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Volčanšek Š, Lunder M, Janež A. Health-Related Quality of Life Assessment in Older Patients with Type 1 and Type 2 Diabetes. Healthcare (Basel) 2023; 11:2154. [PMID: 37570394 PMCID: PMC10418676 DOI: 10.3390/healthcare11152154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/20/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
Type 1 (T1D) and type 2 diabetes (T2D) are determinants of health-related outcomes including health-related quality of life (HRQOL). We aimed to determine differences in HRQOL between older adults with T1D and T2D and specific factors influencing HRQOL in this age group. This study used a cross-sectional design with 56 age- and HbA1c-matched T1D and T2D patients (aged 68.9 ± 7.8 years; 55% had T2D). We employed several validated questionnaires (Short Form-36 (SF-36) and the EuroQol-5 Dimensions/Visual Analog Scale (VAS)) to investigate the relationships between HRQOL domains and diabetes type, glycemic control, complications, and comorbidities. T1D was associated with better self-reported general health (assessed with the SF-36 general health domain (p = 0.048) and the EuroQol-5 VAS (p = 0.002), whereas no significant differences in the other SF-36 domains, self-reported diabetes distress, anxiety, or depression were found. Most HRQOL domains were not associated with HbA1c or the presence of diabetes complications. The most significant reduction in HRQOL was experienced by patients with higher BMIs, irrespective of the diabetes type. The obtained HRQOL data could be used in clinical settings for evidence-based patient education focused on specific subgroups of patients, as well as in national healthcare policies, e.g., interventions designed to alleviate obesity.
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Affiliation(s)
- Špela Volčanšek
- Clinical Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Zaloška 7, 1000 Ljubljana, Slovenia; (M.L.); (A.J.)
- Medical Faculty, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia
| | - Mojca Lunder
- Clinical Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Zaloška 7, 1000 Ljubljana, Slovenia; (M.L.); (A.J.)
- Medical Faculty, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia
| | - Andrej Janež
- Clinical Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Zaloška 7, 1000 Ljubljana, Slovenia; (M.L.); (A.J.)
- Medical Faculty, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia
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Liu X, Wu Z, Li N. Association between physical exercise and all-cause and CVD mortality in patients with diabetes: an updated systematic review and meta-analysis. Afr Health Sci 2022; 22:250-266. [PMID: 36910366 PMCID: PMC9993283 DOI: 10.4314/ahs.v22i3.27] [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: 11/16/2022] Open
Abstract
Objectives Physical activity is recommended in guidelines for treatment for diabetes, but the association between physical activity and mortality among diabetic patients has not been extensively studied. Methods Databases were searched from inception to July 10, 2020. Prospective studies were selected to evaluate the association between physical activity and risk for total and cardiovascular diseases (CVD) mortality among diabetic patients. Data were pooled using random-effect model to calculate the relative risks (RRs) with 95% confidence intervals (CIs). Results We included 16 eligible studies involving with 155,203 diabetic participants and 13,821 cases of death. Our study suggested that physical activity in diabetic patients may decrease risk for all-cause (RR 0.57, 95% CI 0.49-0.67) and CVD mortality (RR 0.55, 95% CI 0.34-0.68). The summary RR for CVD events was 0.65 (95% CI 0.41-1.03). Furthermore, the reductions in all-cause mortality were more significant in diabetic patients with old age (> 60 years) (RR 0.46, 95% CI 0.29 -0.75), higher body mass index (BMI ≥ 28) (RR 0.53, 95% CI 0.42-0.69) and shorter duration of diabetes (RR 0.45, 95% CI 0.24-0.84). Conclusion Physical activity reduced the risk of total and CVD mortality among patients with diabetes, in particular in diabetic patients with old age (> 60 years), obesity and shorter duration of diabetes.
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Affiliation(s)
- Xinmin Liu
- Sports and Health University of Heze University, Heze, China
| | - Zhen Wu
- Sports and Health University of Heze University, Heze, China
| | - Ning Li
- Sports and Health University of Heze University, Heze, China
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Wake AD. Protective effects of physical activity against health risks associated with type 1 diabetes: “Health benefits outweigh the risks”. World J Diabetes 2022; 13:161-184. [PMID: 35432757 PMCID: PMC8984568 DOI: 10.4239/wjd.v13.i3.161] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 12/08/2021] [Accepted: 02/20/2022] [Indexed: 02/06/2023] Open
Abstract
The magnitude of diabetes mellitus (DM) has increased in recent decades, where the number of cases and the proportion of the disease have been gradually increasing over the past few decades. The chronic complications of DM affect many organ systems and account for the majority of morbidity and mortality associated with the disease. The prevalence of type 1 DM (T1DM) is increasing globally, and it has a very significant burden on countries and at an individual level. T1DM is a chronic illness that requires ongoing medical care and patient self-management to prevent complications. This study aims to discuss the health benefits of physical activity (PA) in T1DM patients. The present review article was performed following a comprehensive literature search. The search was conducted using the following electronic databases: “Cochrane Library”, Web of Science, PubMed, HINARI, EMBASE, Google for grey literature, Scopus, African journals Online, and Google Scholar for articles published up to June 21, 2021. The present review focused on the effects of PA on many outcomes such as blood glucose (BG) control, physical fitness, endothelial function, insulin sensitivity, well-being, the body defense system, blood lipid profile, insulin resistance, cardiovascular diseases (CVDs), insulin requirements, blood pressure (BP), and mortality. It was found that many studies recommended the use of PA for the effective management of T1DM. PA is a component of comprehensive lifestyle modifications, which is a significant approach for the management of T1DM. It provides several health benefits, such as improving BG control, physical fitness, endothelial function, insulin sensitivity, well-being, and the body defense system. Besides this, it reduces the blood lipid profile, insulin resistance, CVDs, insulin requirements, BP, and mortality. Overall, PA has significant and essential protective effects against the health risks associated with T1DM. Even though PA has several health benefits for patients with T1DM, these patients are not well engaged in PA due to barriers such as a fear of exercise-induced hypoglycemia in particular. However, several effective strategies have been identified to control exercise-induced hypoglycemia in these patients. Finally, the present review concludes that PA should be recommended for the management of patients with T1DM due to its significant health benefits and protective effects against associated health risks. It also provides suggestions for the future direction of research in this field.
