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Kim H, Bae EJ, Choi Y, Son H. Biopsychosocial factors of quality of life among middle-aged adults living alone in South Korea: a secondary data analysis using the 2017 Korea Community Health Survey. Arch Public Health 2024; 82:108. [PMID: 39026231 PMCID: PMC11256506 DOI: 10.1186/s13690-024-01342-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 07/11/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND This study aimed to investigate quality of life (QoL) in middle-aged adults living alone and identify comprehensive biological, psychological, interpersonal, and contextual factors related to QoL using the dynamic biopsychosocial model. As a secondary analysis, this study used data from the 2017 Korea Community Health Survey conducted by the Korea Disease Control and Prevention Agency. METHODS Among the total 228,381 respondents, 10,639 middle-aged individuals aged 40-64 years from single-person households (5,036 men and 5,603 women) were included in the analysis. QoL was measured using the EuroQoL-5 Dimension (EQ-5D). The EQ-5D descriptive statistics were provided according to biological, psychological, interpersonal, and contextual factors. Considering the data structure of the multistage stratified cluster sampling method, a complex samples general linear model statistic was used to identify the predictors of QoL. RESULTS QoL was lower in those who had undesirable psychological status (e.g., more depressive symptoms, poor subjective health, and higher perceived stress), less engagement in social networking (less frequent contact with friends and less frequent participation in social activities such as religious activities, friendship gathering, and leisure), and lower physical, behavioral, and socioeconomic factors. CONCLUSIONS This study's findings indicate that psychological and interpersonal factors should be addressed and prioritized to improve the QoL of middle-aged adults living alone. By providing many opportunities for easily accessible social activities that meet the needs and interests of this demographic, their QoL can be improved through strengthening social support.
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Affiliation(s)
- Hyerang Kim
- Department of Nursing Science, Howon University, 64 Howondae 3gil, Impi, Gunsan city, Jeollabuk-do, 54508, Republic of Korea
| | - Eun Jung Bae
- Department of Nursing, Ansan University, 155Ansan Daehak-ro, Sangnok-gu, Ansan-si, Gyeonggi-do, 15328, Republic of Korea
| | - Yunkyung Choi
- College of Nursing, Chonnam National University, 160 Baekseo-ro, Dong-gu, Gwangju, 61469, Republic of Korea
| | - Heesook Son
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06974, Republic of Korea.
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Ha T, Shi H, Shrestha R, Gaikwad SS, Joshi K, Padiyar R, Schensul SL. The Mediating Effect of Changes in Depression Symptoms on the Relationship between Health-Related Quality of Life and Alcohol Consumption: Findings from a Longitudinal Study among Men Living with HIV in India. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085567. [PMID: 37107849 PMCID: PMC10138320 DOI: 10.3390/ijerph20085567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 04/03/2023] [Accepted: 04/13/2023] [Indexed: 05/11/2023]
Abstract
Heavy alcohol use is negatively affecting antiretroviral therapy adherence, mental health and health-related quality of life among people living with HIV (PLWH). This paper aims to test the mediation model examining whether changes in depression symptoms mediate in the relationship between health-related quality of life and alcohol use among male PLWH who consume alcohol in India. The study is guided by the stress-coping model, which posits that individuals facing stress may turn to maladaptive coping mechanisms such as alcohol use to alleviate their distress, which includes depression and a low health-related quality of life due to various physical, psychological, and social factors associated with the HIV infection. This study used the data from a randomized controlled clinical trial entitled 'Alcohol and ART adherence: Assessment, Intervention, and Modeling in India'. Participants completed surveys assessing demographic characteristics, health-related quality of life, depressive symptoms, and alcohol use. Multiple simple mediation models were investigated to examine whether changes in depression symptoms mediated the association between the changes in health-related quality of life and alcohol use after a 9-month follow-up. A total of 940 male PLWH were recruited and interviewed, with 564 participants in the intervention group and 376 participants in the control group. After a 9-month intervention, the mediation results showed that, among intervention participants, a decrease in depressiove symptoms mediated the relationship between improved health-related quality of life and lower alcohol use. However, among control participants, changes in depressive symptoms did not mediate the relationship between changes in health-related quality of life and alcohol use. The study findings have practical and theoretical implications. From a practical perspective, the results suggest that interventions aimed at simultaneously improving HRQoL and depressive symptoms among male PLWH with alcohol use may help reduce alcohol consumption. Therefore, interventions that address depressive symptoms in addition to improving HRQoL may have an even greater impact on reducing alcohol use among this population. Theoretically, the study supports the use of the stress-coping theory in understanding the association between HRQoL, mental health, and alcohol use among male PLWH, contributing to existing literature on a gap in our understanding of the interactions among these factors among PLWH.
