Translation, cross-cultural adaptation, and psychometric validation of the WHOQOL-AGE in a Greek older adult population

Introduction. The reliable and valid assessment of quality of life (QoL) in older
adults is essential for clinical practice and public health research. The WHOQOL-
AGE, a brief 13-item instrument developed under the auspices of the World Health
Organization for older populations, has not previously been translated and validated in
Greek. This study aimed to translate, culturally adapt, and evaluate the psychometric
properties of the Greek version of the WHOQOL-AGE.
Methods. Cross-cultural adaptation followed the Beaton et al. protocol. The adapted
instrument was administered to 250 older adults recruited from a secondary hospital
in Greece (Mean age = 77.58 years, SD = 7.04, range 64–89; 63.6% women).
Convergent validity was assessed through concurrent administration of the
WHOQOL-BREF, while test-retest reliability was evaluated in a subsample of 40
participants after two weeks. Analyses included confirmatory factor analysis (CFA),
Cronbach’s α, McDonald’s ω, corrected item-total correlations, intraclass correlation
coefficients ICC (2,1), and floor/ceiling effects.
Results. CFA confirmed the original two-factor structure with excellent fit: χ²(64) =
66.61, p = .387; CFI = .998; TLI = .998; RMSEA = .013; SRMR within acceptable
limits. Standardized factor loadings ranged from .66 to .77 (p < .001), and the inter-
factor correlation was r = .54. Internal consistency was high for Factor 1, Factor 2,
and the total scale (α = .87, .85, and .90; ω = .87, .85, and .93, respectively). Test-
retest reliability was excellent (ICC = .90–.94), and no relevant floor or ceiling effects
were observed. Convergent validity was supported by significant correlations with
WHOQOL-BREF domains (r = .50–.79).
Conclusions. The Greek WHOQOL-AGE preserves the original two-factor structure
and demonstrates strong psychometric properties. It is suitable for assessing health-
related QoL among older adults in Greek clinical and research settings.