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Affiliation(s)
- Addisu Dabi Wake
- Department of Nursing, College of Health Sciences, Arsi University, Asella 193/4, Ethiopia
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Li CL, Chiu YC, Shyu YIL, Stanaway FF, Chang HY, Bai YB. Does physical activity protect older persons with frailty and cognitive impairment from excess all-cause mortality? Arch Gerontol Geriatr 2021; 97:104500. [PMID: 34388680 DOI: 10.1016/j.archger.2021.104500] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The main aim of this study was to examine how physical activity in combination with physical frailty and cognitive impairment affects risk of mortality in older adults. STUDY DESIGN A national sample of community-dwelling Taiwanese aged 65 years or older (n=2678) was followed for 5 years. MAIN OUTCOME MEASURES Frailty was determined based on the Fatigue, Resistance, Ambulation, Illness, and Loss of weight (FRAIL) scale. The Mini-Mental State Examination was used to assess cognitive impairment. Information on self-reported physical activity was collected at baseline. The study cohort was followed until the date of death or the end of the study period (31 December 2018). Deaths were confirmed by the computerized data files of the National Register of Deaths. RESULTS A total of 417 deaths were recorded after 12415.2 person-years of follow-up. After adjustment for other factors, compared with active participants who were physically robust with normal cognition, inactive participants who were with either frail/pre-frail or cognitively impaired had hazard ratios for mortality of 2.65 (95% CI=[1.88-3.74]) and 3.09 (95% CI=[2.08-4.59]), respectively. Inactive participants with coexisting frailty/pre-frailty and cognitive impairment had the highest hazard ratio for mortality of 3.85 (95% CI=[2.73-5.45]). Being active was associated with a mortality reduction of 31%, 38%, and 42% in physically robust participants with normal cognition, those who were frail/pre-frail only, and those with cognitive impairment only, respectively. CONCLUSIONS Having a physically active life style has beneficial effects on survival in older persons with either frailty/pre-frailty or cognitive impairment.
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Affiliation(s)
- Chia-Lin Li
- Department of Health Care Management, College of Management, Chang Gung University, Taoyuan, Taiwan.
| | - Yu-Chan Chiu
- Department of Bio-Industry Communication and Development, National Taiwan University, Taipei, Taiwan
| | - Yea-Ing L Shyu
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Fiona F Stanaway
- University of Sydney School of Public Health, Faculty of Medicine and Health, New South Wales, Australia
| | - Hsing-Yi Chang
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Yuh-Bin Bai
- Department of Health Care Management, College of Management, Chang Gung University, Taoyuan, Taiwan
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Nutritional Determinants of Quality of Life in a Mediterranean Cohort: The SUN Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17113897. [PMID: 32486373 PMCID: PMC7312060 DOI: 10.3390/ijerph17113897] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/19/2020] [Accepted: 05/28/2020] [Indexed: 12/13/2022]
Abstract
Health related quality of life (HRQoL) is a subjective appreciation of how personal characteristics and health influence well-being. This cross-sectional analysis aimed to quantitatively measure the influence of dietary, lifestyle, and demographic factors on HRQoL. A sub-sample of the Seguimiento Universidad de Navarra (SUN) Project, a Mediterranean cohort, was analyzed (n = 15,674). Through self-administered questionnaires the relationship between HRQoL and dietary patterns (Mediterranean-diet (MedDiet) and provegetarian food pattern (FP) assessment), lifestyles (sleeping hours, physical activity) and demographic characteristics were measured. Multivariate linear regression and flexible regression models were used to estimate the pondered effect of personal factors on Short Form-36 (SF-36) scores. Coefficients for MedDiet and provegetarian scores (β-coefficient for global SF-36 score: 0.32 (0.22, 0.42); 0.09 (0.06, 0.12) respectively for every unit increase), physical activity (β: 0.03 (0.02, 0.03) for every metabolic equivalent of task indexes (MET)-h/week) had a positive association to HRQoL. The female sex (β: −3.28 (−3.68, −2.89)), and pre-existing diseases (diabetes, β: −2.27 (−3.48, −1.06), hypertension β: −1.79 (−2.36, −1.22), hypercholesterolemia β: −1.04 (−1.48, −0.59)) account for lower SF-36 scores. Adherence to MedDiet or provegetarian FP, physical activity and sleep are associated with higher HRQoL, whereas the female sex, “other” (versus married status) and the presence of chronic diseases were associated with lower SF-36 scores in this sample.