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Affiliation(s)
- Toan Ha
- Department of Infectious Diseases and Microbiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA
- Correspondence: ; Tel.: +1-412-383-4576
| | - Hui Shi
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Roman Shrestha
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA;
| | - Sushma S Gaikwad
- Medical College & B.Y.L. Nair Ch. Hospital, Mumbai 400008, India
| | | | - Rupal Padiyar
- Lokmanya Tilak Municipal Medical College, Mumbai 400022, India
| | - Stephen L. Schensul
- Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT 06030, USA;
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Katayama Y, Miyawaki Y, Shidahara K, Nawachi S, Asano Y, Ohashi K, Katsuyama E, Katsuyama T, Narazaki M, Matsumoto Y, Sada KE, Yajima N, Shimojima Y, Yoshimi R, Ichinose K, Kajiyama H, Fujiwara M, Sato S, Wada J. Association of alcohol consumption and fatigue in SLE: A cross-sectional study from Lupus Registry of Nationwide Institution (LUNA) cohort. Lupus 2023; 32:531-537. [PMID: 36800905 DOI: 10.1177/09612033231159471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
OBJECTIVE Fatigue is one of the most common complaints and is a potentially modifiable issue in systemic lupus erythematosus (SLE). Studies suggest that alcohol consumption has a protective effect against the development of SLE; however, an association between alcohol consumption and fatigue in patients with SLE has not been studied. Here, we assessed whether alcohol consumption was associated with fatigue using lupus patient-reported outcomes (LupusPRO). METHODS This cross-sectional study, conducted between 2018 and 2019, included 534 patients (median age, 45 years; 87.3% female) from 10 institutions in Japan. The main exposure was alcohol consumption, which was defined as the frequency of drinking [<1 day/month (none group), ≤1 day/week (moderate group), and ≥2 days/week (frequent group)]. The outcome measure was the Pain Vitality domain score in LupusPRO. Multiple regression analysis was performed as the primary analysis after adjusting for confounding factors, such as age, sex, and damage. Subsequently, the same analysis was performed as a sensitivity analysis after multiple imputations (MIs) for missing data (n = 580). RESULTS In total, 326 (61.0%) patients were categorized into the none group, 121 (22.7%) into the moderate group, and 87 (16.3%) into the frequent group. The frequent group was independently associated with less fatigue compared with none group [β = 5.98 (95% CI 0.19-11.76), p = 0.04], and the results did not substantially deviate after MI. CONCLUSIONS Frequent drinking was associated with less fatigue, which highlights the need for further longitudinal studies focusing on drinking habits in patients with SLE.
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Affiliation(s)
- Yu Katayama
- Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, 199491Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yoshia Miyawaki
- Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, 199491Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kenta Shidahara
- Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, 199491Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Shoichi Nawachi
- Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, 199491Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yosuke Asano
- Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, 199491Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Keiji Ohashi
- Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, 199491Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Eri Katsuyama
- Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, 199491Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Takayuki Katsuyama
- Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, 199491Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Mariko Narazaki
- Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, 199491Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yoshinori Matsumoto
- Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, 199491Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Ken-Ei Sada
- Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, 199491Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.,Department of Clinical Epidemiology, Kochi Medical School, Kochi University, Kochi, India
| | - Nobuyuki Yajima
- Division of Rheumatology, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan.,Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Center for Innovative Research for Communities and Clinical Excellence, Fukushima Medical University, Fukushima, Japan
| | - Yasuhiro Shimojima
- Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Matsumoto, Japan
| | - Ryusuke Yoshimi
- Department of Stem Cell and Immune Regulation, 26438Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kunihiro Ichinose
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hiroshi Kajiyama
- Department of Rheumatology and Applied Immunology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Michio Fujiwara
- Department of Rheumatology, 84178Yokohama Rosai Hospital, Yokohama, Japan
| | - Shuzo Sato
- Department of Rheumatology, 183174Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Jun Wada
- Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, 199491Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Krause K, Guertler D, Moehring A, Batra A, Eck S, Rumpf HJ, Bischof G, Buchholz M, John U, Meyer C. Association between Alcohol Consumption and Health-Related Quality of Life among Hospital and Ambulatory Care Patients with Past Year Depressive Symptoms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14664. [PMID: 36429382 PMCID: PMC9690263 DOI: 10.3390/ijerph192214664] [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: 10/14/2022] [Revised: 11/01/2022] [Accepted: 11/02/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Little is known about how substance use affects health-related quality of life (HRQOL) in depressed individuals. Here, associations between alcohol consumption and HRQOL in hospital and ambulatory care patients with past-year depressive symptoms are analyzed. METHOD The sample consisted of 590 participants (26.8% non-drinkers) recruited via consecutive screenings. Individuals with alcohol use disorders were excluded. HRQOL was assessed with the Veterans Rand 12-item health survey (VR-12). Multivariable fractional polynomials (MFP) regression analyses were conducted (1) to test for non-linear associations between average daily consumption and HRQOL and (2) to analyze associations between alcohol consumption and the physical and mental health component summaries of the VR-12 and their subdomains. RESULTS Alcohol consumption was positively associated with the physical health component summary of the VR-12 (p = 0.001) and its subdomains general health (p = 0.006), physical functioning (p < 0.001), and bodily pain (p = 0.017), but not with the mental health component summary (p = 0.941) or any of its subdomains. Average daily alcohol consumption was not associated with HRQOL. CONCLUSION Alcohol consumption was associated with better physical HRQOL. Findings do not justify ascribing alcohol positive effects on HRQOL. Data indicate that non-drinkers may suffer from serious health disorders. The results of this study can inform the development of future alcohol- and depression-related interventions.
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Affiliation(s)
- Kristian Krause
- Evangelic Hospital Bethania, Gützkower Landstraße 69, 17489 Greifswald, Germany
| | - Diana Guertler
- Department of Prevention Research and Social Medicine, Institute for Community Medicine, University Medicine Greifswald, Walther-Rathenau-Straße 48, 17475 Greifswald, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Fleischmannstraße 42-44, 17489 Greifswald, Germany
| | - Anne Moehring
- Department of Prevention Research and Social Medicine, Institute for Community Medicine, University Medicine Greifswald, Walther-Rathenau-Straße 48, 17475 Greifswald, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Fleischmannstraße 42-44, 17489 Greifswald, Germany
| | - Anil Batra
- Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, Geissweg 3, 72076 Tübingen, Germany
| | - Sandra Eck
- Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, Geissweg 3, 72076 Tübingen, Germany
| | - Hans-Jürgen Rumpf
- Research Group S:TEP, Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, 23583 Lübeck, Germany
| | - Gallus Bischof
- Research Group S:TEP, Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, 23583 Lübeck, Germany
| | - Maresa Buchholz
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Ellernholzstraße 1-2, 17489 Greifswald, Germany
| | - Ulrich John
- Department of Prevention Research and Social Medicine, Institute for Community Medicine, University Medicine Greifswald, Walther-Rathenau-Straße 48, 17475 Greifswald, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Fleischmannstraße 42-44, 17489 Greifswald, Germany
| | - Christian Meyer
- Department of Prevention Research and Social Medicine, Institute for Community Medicine, University Medicine Greifswald, Walther-Rathenau-Straße 48, 17475 Greifswald, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Fleischmannstraße 42-44, 17489 Greifswald, Germany
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5
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Grønkjær M, Wimmelmann CL, Mortensen EL, Flensborg-Madsen T. Prospective associations between alcohol consumption and psychological well-being in midlife. BMC Public Health 2022; 22:204. [PMID: 35101012 PMCID: PMC8802415 DOI: 10.1186/s12889-021-12463-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 12/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Alcohol consumption potentially influences psychological well-being in beneficial and harmful ways, but prospective studies on the association show mixed results. Our main purpose was to examine prospective associations between alcohol consumption and psychological well-being in middle-aged men and women. METHODS The study sample included 4148 middle-aged individuals (80% men) from the Copenhagen Aging and Midlife Biobank who reported their alcohol consumption (average weekly consumption and frequency of binge drinking) at baseline in 2004 or 2006 and reported their psychological well-being (satisfaction with life and vitality) at follow-up in 2009-2011. Analyses were adjusted for sociodemographic factors, lifestyle, social relations, and morbidity. RESULTS For satisfaction with life at follow-up, lower scores were observed in men and women who were alcohol abstinent at baseline as well as in men with heavy alcohol consumption compared with moderate alcohol consumption at baseline. Moreover, men with weekly binge drinking at baseline had lower satisfaction with life scores at follow-up than men with moderate frequency of binge drinking (1-3 times/month). In relation to vitality at follow-up, alcohol abstinence at baseline in men and women and heavy alcohol consumption at baseline in men were associated with lower scores compared with moderate alcohol consumption (yet in men these findings were not robust to adjustment for covariates). CONCLUSIONS Alcohol abstinence seems to be prospectively associated with adverse psychological well-being (vitality and life satisfaction) in men and women, while heavy alcohol consumption seems to be prospectively associated with adverse satisfaction with life in men. Finally, a prospective association between weekly binge drinking and lower life satisfaction was observed in men.
