This observational study validated the Quality of Dying Index in 2,705 decedents aged 80 and older, suggesting its utility in end-of-life care assessment.
With population aging accelerating, ensuring high-quality end-of-life care for older adults is urgent. This study developed and validated the Quality of Dying Index (QODI) for adults aged 80-105 using data from 2,705 decedents in the 2022 Chinese Longitudinal Healthy Longevity Survey. The 23-item QODI includes three subdomains: activities of daily living, cognitive functioning, and hospitalizations. Internal consistency was high (Cronbach's α ≥ 0.90), and convergent and divergent validity were supported by significant correlations with related constructs. Known-group validity was confirmed, and concurrent validity was demonstrated with AUC ≥ 0.70 across subdomains. Findings were consistent across age and sex subgroups. The QODI is a reliable, multidimensional tool for assessing the quality of dying in advanced old age, offering insights to inform hospice planning and end-of-life services. Developed and initially validated in a Chinese cohort, the index has uncertain external validity to other countries and cultural groups, and cross-national validation is warranted.
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Zhu et al. (2025) studied this question.
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