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Adebusoye LA, Cadmus EO, Owolabi MO, Ogunniyi A. Frailty and mortality among older patients in a tertiary hospital in Nigeria. Ghana Med J 2020; 53:210-216. [PMID: 31741493 PMCID: PMC6842731 DOI: 10.4314/gmj.v53i3.5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Background This study determined the frailty status and its association with mortality among older patients. Design A prospective cohort design. Setting Study was conducted at the medical wards of University College Hospital, Ibadan, Nigeria. Participants and study tools Four hundred and fifty older patients (>60 years) were followed up from the day of admission to death or discharge. Information obtained includes socio-demographic characteristics and clinical frailty was assessed using the Canadian Study of Health and Aging (CSHA) scale. Bivariate and multivariate analyses were carried out using SPSS version 21 at a p <0.05. Results Overall, frailty was identified in 285 (63.3%) respondents. Mortality was significantly higher among frail respondents (25.3%) than non-frail respondents (15.4%) p=0.028. Logistic regression analysis showed factors associated with frailty were: male sex (OR=1.946 [1.005–3.774], p=0.048), non-engagement in occupational activities (OR=2.642 [1.394–5.008], p=0.003), multiple morbidities (OR=4.411 [1.944–10.006], p<0.0001), functional disability (OR=2.114 [1.029–4.343), p=0.042], malnutrition (OR=9.258 [1.029–83.301], p=0.047) and being underweight (OR=7.462 [1.499–37.037], p=0.014). Conclusion The prevalence of frailty among medical in-hospital older patients is very high and calls for its prompt identification and management to improve their survival. Funding The study was self-funded by the authors
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Affiliation(s)
- Lawrence A Adebusoye
- Chief Tony Anenih Geriatric Centre (CTAGC), University College Hospital, Ibadan, Nigeria
| | - Eniola O Cadmus
- Department of Community Medicine, College of Medicine, University of Ibadan, Nigeria
| | - Mayowa O Owolabi
- Department of Medicine, College of Medicine, University of Ibadan, Nigeria
| | - Adesola Ogunniyi
- Department of Medicine, College of Medicine, University of Ibadan, Nigeria
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Hayashino Y, Okamura S, Tsujii S, Ishii H. Predictive Validity of Each Item of the 8-Item Short-Form Health Survey for All-Cause Mortality in Japanese patients with type 2 diabetes: A prospective Cohort Study (Diabetes Distress and Care Registry at Tenri [DDCRT 19]). Exp Clin Endocrinol Diabetes 2019; 129:722-728. [PMID: 31822020 DOI: 10.1055/a-1044-2041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
AIMS While health-related quality of life (HRQOL) is reported to be associated with mortality, this assessment was made using surveys with a large number of questions, not specifically focused on populations with diabetes, or in western countries alone. We thus evaluated the predictive validity of summary scores, and each item score of the 8-Item Short-Form Health Survey in Japanese individuals with type-2 diabetes. MATERIALS AND METHODS Longitudinal data from 3269 individuals with diabetes were obtained from a large Japanese diabetes registry. To assess the independent correlation between the 10-point scores of the SF-8 physical component summary (PCS) and mental component summary (MCS), each item score, and all-cause mortality, the Cox proportional hazards model was used with adjustment for potential confounders. RESULTS Mean cohort parameters included age (64.9 years [SD 11.2]), body mass index (24.6 kg/m2 [SD, 3.9]), and HbA1c level (7.5% [SD, 1.2]; or 58.6 mmol/mol [SD, 12.7]). We recorded 248 deaths during the median follow-up of 7.2 years (incidence ratio, 12.2 per 1000 person-years). Multivariable-adjusted HRs for all-cause mortality were 0.780 (95%CI, 0.674-0.902; p=0.001) and 0.776 (95%CI, 0.656-0.917; p=0.003), respectively, for 10-point increment of PCS and MCS scores. Higher score of any single item of SF-8 was associated with lower risk of all-cause mortality even after adjusting for possible confounders. CONCLUSIONS As assessed by the SF-8, higher PCS, MCS, and any single 1-item scores were associated with lower risk of all-cause mortality in Japanese individuals with type 2 diabetes.
