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Nevarez-Flores AG, Chappell KJ, Morgan VA, Neil AL. Health-Related Quality of Life Scores and Values as Predictors of Mortality: A Scoping Review. J Gen Intern Med 2023; 38:3389-3405. [PMID: 37653208 PMCID: PMC10682357 DOI: 10.1007/s11606-023-08380-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 08/15/2023] [Indexed: 09/02/2023]
Abstract
Health-related quality of life (HRQoL) can be assessed through measures that can be generic or disease specific, encompass several independent scales, or employ holistic assessment (i.e., the derivation of composite scores). HRQoL measures may identify patients with differential risk profiles. However, the usefulness of generic and holistic HRQoL measures in identifying patients at higher risk of death is unclear. The aim of the present study was to undertake a scoping review of generic, holistic assessments of HRQoL as predictors of mortality in general non-patient populations and clinical sub-populations with specified conditions or risk factors in persons 18 years or older. Five databases were searched from 18 June to 29 June 2020 to identify peer-reviewed published articles. The searches were updated in August 2022. Reference lists of included and cited articles were also searched. Of 2552 articles screened, 110 met criteria for inclusion. Over one-third of studies were from North America. Most studies pertained to sub-populations with specified conditions and/or risk factors, almost a quarter for people with cardiovascular diseases. There were no studies pertaining to people with mental health conditions. Nearly three-quarters of the studies used a RAND Corporation QoL instrument, predominantly the SF-36, and nearly a quarter, a utility instrument, predominantly the EQ-5D. HRQoL was associated with mortality in 67 of 72 univariate analyses (92%) and 100 of 109 multivariate analyses (92%). HRQoL was found to be associated with mortality in the general population and clinical sub-populations with physical health conditions. Whether this relationship holds in people with mental health conditions is not known. HRQoL assessment may be useful for screening and/or monitoring purposes to understand how people perceive their health and well-being and as an indicator of mortality risk, encouraging better-quality and timely patient care to support and maximize what may be a patient's only modifiable outcome.
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Affiliation(s)
| | - Katherine J Chappell
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Vera A Morgan
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
- Neuropsychiatric Epidemiology Research Unit, School of Population and Global Health, The University of Western Australia, Crawley, WA, Australia
| | - Amanda L Neil
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.
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Vasbinder A, Zaslavsky O, Heckbert SR, Thompson H, Cheng RK, Saquib N, Wallace R, Haque R, Paskett ED, Reding KW. Associations of Health-Related Quality of Life and Sleep Disturbance With Cardiovascular Disease Risk in Postmenopausal Breast Cancer Survivors. Cancer Nurs 2023; 46:E355-E364. [PMID: 35816026 PMCID: PMC10232669 DOI: 10.1097/ncc.0000000000001133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Breast cancer (BC) survivors are at an increased risk of long-term cardiovascular disease (CVD), often attributed to cancer treatment. However, cancer treatment may also negatively impact health-related quality of life (HRQoL), a risk factor of CVD in the general population. OBJECTIVE We examined whether sleep disturbance, and physical or mental HRQoL were associated with CVD risk in BC survivors. METHODS We conducted a longitudinal analysis in the Women's Health Initiative of postmenopausal women given a diagnosis of invasive BC during follow-up through 2010 with no history of CVD before BC. The primary outcome was incident CVD, defined as physician-adjudicated coronary heart disease or stroke, after BC. Physical and mental HRQoL, measured by the Short-Form 36 Physical and Mental Component Summary scores, and sleep disturbance, measured by the Women's Health Initiative Insomnia Rating Scale, were recorded post BC. Time-dependent Cox proportional hazards models were used starting at BC diagnosis until 2010 or censoring and adjusted for relevant confounders. RESULTS In 2884 BC survivors, 157 developed CVD during a median follow-up of 9.5 years. After adjustment, higher Physical Component Summary scores were significantly associated with a lower risk of CVD (hazard ratio, 0.90 [95% confidence interval, 0.81-0.99]; per 5-point increment in Physical Component Summary). No associations with CVD were found for Mental Component Summary or Insomnia Rating Scale. CONCLUSION In BC survivors, poor physical HRQoL is a significant predictor of CVD. IMPLICATIONS FOR PRACTICE Our findings highlight the importance for nurses to assess and promote physical HRQoL as part of a holistic approach to mitigating the risk of CVD in BC survivors.
