Utilizing the International Classification of Functioning, Disability and Health to Describe Quality-of-Life Assessment in Older Adults in a Middle-Income Country

BACKGROUND AND PURPOSE: The global aging population is rapidly increasing, prompting the United Nations to declare the "Decade of Healthy Aging" (2021-2030) to improve the quality of life for older adults. Health-related quality of life (HRQoL) is crucial in this context, and the International Classification of Functioning, Disability and Health (ICF) provides a standardized framework for its evaluation. This study aimed to apply a previously proposed method for converting SF-36 domain scores into ICF qualifiers in community-dwelling older adults attending primary care services in a middle-income country, describing the resulting classification of functioning domains using standardized ICF qualifiers. METHODS: A cross-sectional study was conducted with older adults aged 60 and above who accessed primary healthcare services and had no cognitive impairment. Participants underwent HRQoL assessment using the SF-36, and ICF codes previously linked to SF-36 domains were classified using ICF qualifiers. A simple calculation method was developed to convert SF-36 scores into ICF qualifiers. RESULTS: The study included 52 participants, with a mean age of 71.6 ± 7.0 years, 92.3% of whom were women. The ICF framework qualified 27 codes from SF-36 domains. Moderate impairments were observed in "Bodily Pain," "General Health," and "Vitality" domains, while "Physical Functioning," "Social Functioning," and "Mental Health" domains showed mild impairments. No impairments were noted in the "Role Physical" and "Role Emotional" domains. DISCUSSION: The application of ICF qualifiers to SF-36 domain scores yielded standardized classifications of HRQoL domains across the ICF framework, allowing HRQoL outcomes to be described according to the severity levels defined by the ICF qualifier scale.