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Affiliation(s)
| | | | - Satoru Tsujii
- Department of Endocrinology, Tenri Hospital, Tenri, Japan
| | - Hitoshi Ishii
- Department of Diabetology, Nara Medical University, Kashihara, Japan
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Patients with Chronic Musculoskeletal Pain of 3-6-Month Duration Already Have Low Levels of Health-Related Quality of Life and Physical Activity. Curr Pain Headache Rep 2019; 23:81. [PMID: 31456081 DOI: 10.1007/s11916-019-0817-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW To determine the level of physical activity and health-related quality of life in patients with chronic musculoskeletal pain of 3-6-month duration who have not been diagnosed or treated before. RECENT FINDINGS Low levels of quality of life and physical activity have been reported for patients with musculoskeletal pain with a duration of longer than 6 months. This study assessed the levels of quality of life and physical activity at the beginning stage of chronic musculuskeletal pain. Prospective cross-sectional study carried out at a musculoskeletal and sports medicine clinic. Eighty-five consecutive patients with muskuloskeletal (i.e., spine, peripheral joint, muscle, tendon) pain of 3-6-month duration, not diagnosed before, age 14 and older, and from either gender were recruited. Short Form-36 Health Survey and International Physical Activity Questionnaire long were administered during assessments. Scores on subscales of Short Form-36 Health Survey and total scores of International Physical Activity Questionnaire were used as outcome measures. A total of 85 patients with an age range of 15-86 (51.22 ± 15.99) were enrolled. There were 23 male (27.06%) and 62 (72.94%) female subjects. Forty-six (54.11%) patients had three or less painful regions; 39 (45.88%) had more than three painful regions. Majority of the patients had low scores on both Short Form-36 Health Survey subscales and International Physical Activity Questionnaire. Forty-nine patients had low, 32 patients had moderate, and 4 patients had high level of physical activity. Overall, females had lower level of physical activity in all age groups. All patients had less than optimal scores on all subscales of Physical Health and Mental Health scales of the Short Form-36. The female patients had lower scores in role physical and bodily pain subscales of physical health. Patients with musculoskeletal pain duration of 3-6 months have low levels of physical activity and health-related quality of life at the time of their first evaluation.
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Pinheiro LC, Reshetnyak E, Sterling MR, Richman JS, Kern LM, Safford MM. Using health-related quality of life to predict cardiovascular disease events. Qual Life Res 2019; 28:1465-1475. [PMID: 30632050 PMCID: PMC7830778 DOI: 10.1007/s11136-019-02103-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2019] [Indexed: 12/22/2022]
Abstract
PURPOSE Although strong associations between self-reported health and mortality exist, quality of life is not conceptualized as a cardiovascular disease (CVD) risk factor. Our objective was to assess the independent association between health-related quality of life (HRQOL) and incident CVD. METHODS This study used the REasons for Geographic And Racial Differences in Stroke data, which enrolled 30,239 adults from 2003 to 2007 and followed them over 10 years. We included 22,229 adults with no CVD history at baseline. HRQOL was measured using the SF-12 Physical Component Summary (PCS) and Mental Component Summary (MCS) scores, which range from 0 to 100, with higher scores indicating better HRQOL. Scores were normed to the general US population with mean 50 and standard deviation 10. We constructed a four-level HRQOL variable: (1) individuals with PCS & MCS < 50, (2) PCS < 50 & MCS ≥ 50, (3) MCS < 50 & PCS ≥ 50, and (4) PCS & MCS ≥ 50, which was the reference. The primary outcome was incident CVD (non-fatal myocardial infarction (MI), fatal MI or coronary heart disease (CHD) death, fatal and non-fatal stroke). Cox proportional hazards models examined associations between HRQOL and CVD. RESULTS Median follow-up was 8.4 (IQR 5.9-10.0) years. We observed 1766 CVD events. Compared to having PCS & MCS ≥ 50, having MCS & PCS < 50 was associated with increased CVD risk (aHR 1.46; 95% 1.24-1.70), adjusting for demographics, comorbidities, and CVD risk factors. Associations between MCS & PCS < 50 and CVD were consistent for CHD (aHR 1.54 [1.26-1.89]) and stroke (aHR 1.35 [1.05-1.72]) endpoints. CONCLUSIONS Given strong, adjusted associations between poor HRQOL and incident CVD, self-reported health may be an excellent complement to current approaches to CVD risk identification.
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Affiliation(s)
- Laura C Pinheiro
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, 525 East 68th Street, Box 331, New York, NY, 10065, USA.
| | - Evgeniya Reshetnyak
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, 525 East 68th Street, Box 331, New York, NY, 10065, USA
| | - Madeline R Sterling
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, 525 East 68th Street, Box 331, New York, NY, 10065, USA
| | - Joshua S Richman
- Department of Surgery, University of Alabama at Birmingham Medical School, Birmingham, AL, USA
| | - Lisa M Kern
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, 525 East 68th Street, Box 331, New York, NY, 10065, USA
| | - Monika M Safford
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, 525 East 68th Street, Box 331, New York, NY, 10065, USA
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Abstract
BACKGROUND Type 2 diabetes is a huge burden both for individuals and society as a whole. Although depression has been negatively associated with ideal glycemic control, little is known about the prevalence of depression or its associated factors among rural Taiwanese adults with Type 2 diabetes mellitus (type2 DM). PURPOSE The purposes of this study were to investigate the prevalence of depression in rural-dwelling sufferers of type2 DM and to highlight the relationships between their depression status and health promoting behaviors such as physical activity, keeping active in life, sleep sufficiency, and adopting a diabetic diet. METHODS A cross-sectional, correlational design was used to recruit 696 participants from local healthcare centers in rural areas of Chiayi County, Taiwan. Data were collected from March 30, 2010, to August 30, 2012. The Chinese version of the Geriatric Depression Scale and its associated physiological biomarkers were used as screening tools. Logistic regression was used to identify the factors that were associated with depression status. RESULTS The prevalence of depression in this study was 16.8%. Factors found to be associated with depression included being female, having a low level of education, receiving reduced family support, having little physical activity, failing to follow a diabetic diet, frequent inactivity, and having insufficient sleep. There were no significant differences in the physiological indicators between the depressive and nondepressive groups. After controlling for confounding factors, a logistic regression model showed that depression status was associated with a lack of sleep (OR = 2.85, p < .001), less frequent exercise (OR = 2.67, p < .001), and frequent inactivity (OR = 2.35, p = .001). CONCLUSIONS/IMPLICATIONS FOR PRACTICE This study showed that the prevalence of depression among adults with type2 DM living in rural areas is relatively high. From the perspective of health promotion, future research should focus on how to improve quality of sleep by enhancing daily physical activity and on investigating the effect of promoting a more active lifestyle among those at risk on depression.