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Affiliation(s)
- Alexi Vasbinder
- Author Affiliations: Department of Biobehavioral Nursing and Health Informatics, School of Nursing (Drs Vasbinder, Zaslavsky, Thompson, and Reding); and Department of Epidemiology, School of Public Health (Dr Heckbert), University of Washington, Seattle; Division of Cardiology, Departments of Medicine and Radiology, University of Washington Medical Center (Dr Cheng), Seattle; Research Unit, College of Medicine, Sulaiman Al-Rajhi University (Dr Saquib), Al Bukairiyah, Saudi Arabia; Department of Epidemiology, College of Public Health, University of Iowa (Dr Wallace), Iowa City; Division of Epidemiologic Research, Department of Research and Evaluation, Kaiser Permanente Southern California & Health Systems Science, Kaiser Permanente School of Medicine (Dr Haque), Pasadena; and Comprehensive Cancer Center and the Department of Medicine, The Ohio State University (Dr Paskett), Columbus
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Hawlader MDH, Rashid MU, Khan MAS, Liza MM, Akter S, Hossain MA, Rahman T, Barsha SY, Shifat AA, Hossian M, Mishu TZ, Sagar SK, Manna RM, Ahmed N, Debu SSSD, Chowdhury I, Sabed S, Ahmed M, Borsha SA, Al Zafar F, Hyder S, Enam A, Babul H, Nur N, Haque MMA, Roy S, Tanvir Hassan KM, Rahman ML, Nabi MH, Dalal K. Quality of life of COVID-19 recovered patients: a 1-year follow-up study from Bangladesh. Infect Dis Poverty 2023; 12:79. [PMID: 37626363 PMCID: PMC10463646 DOI: 10.1186/s40249-023-01125-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 08/01/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic posed a danger to global public health because of the unprecedented physical, mental, social, and environmental impact affecting quality of life (QoL). The study aimed to find the changes in QoL among COVID-19 recovered individuals and explore the determinants of change more than 1 year after recovery in low-resource settings. METHODS COVID-19 patients from all eight divisions of Bangladesh who were confirmed positive by reverse transcription-polymerase chain reaction from June 2020 to November 2020 and who subsequently recovered were followed up twice, once immediately after recovery and again 1 year after the first follow-up. The follow-up study was conducted from November 2021 to January 2022 among 2438 individuals using the World Health Organization Quality of Life Brief Version (WHOQOL-BREF). After excluding 48 deaths, 95 were rejected to participate, 618 were inaccessible, and there were 45 cases of incomplete data. Descriptive statistics, paired-sample analyses, generalized estimating equation (GEE) analysis, and multivariable logistic regression analyses were performed to test the mean difference in participants' QoL scores between the two interviews. RESULTS Most participants (n = 1710, 70.1%) were male, and one-fourth (24.4%) were older than 46. The average physical domain score decreased significantly from baseline to follow-up, and the average scores in psychological, social, and environmental domains increased significantly at follow-up (P < 0.05). By the GEE equation approach, after adjusting for other factors, we found that older age groups (P < 0.001), being female (P < 0.001), having hospital admission during COVID-19 illness (P < 0.001), and having three or more chronic diseases (P < 0.001), were significantly associated with lower physical and psychological QoL scores. Higher age and female sex [adjusted odd ratio (aOR) = 1.3, 95% confidence interval (CI) 1.0-1.6] were associated with reduced social domain scores on multivariable logistic regression analysis. Urban or semi-urban people were 49% less likely (aOR = 0.5, 95% CI 0.4-0.7) and 32% less likely (aOR = 0.7, 95% CI 0.5-0.9) to have a reduced QoL score in the psychological domain and the social domain respectively, than rural people. Higher-income people were more likely to experience a decrease in QoL scores in physical, psychological, social, and environmental domains. Married people were 1.8 times more likely (aOR = 1.8, 95% CI 1.3-2.4) to have a decreased social QoL score. In the second interview, people admitted to hospitals during their COVID-19 infection showed a 1.3 times higher chance (aOR = 1.3, 95% CI 1.1-1.6) of a decreased environmental QoL score. Almost 13% of participants developed one or more chronic diseases between the first and second interviews. Moreover, 7.9% suffered from reinfection by COVID-19 during this 1-year time. CONCLUSIONS The present study found that the QoL of COVID-19 recovered people improved 1 year after recovery, particularly in psychological, social, and environmental domains. However, age, sex, the severity of COVID-19, smoking habits, and comorbidities were significantly negatively associated with QoL. Events of reinfection and the emergence of chronic disease were independent determinants of the decline in QoL scores in psychological, social, and physical domains, respectively. Strong policies to prevent and minimize smoking must be implemented in Bangladesh, and we must monitor and manage chronic diseases in people who have recovered from COVID-19.
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Affiliation(s)
| | - Md Utba Rashid
- Department of Public Health, North South University, Bashundhara, Dhaka, 1229, Bangladesh
- International Centre for Diarrhoeal Disease Research, Bangladesh, Mohakhali, Dhaka, 1212, Bangladesh
| | - Md Abdullah Saeed Khan
- Department of Public Health, North South University, Bashundhara, Dhaka, 1229, Bangladesh
- National Institute of Preventive and Social Medicine, Mohakhali, Dhaka, 1212, Bangladesh
| | - Mowshomi Mannan Liza
- Department of Public Health, North South University, Bashundhara, Dhaka, 1229, Bangladesh
- Ibn Sina Medical College Hospital, Kallyanpur, Dhaka, 1216, Bangladesh
| | - Sharmin Akter
- Department of Public Health, North South University, Bashundhara, Dhaka, 1229, Bangladesh
- Ibn Sina Medical College Hospital, Kallyanpur, Dhaka, 1216, Bangladesh
| | - Mohammad Ali Hossain
- Department of Public Health, North South University, Bashundhara, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Tajrin Rahman
- Department of Public Health, North South University, Bashundhara, Dhaka, 1229, Bangladesh
| | - Sabrina Yesmin Barsha
- Department of Public Health, North South University, Bashundhara, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Alberi Afifa Shifat
- Department of Public Health, North South University, Bashundhara, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Mosharop Hossian
- Department of Public Health, North South University, Bashundhara, Dhaka, 1229, Bangladesh