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Affiliation(s)
- Marie Grønkjær
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark. .,Unit of Medical Psychology, Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark. .,Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark.
| | - Cathrine Lawaetz Wimmelmann
- Unit of Medical Psychology, Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Erik Lykke Mortensen
- Unit of Medical Psychology, Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Trine Flensborg-Madsen
- Unit of Medical Psychology, Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
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TOYGAR İ, HANÇERLİOĞLU S, ŞİMŞİR IY, ÇETİNKALP Ş. Diyabetik ayak hastalarının yaşam kalitesi ve etkileyen faktörler. EGE TIP DERGISI 2020. [DOI: 10.19161/etd.834143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Yao XI, Ni MY, Cheung F, Wu JT, Schooling CM, Leung GM, Pang H. Change in moderate alcohol consumption and quality of life: evidence from 2 population-based cohorts. CMAJ 2020; 191:E753-E760. [PMID: 31285378 DOI: 10.1503/cmaj.181583] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Although the association of moderate alcohol consumption with specific disorders, such as cardiovascular disease and cancers, has been well documented, the evidence of the broader impact of alcohol consumption on health-related quality of life is less clear. Our objective was to examine the association of drinking patterns with changes in physical and mental well-being across populations. METHODS We conducted a multilevel analysis with multivariate responses in the population-representative FAMILY Cohort in the Hong Kong Special Administrative Region, China, to examine the association between alcohol drinking patterns across 2 waves (2009-2013) (i.e., quitters, initiators, persistent drinkers, persistent former drinkers and lifetime abstainers) and changes in physical and mental well-being (Physical and Mental Component Summary of the 12-Item Short Form Health Survey [SF-12]). Analyses were stratified by sex. We validated findings using a nationally representative cohort in the United States, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, 2001-2005). RESULTS In the FAMILY Cohort (n = 10 386; median follow-up 2.3 yr), the change in mental well-being was more favourable in female quitters than in lifetime abstainers (β = 1.44, 95% confidence interval [CI] 0.43 to 2.45; mean score change of +2.0 for quitters and +0.02 for lifetime abstainers). This association was validated in the NESARC (n = 31 079; median follow-up 3.1 yr) (β = 0.83, 95% CI 0.08 to 1.58; mean score change of -1.1 for quitters and -1.6 for lifetime abstainers). INTERPRETATION The change in mental well-being was more favourable in female quitters, approaching the level of mental well-being of lifetime abstainers within 4 years of quitting in both Chinese and American populations.
