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Theis S, Bitterlich N, von Wolff M, Stute P. Measuring Quality of Life: Incorporating Objectively Measurable Parameters within the Cross-Sectional Bern Cohort Study 2014 (BeCS-14). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:94. [PMID: 38248557 PMCID: PMC10815394 DOI: 10.3390/ijerph21010094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 01/06/2024] [Accepted: 01/09/2024] [Indexed: 01/23/2024]
Abstract
Up until now, the measurement of Quality of Life (QoL) was based on validated subjective rating tools rather than objective measurement. To become more independent of the self-assessment of probands, a way to objectively measure QoL should be found. A monocenter, cross-sectional, observational, non-interventional trial was performed from 2012 to 2014 at Inselspital Bern to evaluate the bio-functional status (BFS), a complex, generic, non-invasive, sex- and age-validated assessment tool, in a wide range of areas. A standardized battery of assessments was performed on 464 females and 166 males, ages 18 to 65 (n = 630). In addition to the survey of the BFS, participants replied-among others-to the validated questionnaire SF-36 for health-related QoL (n = 447, subgroup 1). Since the accepted cut-off value for BFA calculation is age ≥ 35 years, subgroup 2 included 227 subjects (all participants aged ≥ 35 years out of subgroup 1). In order to be able to compare the eight SF-36 subscales to BFS parameters, a comparable score set of single BFS items had to be constructed. Subsequently, we aimed to statistically identify BFS item combinations that best represented each SF-36 subscale. All eight SF-36 subscales were significantly represented by various different combinations of BFS items. A total of 24 single BFS items significantly correlated with SF-36 subscales, of which 15 were objective and nine were subjective. All eight SF-36 subscales were significantly represented by various different combinations of BFS items leading to stronger correlations (range five to nine BFS items), and overall, sex and age did not affect these associations, but in the SF-36 subscales 'bodily pain' (sex) and 'role limitations due to physical health problems' (age in men). To our knowledge, we are the first to correlate a validated set of 34 objective and 9 subjective parameters with subjectively evaluated SF-36 subscales. This first study on the objectifiability of the SF-36 questionnaire demonstrated that questions on quality of life can be answered independently of a subjective assessment by subjects in future scientific studies.
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Affiliation(s)
- Susanne Theis
- Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Division of Gynecological Endocrinology and Reproductive Medicine, Langenbeckstr. 1, 55131 Mainz, Germany;
| | - Norman Bitterlich
- Independent Researcher, Draisdorfer Str. 21, 09114 Chemnitz, Germany;
| | - Michael von Wolff
- University Clinic Bern, Division of Gynecological Endocrinology and Reproductive Medicine, University Women’s Hospital, Inselspital Bern, Friedbühlstrasse 19, 3010 Bern, Switzerland;
| | - Petra Stute
- University Clinic Bern, Division of Gynecological Endocrinology and Reproductive Medicine, University Women’s Hospital, Inselspital Bern, Friedbühlstrasse 19, 3010 Bern, Switzerland;
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Arifi D, Bitterlich N, von Wolff M, Poethig D, Stute P. Impact of chronic stress exposure on cognitive performance incorporating the active and healthy aging (AHA) concept within the cross-sectional Bern Cohort Study 2014 (BeCS-14). Arch Gynecol Obstet 2021; 305:1021-1032. [PMID: 34741667 PMCID: PMC8967732 DOI: 10.1007/s00404-021-06289-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 10/13/2021] [Indexed: 11/25/2022]
Abstract
Purpose This study aims to verify that the mental-cognitive domain of the validated generic bio-functional status (BFS)/bio-functional age (BFA) assessment tool, incorporating the concept of Active and Healthy Ageing (AHA), reflects cognitive performance. In addition, the effects of chronic stress exposure on the mental-cognitive BFS/BFA should be investigated. Methods The study was carried out as a monocenter, cross-sectional, observational, non-interventional trial (Bern Cohort Study 2014, BeCS-14) with the participation of 147 non-pediatric, non-geriatric subjects. All participants followed a standardized battery of biopsychosocial assessments consisting of BFS/BFA, a validated cognitive performance test battery (Inventar zur Gedächtnisdiagnostik; IGD) and a validated questionnaire for the assessment of chronic stress (Trier Inventory for the assessment of Chronic Stress; TICS), respectively. Results Mean cognitive performance was average and higher in younger or better educated individuals. The BFA of the participants was 7.8 ± 7.8 year-equivalents below their chronological age. The mental-cognitive BFS/BFA assessment correlated well with the validated questionnaire for cognition assessment, the IGD. Further, three TICS subdomains (work overload (r = − 0.246, p = 0.003), work discontent (r = − 0.299, p = 0.006) and pressure to succeed (r = − 0.274, p < 0.001)), reflecting mainly work-related stress, showed a significant negative correlation with the mental-cognitive BFS/BFA. Conclusions Our study shows that the BFS/BFA assessment tool follows European Innovation Partnership on Active and Healthy Ageing (EIP-AHA) requirements. Further, we could demonstrate that higher levels of chronic work-related stress may be associated with poorer mental-cognitive performance and a pro-aging state indicating that cognitive impairments can be reduced by stress management interventions. Supplementary Information The online version contains supplementary material available at 10.1007/s00404-021-06289-z.