| | - Tahmina Zerin Mishu
- Department of Public Health, North South University, Bashundhara, Dhaka, 1229, Bangladesh
| | - Soumik Kha Sagar
- Department of Public Health, North South University, Bashundhara, Dhaka, 1229, Bangladesh
- International Centre for Diarrhoeal Disease Research, Bangladesh, Mohakhali, Dhaka, 1212, Bangladesh
| | - Ridwana Maher Manna
- Department of Public Health, North South University, Bashundhara, Dhaka, 1229, Bangladesh
- International Centre for Diarrhoeal Disease Research, Bangladesh, Mohakhali, Dhaka, 1212, Bangladesh
| | - Nawshin Ahmed
- Department of Public Health, North South University, Bashundhara, Dhaka, 1229, Bangladesh
| | | | - Irin Chowdhury
- Department of Public Health, North South University, Bashundhara, Dhaka, 1229, Bangladesh
| | - Samanta Sabed
- Department of Public Health, North South University, Bashundhara, Dhaka, 1229, Bangladesh
| | - Mashrur Ahmed
- Department of Public Health, North South University, Bashundhara, Dhaka, 1229, Bangladesh
| | - Sabrina Afroz Borsha
- Department of Public Health, North South University, Bashundhara, Dhaka, 1229, Bangladesh
| | - Faraz Al Zafar
- Department of Public Health, North South University, Bashundhara, Dhaka, 1229, Bangladesh
| | - Sabiha Hyder
- Department of Public Health, North South University, Bashundhara, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Abdullah Enam
- Department of Public Health, North South University, Bashundhara, Dhaka, 1229, Bangladesh
- Covid Vaccine Coordination Cell, Directorate General of Health Services (DGHS), Dhaka, Bangladesh
| | - Habiba Babul
- Department of Public Health, North South University, Bashundhara, Dhaka, 1229, Bangladesh
| | - Naima Nur
- Department of Public Health, North South University, Bashundhara, Dhaka, 1229, Bangladesh
| | - Miah Md Akiful Haque
- Department of Public Health, North South University, Bashundhara, Dhaka, 1229, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, 1205, Bangladesh
| | - Shopnil Roy
- Institute of Statistical Research and Training (ISRT), University of Dhaka, Dhaka, 1000, Bangladesh
| | - K M Tanvir Hassan
- Institute of Statistical Research and Training (ISRT), University of Dhaka, Dhaka, 1000, Bangladesh
| | - Mohammad Lutfor Rahman
- Institute of Statistical Research and Training (ISRT), University of Dhaka, Dhaka, 1000, Bangladesh
| | - Mohammad Hayatun Nabi
- Department of Public Health, North South University, Bashundhara, Dhaka, 1229, Bangladesh
| | - Koustuv Dalal
- School of Health Sciences, Division of Public Health Science, Mid Sweden University, Sundsvall, Sweden.
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López-Herreros J, Martínez-González MA, Gea A, Sánchez-Villegas A, Dierssen-Sotos T, Jiménez-Moleón JJ, Ruiz-Canela M, Toledo E. Health-related quality of life and mortality in the 'Seguimiento Universidad de Navarra' prospective cohort study. Exp Gerontol 2023; 178:112224. [PMID: 37244372 DOI: 10.1016/j.exger.2023.112224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 05/03/2023] [Accepted: 05/24/2023] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To study the association between health-related quality of life (HRQoL) and all-cause mortality in a healthy middle-aged Mediterranean cohort. METHODS We included 15,390 participants -mean age 42.8 years at first HRQoL ascertainment, all university graduates-. HRQoL was assessed with the self-administered Medical Outcomes Study Short Form-36 (SF-36) twice, with a 4-year gap. We used multivariable-adjusted Cox regression models to address the relation between self-reported health and Physical or Mental Component Summary (PCS-36 or MCS-36) and mortality, and their interaction with prior comorbidities or adherence to the Mediterranean diet (MedDiet). RESULTS Over 8.7 years of median follow-up time, 266 deaths were identified. Hazard ratio (HR) for the excellent vs. poor/fair category in self-reported health was 0.30 (95 % confidence interval (CI), 0.16-0.57) in the model with repeated measurements of HRQoL. Both the PCS-36 (HRquartile4(Q4)vs.Q1 0.57 [95%CI, 0.36-0.90], ptrend < 0.001; HRper+10points: 0.64 [95%CI, 0.54-0.75]) and the MCS-36 (HRQ4vs.Q1 0.67 [95%CI, 0.46-0.97], ptrend = 0.025; HRper+10points: 0.86 [95%CI, 0.74-0.99]) were inversely associated with mortality in the model with repeated measurements of HRQoL. Previous comorbidities or adherence to the MedDiet did not modify these associations. CONCLUSIONS Self-reported HRQoL -assessed as self-reported health, PCS-36 and MCS-36- obtained with the Spanish version of the SF-36 were inversely associated with mortality risk, regardless of the presence of previous comorbidities or adherence to the MedDiet.
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Affiliation(s)
- J López-Herreros
- Universidad de Navarra, Department of Preventive Medicine and Public Health, Pamplona, Spain
| | - M A Martínez-González
- Universidad de Navarra, Department of Preventive Medicine and Public Health, Pamplona, Spain; Biomedical Research Network Centre for Pathophysiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain; Department of Nutrition, Harvard T. H Chan School, Boston, MA 02115, USA
| | - A Gea
- Universidad de Navarra, Department of Preventive Medicine and Public Health, Pamplona, Spain; Biomedical Research Network Centre for Pathophysiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - A Sánchez-Villegas
- Biomedical Research Network Centre for Pathophysiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain; ISFOOD - Institute for Innovation & Sustainable Development in Food Chain, Universidad Pública de Navarra (UPNA), Pamplona, Spain
| | - T Dierssen-Sotos
- Biomedical Research Network Centre for Pathophysiology of Epidemiology and Public Health (CIBERESP), Carlos III Health Institute, Madrid, Spain; IDIVAL Santander, 39011 Santander, Spain; Faculty of Medicine, University of Cantabria, 39011 Santander, Spain
| | - J J Jiménez-Moleón
- Biomedical Research Network Centre for Pathophysiology of Epidemiology and Public Health (CIBERESP), Carlos III Health Institute, Madrid, Spain; Universidad de Granada, Department of Preventive Medicine and Public Health, Granada, Spain; Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain
| | - M Ruiz-Canela
- Universidad de Navarra, Department of Preventive Medicine and Public Health, Pamplona, Spain; Biomedical Research Network Centre for Pathophysiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - E Toledo
- Universidad de Navarra, Department of Preventive Medicine and Public Health, Pamplona, Spain; Biomedical Research Network Centre for Pathophysiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain.