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Affiliation(s)
- Xiaoxin I Yao
- School of Public Health, Li Ka Shing Faculty of Medicine (Yao, Ni, Cheung, Wu, Schooling, Leung, Pang), and The State Key Laboratory of Brain and Cognitive Sciences (Ni), The University of Hong Kong, Hong Kong Special Administrative Region, China; Graduate School of Public Health and Health Policy (Schooling), City University of New York, New York, NY
| | - Michael Y Ni
- School of Public Health, Li Ka Shing Faculty of Medicine (Yao, Ni, Cheung, Wu, Schooling, Leung, Pang), and The State Key Laboratory of Brain and Cognitive Sciences (Ni), The University of Hong Kong, Hong Kong Special Administrative Region, China; Graduate School of Public Health and Health Policy (Schooling), City University of New York, New York, NY
| | - Felix Cheung
- School of Public Health, Li Ka Shing Faculty of Medicine (Yao, Ni, Cheung, Wu, Schooling, Leung, Pang), and The State Key Laboratory of Brain and Cognitive Sciences (Ni), The University of Hong Kong, Hong Kong Special Administrative Region, China; Graduate School of Public Health and Health Policy (Schooling), City University of New York, New York, NY
| | - Joseph T Wu
- School of Public Health, Li Ka Shing Faculty of Medicine (Yao, Ni, Cheung, Wu, Schooling, Leung, Pang), and The State Key Laboratory of Brain and Cognitive Sciences (Ni), The University of Hong Kong, Hong Kong Special Administrative Region, China; Graduate School of Public Health and Health Policy (Schooling), City University of New York, New York, NY
| | - C Mary Schooling
- School of Public Health, Li Ka Shing Faculty of Medicine (Yao, Ni, Cheung, Wu, Schooling, Leung, Pang), and The State Key Laboratory of Brain and Cognitive Sciences (Ni), The University of Hong Kong, Hong Kong Special Administrative Region, China; Graduate School of Public Health and Health Policy (Schooling), City University of New York, New York, NY
| | - Gabriel M Leung
- School of Public Health, Li Ka Shing Faculty of Medicine (Yao, Ni, Cheung, Wu, Schooling, Leung, Pang), and The State Key Laboratory of Brain and Cognitive Sciences (Ni), The University of Hong Kong, Hong Kong Special Administrative Region, China; Graduate School of Public Health and Health Policy (Schooling), City University of New York, New York, NY
| | - Herbert Pang
- School of Public Health, Li Ka Shing Faculty of Medicine (Yao, Ni, Cheung, Wu, Schooling, Leung, Pang), and The State Key Laboratory of Brain and Cognitive Sciences (Ni), The University of Hong Kong, Hong Kong Special Administrative Region, China; Graduate School of Public Health and Health Policy (Schooling), City University of New York, New York, NY
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Gémes K, Moeller J, Engström K, Sidorchuk A. Alcohol consumption trajectories and self-rated health: findings from the Stockholm Public Health Cohort. BMJ Open 2019; 9:e028878. [PMID: 31427328 PMCID: PMC6701653 DOI: 10.1136/bmjopen-2018-028878] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 05/20/2019] [Accepted: 07/12/2019] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To investigate whether poor self-rated health and psychological distress are differentially associated with drinking trajectories over time. METHODS From the Stockholm Public Health Cohort, two subcohorts surveyed in 2002-2010-2014 and 2006-2010-2014 (n=23 794 and n=34 667 at baseline, respectively) were used. Alcohol consumption, self-rated health, psychological distress (measured by General Health Questionnaire-12), lifestyle factors and longstanding illness were assessed by questionnaires. Demographic and socioeconomic variables were obtained by register linkage. Logistic regression was fitted to assess the associations with eight alcohol consumption trajectories, which were constructed among 30 228 individuals (13 898 and 16 330 from the 2002 and 2006 subcohorts, respectively) with measures of consumption at three time points. RESULTS Compared with stable moderate drinkers, all other trajectories were associated with poor self-rated health with multiadjusted OR for stable non-drinkers of 2.35 (95% CIs 1.86 to 2.97), unstable non-drinkers (OR=2.58, 95% CI 1.54 to 3.32), former drinkers (OR=2.81, 95% CI 2.31 to 3.41) and stable heavy drinkers (OR=2.16, 95% CI 1.47 to 3.20). The associations were not fully explained by sociodemographic and lifestyle factors and longstanding illness. Former drinking, but no other trajectories, was associated with psychological distress (OR=1.24; 95% CI 1.10 to 1.41). CONCLUSION We found a U-shape association between alcohol trajectories and self-rated health, but not with psychological distress. Compared with stable moderate drinking, former drinking was associated with the highest odds of both poor self-rated health and psychological distress. The study confirms the importance of a life-course approach to examining the effect of alcohol consumption on health and highlights the poorer general and mental health status of non-drinkers who were former drinkers.