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Are We Compensating for the Lack of Physical Activity in Our Diabetic Patients with Treatment Intensification? Sports (Basel) 2017; 5:sports5030058. [PMID: 29910418 PMCID: PMC5968955 DOI: 10.3390/sports5030058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 08/01/2017] [Accepted: 08/04/2017] [Indexed: 11/30/2022] Open
Abstract
Background: We studied the association between leisure time physical activity (LTPA) and glycemic control, body mass index (BMI), and hypoglycemic incidents in type 1 (T1DM) and type 2 diabetes patients (T2DM). Methods: This is a cross-sectional study of 198 diabetic patients (60 with type 1 diabetes, 138 with type 2 diabetes). LTPA was assessed by a validated 12-month questionnaire. Patients were grouped as sedentary and moderately to vigorously active. Outcome measures were Hemoglobin A1c (HbA1c), BMI, and hypoglycemic episodes. Results: LTPA effect on the HbA1c reduction was present in diabetes type 1 patients. Patients who were involved in the moderate to vigorous-intensity physical activity had a greater decrease in the HbA1c (p = 0.048) than patients with low physical activity (p = 0.085). Level of LTPA was neither associated with increased number of hypoglycemic episodes, nor BMI. After an average of 4 years of diabetes, the number of patients requiring more than one antidiabetic agent increased, although the observed difference did not correlate with LTPA level. Conclusions: LTPA has an influence on the regulation of diabetes type 1, and intensification of medical treatment is compensating for the lack of lifestyle change—especially in type 2 diabetics.
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Weber S, Jud A, Landolt MA, Goldbeck L. Predictors of health-related quality of life in maltreated children and adolescents. Qual Life Res 2017. [PMID: 28620875 DOI: 10.1007/s11136-017-1615-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Research on the consequences of child maltreatment has primarily focused on behavior and mental health; the children's overall well-being has not received the same attention. A number of studies have investigated health-related quality of life (HRQoL) among victims of child maltreatment, but there is still a lack of knowledge about predictors of HRQoL in maltreated children and adolescents. This study seeks to bridge the gap by drawing data from the German multi-site study Child Abuse and Neglect Case-Management (CANMANAGE). METHODS Parents or caregivers of 350 children and adolescents completed a proxy version of the Kidscreen-10-Index, a multidimensional instrument measuring child HRQoL. An additional 249 children age 8 years and older completed a self-report version. Multiple regression analyses were performed to identify potential predictors for both self- and proxy-rated HRQoL. RESULTS Comparisons with the reference group revealed a significantly lower mean proxy-rated HRQoL, the self-rated HRQoL of the study sample was not significantly impaired. Predictors of impaired self-reported HRQoL were older age, self-reported posttraumatic stress symptoms (PTSS), and self-reported emotional and behavioral symptoms. Predictors of impaired proxy-reported HRQoL again were older age, self-reported PTSS, and emotional and behavioral symptoms in the child/adolescent, as reported by the caregiver, as well as low socioeconomic status. Multivariate analysis explained 20% and 38% of the variability in self-reported and proxy-rated HRQoL, respectively. CONCLUSIONS It is important to treat PTSS and emotional and behavioral symptoms in maltreated children, as these two phenomena are strong cross-sectional predictors of a child's HRQoL. Trauma-focused cognitive behavioral therapies are one possible option to address the needs of such children.
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Affiliation(s)
- Sabine Weber
- Child Protection Group, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland.