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Luo G, Li W, Wu D, Wei X, Zang Y, Liu JD. Quality of life profiles and their associations with depressive symptoms and cognitive impairment of community-dwelling older adults in Hong Kong. Front Public Health 2023; 11:1165934. [PMID: 37275496 PMCID: PMC10233146 DOI: 10.3389/fpubh.2023.1165934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 04/17/2023] [Indexed: 06/07/2023] Open
Abstract
Background This study aimed to (1) explore the quality of life (QoL) profiles of older adults in Hong Kong and (2) examine their association with predictors (age, sex, body mass index, and depressive symptoms) and distal outcome (cognitive impairment) using a person-centered approach. Methods A total number of 328 community-dwelling older adults in Hong Kong were invited to participate in this study. Data from 259 older adults were identified as valid for the primary analysis. Latent profile analysis was used to explore QoL profiles. Multinomial logistic regression using the R3STEP function in Mplus was used to explore the predictive role of age, sex, body mass index, and depressive symptoms in profile membership. The Bolck-Croon-Hagenaars approach was used to examine how the distal outcome of cognitive impairment differs as a function of QoL profiles. Results Three QoL profiles emerged from the latent profile analysis (Low, Moderate and High QoL). It was found that depression, but not age, sex, or body mass index, significantly predicted QoL profile membership. The results of the Bolck-Croon-Hagenaars analysis revealed no significant differences in cognitive impairment across the three QoL profiles. Conclusion This is the first study that examined the relationship between QoL, depressive symptoms and cognitive impairment of older adults using a person-centered approach. The findings provide additional information for the evidence obtained from variable-centered approach on the associations among variables abovementioned. Our additional focus on the antecedents of emergent QoL profiles also provide practical knowledge regarding timely treatment for or prevention of depressive symptoms, which we submit will be crucial for enhancing the QoL of older adults.
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Affiliation(s)
- Guozhi Luo
- Department of Geriatric Psychiatry, Shenzhen Kangning Hospital, Shenzhen, China
| | - Weiping Li
- Weighting and Combat Sports Administrative Center of Guangdong, Guangzhou, China
| | - Donghai Wu
- Department of Physical Education, Sun Yat-Sen University, Guangzhou, China
| | - Xinyue Wei
- Department of Physical Education, Sun Yat-Sen University, Guangzhou, China
| | - Yanpeng Zang
- Department of Physiotherapy, School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, Hong Kong SAR, China
| | - Jing-Dong Liu
- Department of Physical Education, Sun Yat-Sen University, Guangzhou, China
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Phyo AZZ, Gonzalez-Chica DA, Stocks NP, Woods RL, Fisher J, Tran T, Owen AJ, Ward SA, Britt CJ, Ryan J, Freak-Poli R. Impact of economic factors, social health and stressful life events on physical health-related quality of life trajectories in older Australians. Qual Life Res 2022; 31:1321-1333. [PMID: 34677781 PMCID: PMC8532095 DOI: 10.1007/s11136-021-03021-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2021] [Indexed: 12/03/2022]
Abstract
PURPOSE Physical health-related quality of life (HRQoL) is associated with adverse health outcomes, including hospitalizations and all-cause mortality. However, little is known about how physical HRQoL changes over time in older people and the predictors of this trajectory. This study (a) identified trajectories of physical HRQoL among older people and (b) explored whether economic factors, social health or stressful life events impact physical HRQoL trajectories. METHOD A cohort of 12,506 relatively 'healthy' community-dwelling Australians aged ≥ 70 years (54.4% females), enrolled in the ASPREE Longitudinal Study of Older Persons (ALSOP) study and was followed for six years. Economic factors, social health and life events in the last 12 months were assessed through a questionnaire at baseline. Physical HRQoL was measured by using the 12-item short form at baseline and annual follow-ups. Growth mixture and structural equation modelling were used to identify physical HRQoL trajectories and their predictors. RESULTS Four physical HRQoL trajectories were identified-stable low (7.1%), declining (9.0%), stable intermediate (17.9%) and stable high (66.0%). Living in more disadvantaged areas, having a lower household income, no paid work, no voluntary work, loneliness and stressful life events (i.e. spousal illness, friend/family illness, financial problem) were associated with a 10%-152% higher likelihood of being in the stable low or declining physical HRQoL trajectory than the stable high group. CONCLUSION Specific stressful life events had a greater impact on adverse physical HRQoL trajectories in older people than other factors. Volunteering may prevent physical HRQoL decline and requires further investigation.
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Affiliation(s)
- Aung Zaw Zaw Phyo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - David A Gonzalez-Chica
- Discipline of General Practice, Adelaide Medical School, The University of Adelaide, Adelaide, SA, 5005, Australia
- Adelaide Rural Clinical School, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - Nigel P Stocks
- Discipline of General Practice, Adelaide Medical School, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - Robyn L Woods
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Jane Fisher
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Thach Tran
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Alice J Owen
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Stephanie A Ward
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Carlene J Britt
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Joanne Ryan
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Rosanne Freak-Poli
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
- Department of Epidemiology, Erasmus Medical Centre, 3015 GD, Rotterdam, The Netherlands.