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Affiliation(s)
- Katalin Gémes
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jette Moeller
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Karin Engström
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Anna Sidorchuk
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute, Stockholm & Healthcare Services, Stockholm County Council, CAP Research Center, Gävlegatan, Stockholm
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Wei MY, Mukamal KJ. Multimorbidity and Mental Health-Related Quality of Life and Risk of Completed Suicide. J Am Geriatr Soc 2019; 67:511-519. [PMID: 30471103 PMCID: PMC6402970 DOI: 10.1111/jgs.15678] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 09/20/2018] [Accepted: 10/11/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Physical functioning indexed multimorbidity is strongly associated with long-term mortality, but its role in poor mental health has not been quantified. METHODS A total of 252 002 community-dwelling adults in the Nurses' Health Study (NHS), NHS II, and Health Professionals Follow-up Study (HPFS) prospective cohorts reported physician-diagnosed diseases and the Short Form-36 over 8 years and had 24-year follow-up for suicide mortality. We quantified multimorbidity using a multimorbidity-weighted index (MWI). We used multivariable-adjusted proportional hazards models with competing risks for suicide mortality and mixed-effects models to estimate mental health-related quality of life (HRQOL). RESULTS Multimorbidity was associated with an increased risk of suicide mortality in an approximately linear manner, with roughly two- to threefold higher risk in adults with the highest vs lowest quartile MWI in adjusted models: NHS hazard ratio (HR) = 3.01 (95% confidence interval [CI] = 1.48-6.11); NHS II HR = 3.04 (95% CI = 1.82-5.09); HPFS HR = 1.74 (95% CI = 1.08-2.81). Greater MWI was associated with worse mental HRQOL 8 years later across all scales and the mental component summary (MCS) in a dose-response manner. This association was attenuated but persisted after adjustment for baseline mental HRQOL and other covariates. Adults with the highest quartile MWI had lower MCS in adjusted models compared with those with the lowest quartile MWI: NHS ß = -0.61 (95% CI = -0.78 to -0.44); NHS II ß = -1.25 (95% CI = -1.44 to -1.06). CONCLUSION Multimorbidity is associated with substantially higher suicide mortality risk and worse mental HRQOL across all available scales, even when indexed to physical functioning. These results highlight the substantial mental health burden imposed by multimorbidity at all ages and sexes. J Am Geriatr Soc 67:511-519, 2019.
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Affiliation(s)
- Melissa Y Wei
- Division of General Medicine and Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan
| | - Kenneth J Mukamal
- Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center and Harvard Medical School, Brookline, Massachusetts
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Zhang FF, Hudson MM, Huang IC, Bhakta N, Ness KK, Brinkman TM, Klosky J, Lu L, Chen F, Ojha RP, Lanctot JQ, Robison LL, Krull KR. Lifestyle factors and health-related quality of life in adult survivors of childhood cancer: A report from the St. Jude Lifetime Cohort Study. Cancer 2018; 124:3918-3923. [PMID: 30204245 DOI: 10.1002/cncr.31647] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 05/18/2018] [Accepted: 06/11/2018] [Indexed: 11/12/2022]
Abstract
BACKGROUND Survivors of childhood cancer report poor health-related quality of life (HRQOL). Modifiable lifestyle factors such as nutrition and physical activity represent opportunities for interventions to improve HRQOL. METHODS The authors examined the association between modifiable lifestyle factors and HRQOL among 2480 adult survivors of childhood cancer in the St. Jude Lifetime Cohort Study. Dietary intake, physical activity, cigarette smoking, and alcohol consumption were assessed through questionnaires. Weight and height were measured in the clinic. HRQOL was evaluated using the Medical Outcome Study 36-Item Short Form Survey. The physical component summary (PCS), mental component summary (MCS), and 8 domain scores of HRQOL were calculated. Multivariable linear regression models were used to estimate regression coefficients (β) associated with HRQOL differences. RESULTS Being physically active (PCS β = 3.10; and MCS β = 1.48) was associated with higher HRQOL whereas current cigarette smoking (PCS β = -2.30; and MCS β = -6.49) and obesity (body mass index ≥30 kg/m2 ) (PCS β = -3.29; and MCS β = -1.61) were associated with lower HRQOL in both the physical and mental domains. Better diet (Healthy Eating Index-2015) was associated with higher physical HRQOL (PCS β = 1.79). Moderate alcohol consumption was associated with higher physical (PCS β = 1.14) but lower mental (MCS β = -1.13) HRQOL (all P <.05). Adherence to multiple healthy lifestyle factors demonstrated a linear trend with high scores in both physical and mental HRQOL (highest vs lowest adherence: PCS β = 7.60; and MCS β = 5.76 [P for trend, <.0001]). CONCLUSIONS The association between healthy lifestyle factors and HRQOL is cumulative, underscoring the importance of promoting multiple healthy lifestyles to enhance HRQOL in long-term survivors of childhood cancer.