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Mount S, Ferrucci L, Wesselius A, Zeegers MP, Schols AM. Measuring successful aging: an exploratory factor analysis of the InCHIANTI Study into different health domains. Aging (Albany NY) 2020; 11:3023-3040. [PMID: 31128067 PMCID: PMC6555461 DOI: 10.18632/aging.101957] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 05/03/2019] [Indexed: 12/22/2022]
Abstract
Advocating continued health into old age, so called successful aging, is a growing public health goal. However, the development of tools to measure aging is limited by the lack of appropriate outcome measures, and operational definitions of successful aging. Using exploratory factor analysis, we attempted to identify distinguishable health domains with representative variables of physical function, cognitive status, social interactions, psychological status, blood biomarkers, disease history, and socioeconomic status from the InCHIANTI study. We then used logistic and mixed effect regression models to determine whether the resulting domains predicted outcomes of successful aging over a nine-year follow-up. A four-domain health model was identified: neuro-sensory function, muscle function, cardio-metabolic function and adiposity. After adjustment for age and gender, all domains contributed to the prediction of walking speed (R2=0.73). Only the muscle function domain predicted dependency (R2=0.50). None of the domains were a strong, significant predictor of self-rated health (R2=0.18) and emotional vitality (R2=0.23). Cross-sectional findings were essentially replicated in the longitudinal analysis extended to nine-year follow-up. Our results suggest a multi-domain health model can predict objective but not subjective measures of successful aging.
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Affiliation(s)
- Sarah Mount
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Luigi Ferrucci
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA
| | - Anke Wesselius
- Department of Complex Genetics, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Maurice P Zeegers
- Department of Complex Genetics, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Annemie Mwj Schols
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, the Netherlands
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Stute P, von Bergen M, Bitterlich N, Meissner F, von Wolff M, Poethig D. Measuring cognitive performance in way that incorporates the concept of active and healthy ageing (AHA). Maturitas 2019; 125:27-32. [DOI: 10.1016/j.maturitas.2019.03.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 02/15/2019] [Accepted: 03/24/2019] [Indexed: 11/26/2022]
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Stute P, Anker M, Hollenstein L, von Wolff M, Bitterlich N, Meissner F, Poethig D. Measuring chronic stress exposure incorporating the active and healthy ageing (AHA) concept within the cross-sectional Bern cohort study 2014 (BeCS-14). Biopsychosoc Med 2019; 13:2. [PMID: 30805024 PMCID: PMC6371589 DOI: 10.1186/s13030-019-0143-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 01/28/2019] [Indexed: 11/24/2022] Open
Abstract
The aim of the study was to represent chronic stress exposure by a complex generic Active and Healthy (AHA) diagnostic assessment tool incorporating ICF. This is a single-centre, cross-sectional, observational, non-interventional, non-randomized trial in University based women's hospital, division of Gynecological Endocrinology and Reproductive Medicine. All participants followed a standardized, holistic battery of biopsychosocial assessments consisting of bio-functional status (BFS), bio-functional age (BFA) and the questionnaire for chronic stress exposure (TICS). 624 non-pediatric, non-geriatric subjects were recruited in the BeCS-14 cohort. The mean difference between chronological age and BFA was 7.8 ± 8.0 year equivalents. The mean stress level score assessed by SSCS was 13.2 with 45.4% being exposed to above average stress intensity. 22 BFS items (14 objective, 7 subjective) significantly correlated with chronic stress exposure (TICS-SSCS). The constructed sum score composed of SOC_L9 and complaint questionnaire (physical and emotional wellbeing) represented chronic stress exposure best (pearson-correlation value 0.564, p < 0.0001). Higher chronic stress exposure was associated with bio-functional pro-aging (less vitality) in both sexes. In conclusion, chronic stress is accepted as a major risk factor for developing non-communicable diseases (NCD). Our ICF compatible, complex, generic BFS/BFA assessment tool reflects chronic stress exposure and may be applied in various health care settings, e.g., in health promotion and prevention of NCDs.