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Jatta S, Ian BS, Robert M. Inequalities in recovery or methodological artefact? A comparison of models across physical and mental health functioning. SSM Popul Health 2022; 17:101067. [PMID: 35284618 PMCID: PMC8914363 DOI: 10.1016/j.ssmph.2022.101067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 01/31/2022] [Accepted: 03/03/2022] [Indexed: 12/03/2022] Open
Abstract
Considerable attention has been paid to inequalities in health. More recently, focus has also turned to inequalities in ‘recovery’; with research, for example, suggesting that lower grade of employment is strongly associated with slower recovery from both poor physical and poor mental health. However, this research has tended to operationalise recovery as ‘return to baseline’, and we know less about patterns and predictors when recovery is situated as a ‘process’. This paper seeks to address this gap. Drawing on data from the UK Household Longitudinal Study, we operationalise recovery as both an ‘outcome’ and as a ‘process’ and compare patterns and predictors across the two models. Our analysis demonstrates that the determinants of recovery from poor health, measured by the SF-12, are robust, regardless of whether recovery is operationalised as an outcome or as a process. For example, being employed and having a higher degree were found to increase the odds of recovery both from poor physical and mental health functioning, when recovery was operationalised as an outcome. These variables were also important in distinguishing health functioning trajectories following a poor health episode. At one and the same time, our analysis does suggest that understandings of inequalities in recovery will depend in part on how we define it. When recovery is operationalised as a simple transition from poor health state to good, it loses sight of the fact that there may be inequalities (i) within a ‘poor health’ state, (ii) in how individuals are able to step into the path of recovery, and (iii) in whether health states are maintained over time. We therefore need to remain alert to the additional nuance in understanding which comes from situating recovery as a process; as well as possible methodological artefacts in population research which come from how recovery is operationalised. There is no consensus on what recovery is and how it should be operationalised. Understanding of inequalities in recovery across health conditions remains scarce. We operationalised recovery both as an outcome and as a process. We found robust inequalities in recovery across the two approaches. Considering recovery as a process revealed more nuanced patterns in inequalities.
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Phyo AZZ, Gonzalez-Chica DA, Stocks NP, Woods RL, Tran T, Reid CM, Tonkin AM, Nelson MR, McNeil JJ, Murray AM, Gasevic D, Freak-Poli R, Ryan J. Trajectories of physical health-related quality of life and the risk of incident cardiovascular disease events and all-cause mortality in older people. AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2022; 13:100117. [PMID: 36959831 PMCID: PMC10031654 DOI: 10.1016/j.ahjo.2022.100117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Study objective The aim of this study was to identify whether physical component score (PCS) of health-related quality of life trajectories over 4.7-years predicted subsequent risk of incident fatal and non-fatal CVD events, and all-cause mortality. Methods This study included 16,871 community-dwelling people aged ≥65 years enrolled in the ASPREE (ASPirin in Reducing Events in the Elderly) trial. PCS was assessed annually using the SF-12 (version-2) over a median 4.7-years (i.e. from baseline (2010-2014) till June 2017). Incident CVD events and all-cause mortality occurring after June 2017 until the second-year after the end of the trial were considered. Growth mixture and logistic regression modelling were used. Results Four PCS trajectories were identified: high (66.5%), intermediate (13.3%), decline (13.8%), and low (6.5%), and there was subsequently a total of 406 (2.50%) incident CVD events, 197 (1.17%) fatal CVD, and 751 (4.45%) deaths. The declining PCS trajectory group had the highest risk of incident CVD (adjusted OR, 1.51; 95% CI 1.14, 1.99), while the low PCS trajectory group had the greatest risk of fatal CVD (adjusted OR, 1.74; 95%CI 1.06, 2.85) and all-cause mortality (adjusted OR, 1.83; 95%CI 1.40, 2.40). After further adjustment for the baseline PCS score, only the association between declining PCS trajectory and incident CVD (adjusted OR, 1.51; 95%CI 1.11, 2.07) remained. Conclusion Our study strengthens the importance of PCS as a predictive measure of CVD and all-cause mortality in older people and also highlights that a declining PCS trajectory could be considered an early predictor of future CVD events.
