave treatment decisions to their doctors.

Co-author Dr Oby Enwo, also from UEA's Norwich Medical School, said: "To me, this highlights the need to explore how we can ensure shared decision-making reaches everyone equally.

"Working with ELSA data has been a privilege because thousands of older adults have given up their time to make research like this possible. I hope our findings emphasize the importance of treating every consultation as a conversation on what matters most to each person."

Understanding personal priorities

The research team say the findings could help clinicians have better conversations with patients, particularly during short appointments where understanding personal priorities can be challenging.

But they caution that demographic trends should never be used as a substitute for asking individual patients what matters to them.

Prof Steel said: "While age, sex and education can offer useful clues about healthcare preferences, every patient's wishes remain unique. Understanding those preferences more quickly could improve both patient satisfaction and health outcomes.

"This work provides a valuable starting point for more personalized care as Britain's population continues to age and healthcare decisions become increasingly complex."

This research was a collaboration between UEA, UCL, the University of Manchester, and the Institute for Fiscal Studies.

'General healthcare preferences for people aged 50 and over in England: English Longitudinal Study of Ageing' is published in the journal PLOS One.