Health-related quality of life in elderly, multimorbid individuals with and without depression and/or mild cognitive impairment using a telemonitoring application

Predictors of poor health-related quality of life among people living with HIV aged ≥60 years in the PISCIS cohort: Findings from the Vive+ project

INTRODUCTION

Advancements in and accessibility to effective antiretroviral therapy has improved the life expectancy of people living with HIV, increasing the proportion of people living with HIV reaching older age (≥60 years), making this population's health-related quality of life (HRQoL) more relevant. Our aim was to identify the determinants of poor HRQoL in people living with HIV aged ≥60 years and compare them with those of their younger counterparts.

METHODS

We used data from the 'Vive+' study, a cross-sectional survey conducted between October 2019 and March 2020, nested within the PISCIS cohort of people living with HIV in Catalonia and the Balearic Islands, Spain. We used the 12-item short-form survey (SF-12), divided into a physical component summary (PCS) and a mental component summary (MCS), to evaluate HRQoL. We used the least absolute shrinkage and selection operator for variable selection and used multivariable regression models to identify predictors.

RESULTS

Of the 1060 people living with HIV (78.6% males) who participated in the study, 209 (19.7%) were aged ≥60 years. When comparing older people living with HIV (≥60 years) and their younger counterparts, older people exhibited a worse PCS (median 51.3 [interquartile range {IQR} 46.0-58.1] vs. 46.43 [IQR 42.5-52.7], p < 0.001) but a similar MCS (median 56.0 [IQR 49.34-64.7] vs. 57.0 [IQR 48.9-66.3], p = 0.476). In the multivariable analysis, cognitive function correlated with a PCS (β correlation factor [β] -0.18, p = 0.014), and depressive symptoms and satisfaction with social role correlated with an MCS (β 0.61 and β -0.97, respectively, p < 0.001) in people living with HIV aged ≥60 years.

CONCLUSION

Depressive symptoms, poor cognitive function, and lower satisfaction with social roles predict poorer HRQoL in older people living with HIV. These factors need to be considered when designing targeted interventions.

Older Adults' Quality of Life in Long-Term Care: A Cross-Sectional Comparison Before and During the COVID-19 Pandemic

This study aims to assess changes in long-term care (LTC) residents' quality of life (QoL) before and during the COVID-19 pandemic. A pre-test post-test study of 49 QoL measures, across four dimensions from the interRAI self-reported QoL survey, was conducted. Secondary data from 2019 (n = 116) and 2020 (n = 128) were analysed to assess the change in QoL. A significant decline in 12 measures was observed, indicating a change in QoL of LTC residents during the pandemic. Social life was the dimension mostly affected with residents reporting less opportunities to spend time with like-minded residents, explore new skills and interests, participate in meaningful religious activities, and have enjoyable things to do in the evenings. Several measures of personal control, staff responsiveness and care, and safety also demonstrated a significant change. The results can inform future strategies for pandemic and outbreak preparedness. Balancing the safety of residents with attention to their QoL should be a priority moving forward.

Multimorbidity and health-related quality of life among patients attending chronic outpatient medical care in Bahir Dar, Northwest Ethiopia: The application of partial proportional odds model

BACKGROUND

Multimorbidity, the presence of two or more chronic non-communicable diseases (NCDs) in a given person affects all aspects of people's lives. Poor quality of life (QoL) is one of the major consequences of living with multimorbidity. Although healthcare should support multimorbid individuals to achieve a better quality of life, little is known about the effect of multimorbidity on the QoL of patients living with chronic conditions. This study aimed to determine the influence of multimorbidity on QoL among clients attending chronic outpatient medical care in Bahir Dar, Northwest Ethiopia.

METHODOLOGY

A multi-centered facility-based study was conducted among 1440 participants aged 40+ years. Two complementary methods were employed to collect sociodemographic and disease related data. We used the short form (SF-12 V2) instrument to measure quality of life (QoL). The data were analyzed by STATA V.16, and a multivariate partial proportional odds model was fitted to identify covariates associated with quality of life. Statistical significance was considered at p-value <0.05.

PRINCIPAL FINDINGS

Multimorbidity was identified in 54.8% (95% CI = 52.2%-57.4%) of the sample. A significant proportion (33.5%) of the study participants had poor QoL and a quarter (25.8%) of them had moderate QoL. Advanced age, obesity and living with multimorbidity were the factors associated with poor QoL. Conversely, perceived social support and satisfaction with care were the variables positively associated with better QoL.

CONCLUSION

The magnitude of multimorbidity in this study was high and individuals living with multimorbidity had a relatively poorer QoL than those without multimorbidity. Care of people with chronic multiple conditions has to be oriented to the realities of multimorbidity burden and its implication on QoL. It is also imperative to replicate the methods we employed to measure and analyze QoL data in this study for facilitating comparison and further development of the approaches.