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Affiliation(s)
- Aung Zaw Zaw Phyo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - David A. Gonzalez-Chica
- Discipline of General Practice, Adelaide Medical School, University of Adelaide, Adelaide, SA 5005, Australia
- Adelaide Rural Clinical School, University of Adelaide, Adelaide, SA 5005, Australia
| | - Nigel P. Stocks
- Discipline of General Practice, Adelaide Medical School, University of Adelaide, Adelaide, SA 5005, Australia
| | - Robyn L. Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Thach Tran
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Christopher M. Reid
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
- School of Public Health, Curtin University, Perth, WA 6102, Australia
| | - Andrew M. Tonkin
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Mark R. Nelson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS 7000, Australia
| | - John J. McNeil
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Anne M. Murray
- Berman Center for Outcomes and Clinical Research, Hennepin HealthCare Research Institute, Hennepin HealthCare, Minneapolis, MN 55415, United States
- Division of Geriatrics, Department of Medicine, Hennepin HealthCare and University of Minnesota, Minneapolis, MN 55415, United States
| | - Danijela Gasevic
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
- Usher Institute, University of Edinburgh, Teviot Place, Edinburgh EH8 9AG, UK
| | - Rosanne Freak-Poli
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
- Corresponding author at: School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Road, Melbourne, VIC 3004, Australia., (J. Ryan)
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9
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Association of Health-Related Quality of Life with Atherosclerotic Cardiovascular Disease: Lifetime Risk Pooling Project. Am J Prev Cardiol 2021; 7:100222. [PMID: 34611648 PMCID: PMC8387281 DOI: 10.1016/j.ajpc.2021.100222] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 06/23/2021] [Accepted: 06/27/2021] [Indexed: 11/22/2022] Open
Abstract
Objective The Pooled Cohort Equations (PCE) serve as the platform for quantitative risk assessment for atherosclerotic cardiovascular disease (ASCVD). Data are sparse regarding the benefit of adding health-related quality of life (HRQoL) measures to the PCE. We sought to estimate the association of HRQoL with ASCVD events and evaluate the potential utility of adding HRQoL to the PCE in refining quantitative risk assessment for primary prevention decisions. Methods Three multi-ethnic longitudinal cohorts were included in the study. HRQoL was measured using the SF-12 physical component summary (PCS) and mental component summary (MCS); higher PCS or MCS scores indicate better HRQoL. We constructed a four-level HRQoL status variable: MCS <50 and PCS <50; MCS <50 and PCS ≥50; MCS ≥50 and PCS <50; MCS ≥50 and PCS ≥50. Harrell's C statistics and net reclassification improvement (NRI) analyses were used to assess the added predictive ability of HRQoL for incident ASCVD. Results A total of 9,904 individuals were included in the analysis, of whom 4,743 were in the low risk subgroup (<5% predicted 10-year risk). HRQoL status, PCS and its subscale scores were independent predictors of ASCVD events. HRQoL improved both discrimination (delta C: 0.004, p = 0.05) and reclassification (cNRI: 0.15, p<0.01) modestly when added to PCE; 3% and 6% of individuals with events were correctly reclassified to higher risk in the overall sample and low risk subgroup, respectively. Conclusion HRQoL is an independent predictor of ASCVD events, and improves ASCVD risk prediction significantly, though modestly, overall and in low-risk individuals. HRQoL may be a cost-effective risk-enhancing factor for refining quantitative risk assessment for primary prevention decisions.
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10
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Health-related quality of life and incident cardiovascular disease events in community-dwelling older people: A prospective cohort study. Int J Cardiol 2021; 339:170-178. [PMID: 34245793 PMCID: PMC9993351 DOI: 10.1016/j.ijcard.2021.07.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/17/2021] [Accepted: 07/02/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND Lower health-related quality of life (HRQoL) has been shown to predict a higher risk of hospital readmission and mortality in patients with cardiovascular disease (CVD). Few studies have explored the associations between HRQoL and incident CVD. We explored the associations between baseline HRQoL and incident and fatal CVD in community-dwelling older people in Australia and the United States. METHODS Longitudinal study using ASPirin in Reducing Events in the Elderly (ASPREE) trial data. This includes 19,106 individuals aged 65-98 years, initially free of CVD, dementia, or disability, and followed between March 2010 and June 2017. The physical (PCS) and mental component scores (MCS) of HRQoL were assessed using the SF-12 questionnaire. Incident major adverse CVD events included fatal CVD (death due to atherothrombotic CVD), hospitalizations for heart failure, myocardial infarction or stroke. Analyses were performed using Cox proportional-hazard regression. RESULTS Over a median 4.7 follow-up years, there were 922 incident CVD events, 203 fatal CVD events, 171 hospitalizations for heart failure, 355 fatal or nonfatal myocardial infarction and 403 fatal or nonfatal strokes. After adjustment for sociodemographic, health-related behaviours and clinical measures, a 10-unit higher PCS, but not MCS, was associated with a 14% lower risk of incident CVD, 28% lower risk of hospitalization for heart failure and 15% lower risk of myocardial infarction. Neither PCS nor MCS was associated with fatal CVD events or stroke. CONCLUSION Physical HRQoL can be used in combination with clinical data to identify the incident CVD risk among older individuals.
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11
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Phyo AZZ, Gonzalez-Chica DA, Stocks NP, Storey E, Woods RL, Murray AM, Orchard SG, Shah RC, Gasevic D, Freak-Poli R, Ryan J. The Utility of Assessing Health-Related Quality of Life to Predict Cognitive Decline and Dementia. J Alzheimers Dis 2021; 80:895-904. [PMID: 33579847 DOI: 10.3233/jad-201349] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Health-related quality of life (HRQoL) has been shown to predict adverse health outcome in the general population. OBJECTIVE We examined the cross-sectional association between HRQoL and cognitive performance at baseline. Next, we explored whether baseline HRQoL predicted 5-year incident cognitive decline and dementia and whether there were gender differences. METHODS 19,106 community-dwelling participants from the ASPirin in Reducing Events in the Elderly (ASPREE) trial, aged 65-98 years, free of major cognitive impairments, and completed the HRQoL 12-item short-form (SF-12) at baseline (2010-2014), were followed until June 2017. The physical (PCS) and mental component scores (MCS) of SF-12 were calculated. The cognitive tests were assessed at baseline, year 1, 3, 5, and 7 or close-out visit. Cognitive decline was defined as > 1.5 SD drop from baseline on any of the cognitive tests. Dementia was adjudicated according to DSM-IV criteria. Linear and Cox proportional-hazards regressions were used to examine the cross-sectional and longitudinal associations respectively. RESULTS At baseline, higher PCS and MCS were associated with better cognition. Over a median 4.7-year follow-up, higher MCS was associated with a reduced risk of cognitive decline and dementia (12% and 15% respectively, per 10-unit increase) and a 10-unit higher PCS was associated with a 6% decreased risk of cognitive decline. PCS did not predict dementia incidence. Findings were not different by gender. CONCLUSION Our study found that higher HRQoL, in particular MCS, predicted a reduced risk of cognitive decline and dementia over time in community-dwelling older people.