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Affiliation(s)
- Petra Stute
- Department of Gynecologic Endocrinology and Reproductive Medicine, University Clinic of Obstetrics and Gynecology, Inselspital Bern, Effingerstrasse 102, 3010 Bern, Switzerland
| | - Marion Anker
- Departement of Visceral and General Surgery, Spital Thun STS, Thun, AG Switzerland
| | - Laura Hollenstein
- Departement of Internal Medicine, Spital Oberengadin, Samedan, Switzerland
| | - Michael von Wolff
- Department of Gynecologic Endocrinology and Reproductive Medicine, University Clinic of Obstetrics and Gynecology, Inselspital Bern, Effingerstrasse 102, 3010 Bern, Switzerland
| | | | | | - Dagmar Poethig
- European Association on Vitality and Active Aging eVAA e.V, Leipzig, Germany
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Mathieu L, Bitterlich N, Meissner F, von Wolff M, Poethig D, Stute P. Illness perception in overweight and obesity and impact on bio-functional age. Arch Gynecol Obstet 2018; 298:415-426. [PMID: 29943131 DOI: 10.1007/s00404-018-4827-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 06/18/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Obesity is pandemic. Yet, the success of most weight loss programmes is poor. The aim of the study was to assess illness perception in overweight/obese people and its impact on bio-functional age (BFA) reflecting physical, mental, emotional and social functioning. METHODS 75 overweight/obese subjects from the cross-sectional Bern Cohort Study 2014 were included. Participants followed a validated "bio-functional status" test battery amended by the validated questionnaires Patiententheoriefragebogen (illness perception) and AD-EVA (eating and movement behaviour). BFA was calculated in subjects aged ≥ 35 years (n = 56). RESULTS (1) Mental occupation with the cause of overweight/obesity was generally moderate to high, but decreasing with age. (2) The predominant theories for being overweight/obese were health behaviour (58.7%) and psychosocial factors (33.3%). (3) Overweight/obese people with psychosocial theories on illness causes were more likely to have emotional or disinhibited eating patterns. (4) Cognitive control of eating patterns increased with age in both sexes. (5) Overweight/obese people were still bio-functionally younger than their chronological age (8.6 ± 0.8 year equivalents), although (6) quality of life was below average and (7) the risk for functional pro-aging was increased in those being especially mentally occupied with causes for overweight/obesity (r = 0.38, p < 0.001) and those having psychosocial (r = 0.32, p < 0.05) or naturalistic theories (r = 0.47, p > 0.001). CONCLUSIONS Consciously perceived psychosocial stress was found to be a main factor to disturb health and promote unhealthy cognitive patterns regulating eating and moving habits. Thus, successful weight reduction programmes should integrate subjective illness perceptions to not only improve the therapeutic outcome, but also functioning (BFA).
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Affiliation(s)
- Luisa Mathieu
- University of Bern, Murtenstrasse 11, 3011, Bern, Switzerland
| | - Norman Bitterlich
- Medizin & Service GmbH, Boettcherstraße 10, 09117, Chemnitz, Germany
| | - Florian Meissner
- Vital Services GmbH, GerontoLab Europe, Dittrichring 4, 04109, Leipzig, Germany
| | - Michael von Wolff
- Department of Gynecologic Endocrinology and Reproductive Medicine, University Clinic of Obstetrics and Gynecology, Inselspital Bern, Effingerstrasse 102, 3010, Bern, Switzerland
| | - Dagmar Poethig
- European Association on Vitality and Active Aging eVAA e.V., EIP-AHA Reference Site Saxony, Dittrichring 4, 04109, Leipzig, Germany
| | - Petra Stute
- Department of Gynecologic Endocrinology and Reproductive Medicine, University Clinic of Obstetrics and Gynecology, Inselspital Bern, Effingerstrasse 102, 3010, Bern, Switzerland.
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