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Affiliation(s)
- Fang Fang Zhang
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Melissa M Hudson
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - I-Chan Huang
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Nickhill Bhakta
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Kirsten K Ness
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Tara M Brinkman
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - James Klosky
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Lu Lu
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Fan Chen
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Rohit P Ojha
- Center for Outcomes Research, JPS Health Network, Fort Worth, Texas
| | - Jennifer Q Lanctot
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Leslie L Robison
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Kevin R Krull
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee
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11
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Hart V, Trentham-Dietz A, Berkman A, Fujii M, Veal C, Hampton J, Gangnon RE, Newcomb PA, Gilchrist SC, Sprague BL. The association between post-diagnosis health behaviors and long-term quality of life in survivors of ductal carcinoma in situ: a population-based longitudinal cohort study. Qual Life Res 2018; 27:1237-1247. [PMID: 29417425 DOI: 10.1007/s11136-018-1807-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2018] [Indexed: 12/13/2022]
Abstract
PURPOSE Women diagnosed with ductal carcinoma in situ (DCIS) often experience adverse changes in health-related behaviors following diagnosis. The impact of health behaviors on long-term quality of life (QoL) in DCIS survivors has not been investigated. METHODS We examined the association of post-diagnosis body mass index (BMI), physical activity, alcohol, and smoking with QoL among 1448 DCIS survivors aged 20-74 enrolled in the population-based Wisconsin in situ Cohort from 1997 to 2006. Health behaviors and QoL were self-reported during biennial post-diagnosis interviews. Physical and mental QoL were measured using the validated SF-36 questionnaire. Generalized linear regression was used to determine the association between behaviors and QoL with adjustment for confounders. Lagged behavior variables were used to predict QoL during follow-up and avoid reverse causation. RESULTS Women reported 3,536 QoL observations over an average 7.9 years of follow-up. Women maintaining a healthy BMI had on average a significantly higher summary measure score of physical QoL than obese women (normal versus obese: β = 3.02; 2.18, 3.85). Physical QoL scores were also elevated among those who were physically active (5 + h/week vs. none: β = 1.96; 0.72, 3.20), those consuming at least seven drinks/week of alcohol (vs. none; β = 1.40; 0.39, 2.41), and nonsmokers (vs. current smokers: β = 1.80; 0.89, 2.71). Summary measures of mental QoL were significantly higher among women who were moderately physically active (up to 2 h/week vs. none: β = 1.11; 0.30, 1.92) and nonsmokers (vs. current smokers: β = 1.49;0.45, 2.53). CONCLUSIONS Our results demonstrate that maintaining healthy behaviors following DCIS treatment is associated with modest improvements in long-term QoL. These results inform interventions aimed at promoting healthy behaviors and optimizing QoL in DCIS survivors.
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Affiliation(s)
- Vicki Hart
- Vermont Center for Behavior and Health, Office of Health Promotion Research, Department of Surgery, University of Vermont, 1 South Prospect Street, Rm. 4425, Burlington, VT, 05401, USA
| | - Amy Trentham-Dietz
- Department of Population Health Sciences and Carbone Cancer Center, University of Wisconsin, Madison, WI, USA
| | - Amy Berkman
- Office of Health Promotion Research and Department of Surgery, University of Vermont, Burlington, VT, USA
| | - Mayo Fujii
- Office of Health Promotion Research and Department of Surgery, University of Vermont, Burlington, VT, USA
| | - Christopher Veal
- Vermont Center for Behavior and Health, Office of Health Promotion Research, Department of Surgery, University of Vermont, 1 South Prospect Street, Rm. 4425, Burlington, VT, 05401, USA
| | - John Hampton
- Department of Population Health Sciences and Carbone Cancer Center, University of Wisconsin, Madison, WI, USA
| | - Ronald E Gangnon
- Departments of Biostatistics and Medical Informatics and Population Health Sciences, Carbone Cancer Center, University of Wisconsin, Madison, WI, USA
| | - Polly A Newcomb
- Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Susan C Gilchrist
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Brian L Sprague
- Vermont Center for Behavior and Health, Office of Health Promotion Research, Department of Surgery, University of Vermont, 1 South Prospect Street, Rm. 4425, Burlington, VT, 05401, USA.
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