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Affiliation(s)
- Aung Zaw Zaw Phyo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - David A Gonzalez-Chica
- Discipline of General Practice, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia.,Adelaide Rural Clinical School, The University of Adelaide, Adelaide, SA, Australia
| | - Nigel P Stocks
- Discipline of General Practice, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
| | - Elsdon Storey
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Robyn L Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Anne M Murray
- Berman Center for Outcomes and Clinical Research, Hennepin HealthCare Research Institute, Hennepin HealthCare Minneapolis, Minnesota, MN, USA.,Division of Geriatrics, Department of Medicine, Hennepin HealthCare and University of Minnesota, Minneapolis, Minnesota, MN, USA
| | - Suzanne G Orchard
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Raj C Shah
- Department of Family Medicine and Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Danijela Gasevic
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,Usher Institute, University of Edinburgh, Teviot Place, Edinburgh, UK
| | - Rosanne Freak-Poli
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,PSNREC, Univ Montpellier, INSERM, Montpellier, France
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12
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Heidemann C, Scheidt-Nave C, Beyer AK, Baumert J, Thamm R, Maier B, Neuhauser H, Fuchs J, Kuhnert R, Hapke U. Health situation of adults in Germany - Results for selected indicators from GEDA 2019/2020-EHIS. JOURNAL OF HEALTH MONITORING 2021; 6:3-25. [PMID: 35146314 PMCID: PMC8734117 DOI: 10.25646/8459] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 08/09/2021] [Indexed: 01/20/2023]
Abstract
In this article, we examine selected health indicators for the adult population aged 18 years and older in Germany (n=22,708) from the German Health Update (GEDA 2019/2020-EHIS) conducted between April 2019 and September 2020. These indicators include those of self-assessed health and depressive symptoms as well as chronic physical diseases and conditions. In young adulthood (18 to 44 years), over 80% of participants report good or very good subjective health. During this phase of life, most chronic diseases and conditions are rare, although allergies are frequent, and bronchial asthma and depressive symptoms are not uncommon. From mid adulthood (45 years and older), there is a gradual increase in the prevalence of chronic diseases such as cardiovascular disease, diabetes, chronic obstructive pulmonary disease and osteoarthritis. Over 60% of older adults (65 years and older) report a chronic disease or long-term health problem, while only half continue to report good or very good subjective health. During this stage of life, allergies and depressive symptoms become less prevalent. For some diseases, there are also differences according to gender and level of education. This article demonstrates the high public health relevance of age-associated chronic physical diseases and health related limitations in everyday life in an ageing society as well as the need to provide care for certain health conditions already in young adulthood.
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Affiliation(s)
- Christin Heidemann
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
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13
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Heidemann C, Scheidt-Nave C, Beyer AK, Baumert J, Thamm R, Maier B, Neuhauser H, Fuchs J, Kuhnert R, Hapke U. Health situation of adults in Germany - Results for selected indicators from GEDA 2019/2020-EHIS. JOURNAL OF HEALTH MONITORING 2021. [PMID: 35146314 DOI: 10.25646/8456:3-27] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
In this article, we examine selected health indicators for the adult population aged 18 years and older in Germany (n=22,708) from the German Health Update (GEDA 2019/2020-EHIS) conducted between April 2019 and September 2020. These indicators include those of self-assessed health and depressive symptoms as well as chronic physical diseases and conditions. In young adulthood (18 to 44 years), over 80% of participants report good or very good subjective health. During this phase of life, most chronic diseases and conditions are rare, although allergies are frequent, and bronchial asthma and depressive symptoms are not uncommon. From mid adulthood (45 years and older), there is a gradual increase in the prevalence of chronic diseases such as cardiovascular disease, diabetes, chronic obstructive pulmonary disease and osteoarthritis. Over 60% of older adults (65 years and older) report a chronic disease or long-term health problem, while only half continue to report good or very good subjective health. During this stage of life, allergies and depressive symptoms become less prevalent. For some diseases, there are also differences according to gender and level of education. This article demonstrates the high public health relevance of age-associated chronic physical diseases and health related limitations in everyday life in an ageing society as well as the need to provide care for certain health conditions already in young adulthood.
