Beyond disease, the role of patient-reported outcomes in aging research

Abstract

Health has traditionally been measured by the presence or absence of disease. However, global initiatives, such as those from the World Health Organization (WHO), emphasize that health also includes functionality, capacity, well-being, and quality of life. Patient-reported outcomes (PROs) capture these dimensions directly from older adults and provide insights that complement clinical and biological markers. Initiatives such as Patient-Centered Outcomes Research Institute similarly promote PROs as core research outcomes. This perspective highlights the role of PROs in geriatric and aging research and presents a conceptual framework linking social determinants, disease burden, and patient-reported health in predicting outcomes. We outline priority research questions, identifying relevant international data sets, and discuss methodological approaches, including nested survival models, event-anchored mixed-effect models, and measurement invariance testing, to study how PROs evolve across populations and over time. Advancing these approaches may help move aging research toward a more holistic, patient-centered model of health.