| | - Andreas Jud
- Child Protection Group, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland.,School of Social Work, Lucerne University of Applied Sciences and Arts, Lucerne, Switzerland
| | - Markus A Landolt
- Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Zurich, Switzerland.,Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Lutz Goldbeck
- Department of Child and Adolescent Psychiatry/Psychotherapy, Medical Centre, University of Ulm, Ulm, Germany
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Yang SH, Chen SF, Nieh S, Liu CL, Lin YS, Lee CC, Lin FH. The Effect of Individual and Neighbourhood Socioeconomic Status on Diabetes Mellitus Survival in Working Age Patients in Taiwan. PLoS One 2017; 12:e0169550. [PMID: 28081258 PMCID: PMC5230791 DOI: 10.1371/journal.pone.0169550] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 12/19/2016] [Indexed: 12/31/2022] Open
Abstract
Purpose Diabetes mellitus (DM) is a global pandemic metabolic disorder. In recent years, the amount of medical resources required for the treatment of diabetes has increased as diabetes rates have gradually risen. The combined effects of individual and neighbourhood socio-economic status (SES) on DM survival rates are still not clear, especially in patients of working age. In this paper, we aim to analyze the combined effects of neighbourhood and individual SES on DM survival rates in patients of working age in Taiwan. Methods The study of 23,781 people who were diagnosed with DM by using population—based study between 2002 and 2006. Each sample was followed up for 4 years or as a sensor case. We defined Individual SES and neighbourhood SES by each patient’s job category and household income which characterized as advantaged or disadvantaged. Then we compared the survival rates by SES group used Cox proportional hazards model for adjust risk factors. Results The 4-year overall survival rates of diabetic patients were worst for those with low individual SES who living in advantaged neighbourhoods. After adjustment for patient characteristics, DM patients with high individual SES living in disadvantaged neighbourhoods had the same risk of mortality as those patients with high individual SES living in advantaged neighbourhoods (hazard ratio: 1.11; 95% confidence interval [CI]: 0.81–1.51). The study found that DM patients with low individual SES who live in disadvantaged areas had a greater risk of mortality than those with high SES (odds ratio: 2.57; 95% CI: 2.04–3.24). There were significant differences in survival rates between patients with high individual SES and patients with low individual SES. In contrast, the results did not statistically significant differences in survival rates between advantaged and disadvantaged neighbourhood SES groups. Conclusion DM patients with low individual SES had the worst survival rate, regardless of whether they were living in a high or low SES neighbourhood area. The competitive cause of death, i.e., the fact that complications, rather than DM itself, are often the cause of death, may be the reason for the inverse relationship found between the effects of individual SES and neighbourhood SES on DM survival. We conclude that the socio-economic gradient in survival among DM patients may be the result of differences in access to medical treatment and attributes related to individual SES.
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Affiliation(s)
- Shih-Hsien Yang
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
- Department of Medical Administration Office, National Defense Medical Center & Tri-Service General Hospital Beitou Branch, Taipei, Taiwan
| | - Su-Feng Chen
- Department of Dental Hygiene, China Medical University, Taichung, Taiwan
| | - Shin Nieh
- Department of Pathology, National Defense Medical Center & Tri-Service General Hospital, Taipei, Taiwan
| | - Chia-Lin Liu
- Department of Pathology, National Defense Medical Center & Tri-Service General Hospital, Taipei, Taiwan
| | - Yaoh-Shiang Lin
- Department of Otorhinolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- * E-mail: (FHL); (YSL)
| | - Ching-Chih Lee
- Department of Otorhinolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Otolaryngology, Head and Neck Surgery, Tri-Service General Hospital, Taipei, Taiwan
- School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Fu-Huang Lin
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- * E-mail: (FHL); (YSL)
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14
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Olson KL, Stiefel M, Ross C, Stadler S, Hornak R, Sandhoff B, Merenich JA. Self-Rated Health Among Patients with Coronary Artery Disease Enrolled in a Cardiovascular Risk Reduction Service. Popul Health Manag 2015; 19:24-30. [PMID: 26237495 DOI: 10.1089/pop.2014.0178] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Little is known about the use of the single self-rated health (SRH) status item measuring health-related quality of life among people with coronary artery disease (CAD). The objective of this study was to assess relationships between SRH and recurrent coronary events, mortality, health care utilization, and intermediate clinical outcomes and to assess predictors of fair/poor SRH. A total of 5573 patients enrolled in a comprehensive cardiac risk reduction service managed by clinical pharmacy specialists were evaluated over a 2-year period. Regression modeling explored relationships among variables, modeling SRH separately as an independent and a dependent variable. The 1374 (24.7%) respondents reporting fair/poor SRH differed statistically from 4199 (75.3%) respondents reporting good/very good/excellent SRH in terms of age, sex, ethnicity, number of comorbid conditions, DxCG scores, lifestyle behaviors, blood pressure control, and inpatient and emergency department (ED) utilization. Respondents reporting fair/poor health were more likely to have recurrent major coronary events (MCE), including death. Fair/poor SRH was consistently statistically significant when it was included as a predictor in regression modeling for poor blood pressure control, health care utilization, MCE, and all-cause mortality. Variables associated with fair/poor SRH in regression modeling included females, Hispanic ethnicity, ≥1 baseline ED visit, and DxCG score. Exercising <30 minutes per week was strongly associated with fair/poor SRH. Single-item SRH status may help identify patients with CAD at higher risk of poor blood pressure control, recurrent MCE, and death and those who may benefit from interventions to increase physical activity.
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Affiliation(s)
- Kari L Olson
- 1 Kaiser Permanente Colorado , Pharmacy Department, Aurora, Colorado
| | - Matt Stiefel
- 2 Center for Population Health, Care Management Institute , Kaiser Permanente, Oakland, California
| | - Colleen Ross
- 3 Institute for Health Research , Kaiser Permanente Colorado, Denver, Colorado
| | - Sheila Stadler
- 1 Kaiser Permanente Colorado , Pharmacy Department, Aurora, Colorado
| | - Roseanne Hornak
- 1 Kaiser Permanente Colorado , Pharmacy Department, Aurora, Colorado
| | - Brian Sandhoff
- 1 Kaiser Permanente Colorado , Pharmacy Department, Aurora, Colorado
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15
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Ramírez-Prado D, Palazón-Bru A, Folgado-de-la Rosa DM, Carbonell-Torregrosa MÁ, Martínez-Díaz AM, Gil-Guillén VF. Predictive models for all-cause and cardiovascular mortality in type 2 diabetic inpatients. A cohort study. Int J Clin Pract 2015; 69:474-84. [PMID: 25234387 DOI: 10.1111/ijcp.12563] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 08/31/2014] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Many authors have analysed premature mortality in cohorts of type 2 diabetic patients, but no analyses have assessed mortality in hospitalised diabetic patients. AIM To construct predictive models to estimate the likelihood of all-cause mortality and cardiovascular mortality in type 2 diabetic inpatients. DESIGN Cohort study with follow-up from 2010 to 2014. METHODS We evaluated mortality in a randomly selected cohort of 112 type 2 diabetic inpatients at the Hospital of Elda (Spain) in 2010-2012. OUTCOMES all-cause mortality and cardiovascular mortality during the follow-up. Other variables: gender, age, depression, asthma/chronic obstructive pulmonary disease, hypertension, dyslipidemia, insulin, pills, smoking, walking, baseline blood glucose and creatinine. Predictive tables with risk groups were constructed to estimate the likelihood of all-cause mortality and cardiovascular mortality. Calculations were made of the area under the ROC curve (AUC). RESULTS During the follow-up, 52 inpatients died (46.4%, 95% CI, confidence interval: 37.2-55.7%), 22 because of cardiovascular causes (19.6%, 95% CI: 12.3-27.0%). The mean follow-up time was 2.7 ± 1.5 years. The AUC for the all-cause mortality model was 0.84 (95% CI: 0.77-0.92, p < 0.001). Associated parameters: pills, smoking, walking, gender, insulin and age. The AUC for the cardiovascular mortality model was 0.79 (95% CI: 0.67-0.91, p < 0.001). Associated parameters: age, pills, walking, smoking, depression and insulin. CONCLUSIONS This study provides tools to predict premature mortality in type 2 diabetic inpatients. However, before their general application they require joint validation by the internal medicine unit, emergency department, primary healthcare unit and endocrinology service to enable better prediction of the prognosis and more adequate decision-taking.
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Affiliation(s)
- D Ramírez-Prado
- Research Unit, Elda Hospital, Elda, Spain; Department of Clinical Medicine, Miguel Hernández University, San Juan de Alicante, Spain
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16
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Oyewole OO, Odusan O, Oritogun KS, Idowu AO. Predictability of physical activity and bodyweight on health-related quality of life amongst Nigerian type 2 diabetes mellitus. Int J Diabetes Dev Ctries 2015. [DOI: 10.1007/s13410-015-0335-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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17
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Ul-Haq Z, Mackay DF, Pell JP. Association between physical and mental health-related quality of life and adverse outcomes; a retrospective cohort study of 5,272 Scottish adults. BMC Public Health 2014; 14:1197. [PMID: 25416612 PMCID: PMC4256892 DOI: 10.1186/1471-2458-14-1197] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 10/30/2014] [Indexed: 01/16/2023] Open
Abstract
Background Health-related quality of life (HRQoL) is associated with adverse outcomes in disease-specific populations. This study examines whether it is also independent predictor of incident cancer, coronary heart disease (CHD) and mortality in the general population. Methods The records of adult participants in the Scottish Health Survey 2003 were linked with hospital admissions, cancer registrations and death certificates. Cox proportional hazard models were used to explore the associations between quintiles of physical and mental component summary score (PCS and MCS respectively) of the SF-12 and adverse outcomes. Higher quintiles of both PCS and MCS indicate better health status. Results Among the 5,272 study participants, the mean PCS score was 49 (standard deviation (SD) 10.3). Participants were followed-up for a mean of 7.6 years. On survival analysis the lowest quintile of PCS was a strong predictor of all-cause death (hazard ratio (HR) 2.81, 95% CI 1.76, 4.49), incident cancer (HR 1.63, 95% CI 1.10, 2.42), and CHD events (HR 1.99, 95% CI 1.00, 3.96), compared to the highest quintile. This association was independent of adiposity and other confounders. The mean MCS score 52 (SD 8.8). MCS quintile was not associated with incident cancer and CHD, and the association between MCS and all-cause death (HR 1.33, 95% CI 1.01, 1.75) became non-significant after adjustment for adiposity. Conclusion Physical HRQoL is a significant predictor of a range of adverse outcomes, even after adjustment for adiposity and other confounders. This study highlights the importance of perceived health in the general population. Electronic supplementary material The online version of this article (doi:10.1186/1471-2458-14-1197) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | - Jill P Pell
- Institute of Health & Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow G12 8RZ, UK.
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18
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Kaizu S, Kishimoto H, Iwase M, Fujii H, Ohkuma T, Ide H, Jodai T, Kikuchi Y, Idewaki Y, Hirakawa Y, Nakamura U, Kitazono T. Impact of leisure-time physical activity on glycemic control and cardiovascular risk factors in Japanese patients with type 2 diabetes mellitus: the Fukuoka Diabetes Registry. PLoS One 2014; 9:e98768. [PMID: 24897110 PMCID: PMC4045868 DOI: 10.1371/journal.pone.0098768] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Accepted: 05/07/2014] [Indexed: 11/18/2022] Open
Abstract
AIMS/HYPOTHESIS The effects of leisure-time physical activity (LTPA) on glycemia and cardiovascular risk factors are not fully understood in Asian type 2 diabetic patients, who are typically non-obese. We studied associations between LTPA and glycemia and cardiovascular risk factors in Japanese type 2 diabetic patients. METHODS A total of 4,870 Japanese type 2 diabetic patients aged ≥ 20 years were divided into eight groups according to their LTPA. We investigated associations between the amount and intensity levels of physical activity (PA) and glycemic control, insulin sensitivity, cardiovascular risk factors, and low-grade systemic inflammation in a cross-sectional study. RESULTS LTPA was dose-dependently associated with body mass index (BMI), waist circumference, hemoglobin A1c (HbA1c), fasting plasma glucose, homeostasis model assessment of insulin resistance, triglyceride, high density lipoprotein cholesterol, high sensitivity C-reactive protein, and prevalence of metabolic syndrome, but not with blood pressure, low density lipoprotein cholesterol or adiponectin. The amount of PA required to lower HbA1c was greater than that required to improve cardiovascular risk factors. LTPA was inversely associated with HbA1c in non-obese participants but not in obese participants after multivariate adjustments for age, sex, duration of diabetes, current smoking, current drinking, energy intake, cardiovascular diseases, depressive symptoms, and treatment of diabetes. Higher-intensity LTPA, not lower-intensity LTPA was associated with HbA1c after multivariate adjustments with further adjustment including BMI. CONCLUSIONS/INTERPRETATION LTPA was dose-dependently associated with better glycemic control and amelioration of some cardiovascular risk factors in Japanese type 2 diabetic patients. In addition, increased higher-intensity LTPA may be appropriate for glycemic control.
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Affiliation(s)
- Shinako Kaizu
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiro Kishimoto
- Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masanori Iwase
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Diabetes Center, Hakujyuji Hospital, Fukuoka, Japan
- * E-mail:
| | - Hiroki Fujii
- Division of General Internal Medicine, School of Oral Health Science, Kyushu Dental University, Kitakyushu, Japan
| | - Toshiaki Ohkuma
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hitoshi Ide
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tamaki Jodai
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | | | | | - Yoichiro Hirakawa
- Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Udai Nakamura
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Maditinos DI, Papadopoulos D, Prats L. The Free Time Allocation and its Relationship with the Perceived Quality of Life (QoL) and Satisfaction with Life (SwL). ACTA ACUST UNITED AC 2014. [DOI: 10.1016/s2212-5671(14)00053-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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20
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Lango MN, Egleston B, Fang C, Burtness B, Galloway T, Liu J, Mehra R, Ebersole B, Moran K, Ridge JA. Baseline health perceptions, dysphagia, and survival in patients with head and neck cancer. Cancer 2013; 120:840-7. [PMID: 24352973 DOI: 10.1002/cncr.28482] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Revised: 09/18/2013] [Accepted: 09/23/2013] [Indexed: 01/06/2023]
Abstract
BACKGROUND In head and neck cancer patients prior to treatment, dysphagia noted by patients is more common than aspiration on formal swallow studies. The authors hypothesized that patient-reported dysphagia impacts multiple domains of quality of life (QOL) and predicts disease recurrence and disease-related death. METHODS The Swal-QOL, a dysphagia-specific, swallowing-related, QOL measure, and the EuroQOL-5D-3L were administered to 159 patients before treatment with curative intent in this prospective cohort study. Logistic regression analysis evaluated associations among clinical and subjective measures. Multivariable competing risk regression tested the impact of clinical, tumor, and patient-reported measures on survival. RESULTS Baseline dysphagia, pain, and diminished patient-reported health state were found to be closely associated with weight loss before treatment and advanced T classification. However, only 58% of patients (23 of 40 patients) reporting dysphagia experienced > 5% weight loss. Dysphagia was found to be associated with pain and/or diminished patient-reported health state, independent of weight loss. Female patients were more likely to report pain and dysphagia, whereas male patients reported dysphagia alone. Dysphagia was found to be predictive of disease recurrence and disease-related death, adjusting for T and N classifications, ECOG performance status, smoking status, and weight loss, and accounting for competing risks of death (recurrence-free survival: hazards ratio, 3.8 [95% confidence interval, 1.7-8.4; P = .001] and disease-related death: hazards ratio, 4.2 [95% confidence interval, 1.04-5; P = .004]). CONCLUSIONS Baseline dysphagia affects multiple domains of QOL and general health perceptions in patients with head and neck cancer prior to treatment. A dysphagia measure captures the effort of maintaining nutrition, and identifies patients predisposed to disease recurrence and disease-related death.
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Affiliation(s)
- Miriam N Lango
- Department of Surgical Oncology, Head and Neck Surgery Section, Fox Chase Cancer Center, Temple University Health System, Philadelphia, Pennsylvania
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