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Affiliation(s)
- Christin Heidemann
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | | | - Ann-Kristin Beyer
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Jens Baumert
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Roma Thamm
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Birga Maier
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Hannelore Neuhauser
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Judith Fuchs
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Ronny Kuhnert
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Ulfert Hapke
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
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14
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Hazelwood JE, Hoeritzauer I, Carson A, Stone J, Demetriades AK. Long-term mental wellbeing and functioning after surgery for cauda equina syndrome. PLoS One 2021; 16:e0255530. [PMID: 34358259 PMCID: PMC8345886 DOI: 10.1371/journal.pone.0255530] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 07/17/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction Cauda Equina Syndrome (CES) can cause persisting life-changing dysfunction. There is scarce literature regarding the long-term assessment of CES symptoms, and rarer still is the impact of these symptoms on mental wellbeing investigated. This study assessed the long-term patient reported mental wellbeing outcomes of post-operative CES patients. Methods Patients who underwent surgery for CES between August 2013 and November 2014 were identified using an ethically approved database. They then completed validated questionnaires over the telephone assessing their mental and physical functioning (Short-Form 12 Questionnaire), generating the Physical Component Summary (PCS) and Mental Component Summary (MCS). Bladder, bowel and sexual function were also assessed using validated questionnaires. MCS scores were compared to both the Scottish mean and previously published cut-offs indicating patients at risk of depression. Correlations of MCS with bladder, bowel, sexual and physical dysfunction were examined and multifactorial regression to predict MCS from these variables analysed. Independent t-tests assessed the mean difference in MCS between patients presenting with incomplete CES (CES-I) and CES with retention (CES-R) and between those with radiologically confirmed and impending CES. Results Forty-six participants with a mean follow-up time of 43 months completed the study. The mean (±SD) MCS was 49 (±11.8) with 22% demonstrating poor mental health related quality of life in comparison to the Scottish mean. Overall, 37% had scores consistent with being at risk for depression with in the last 30 days, and 45% within the last 12 months. MCS was significantly correlated with Urinary Symptoms Profile (USP) score (-0.608), NBDS score (-0.556), ASEX score (-0.349) and PCS score (0.413) with worse bladder, bowel, sexual and physical dysfunction associated with worse MCS score. Multifactorial regression analysis demonstrated both urinary (USP score p = 0.031) and bowel function (NBDS score p = 0.009) to be significant predictive variables of mental health related quality of life. There were no significant mean differences in MCS between those presenting with CES-I and CES-R or those with radiologically complete and impending CES. Discussion This study demonstrates a high frequency of being at risk for depression in patients with CES and identifies outcome measures (physical, sexual and more so bladder and bowel dysfunction) associated with poorer mental wellbeing. Our large cohort and long follow-up highlight that CES patients should be considered at risk of depression, and the need to consider mental health outcomes following CES surgery.
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Affiliation(s)
- James E. Hazelwood
- Edinburgh Spinal Surgery Outcomes Study Group, Edinburgh, United Kingdom
- Chelsea and Westminster Hospital, London, United Kingdom
| | - Ingrid Hoeritzauer
- Edinburgh Spinal Surgery Outcomes Study Group, Edinburgh, United Kingdom
- Department of Clinical Neurosciences (Neurology), Royal Infirmary of Edinburgh, Little France, Edinburgh, Scotland, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Alan Carson
- Department of Clinical Neurosciences (Neurology), Royal Infirmary of Edinburgh, Little France, Edinburgh, Scotland, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Department of Rehabilitation Medicine, NHS Lothian, Edinburgh, United Kingdom
| | - Jon Stone
- Department of Clinical Neurosciences (Neurology), Royal Infirmary of Edinburgh, Little France, Edinburgh, Scotland, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Andreas K. Demetriades
- Edinburgh Spinal Surgery Outcomes Study Group, Edinburgh, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Department of Clinical Neurosciences (Neurosurgery), Royal Infirmary of Edinburgh, Little France, Edinburgh, Scotland, United Kingdom
- * E-mail:
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15
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Pan CW, Liu RJ, Yang XJ, Ma QH, Xu Y, Luo N, Wang P. Could the EQ-5D-3L predict all-cause mortality in older Chinese? Evidence from a 5-year longitudinal study in eastern China. Qual Life Res 2021; 30:2887-2894. [PMID: 34028640 DOI: 10.1007/s11136-021-02883-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To assess the ability of the 3-level EQ-5D (i.e., EQ-5D-3L) in predicting all-cause mortality in older Chinese adults. METHODS The data were from a 5-year longitudinal study, Weitang Geriatric Diseases Study, including 4579 community-dwelling older people in eastern China, with the mean age of 72.5 years at baseline and female being 52.0%. Three multivariable logistic regression models were adopted to assess the associations of the baseline EQ-5D data [i.e., the EQ-5D problems, EQ-5D-3L index score, and EQ-5D visual analog scale (VAS) score] with the 5-year all-cause mortality, adjusting for socio-demographic characteristics, and subsequently, health conditions and lifestyle habits. RESULTS A total of 183 participants died over the 5-year study period. A larger proportion of the dead reported problems in physical dimensions (i.e., including three dimensions: mobility, self-care, and usual activities, p < 0.05 for all). The mean EQ-5D index score (0.928) and EQ-VAS score (79.7) of the living were higher than those of the dead (0.915 and 73.2, p < 0.05 for both). In multivariable logistic analyses, the EQ-5D health problems in the physical-related dimensions [odds ratio (OR) 2.16, p < 0.05] and the EQ-VAS score (OR: 0.97, p < 0.001) were associated with the 5-year all-cause mortality when adjusting for socio-demographic characteristics, health conditions, and lifestyle habits. CONCLUSIONS It appears that the EQ-5D-3L could predict mortality in general older Chinese, which could be used to detect high-risk older individuals in China.
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Affiliation(s)
- Chen-Wei Pan
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Rui-Jie Liu
- School of Public Health, Fudan University, 130 Dong An Road, Shanghai, 200032, China
| | - Xue-Jiao Yang
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Qing-Hua Ma
- The 3rd People's Hospital of Xiangcheng District, Suzhou, China
| | - Yong Xu
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Pei Wang
- School of Public Health, Fudan University, 130 Dong An Road, Shanghai, 200032, China. .,Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), Shanghai, China.
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16
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Phyo AZZ, Ryan J, Gonzalez-Chica DA, Woods RL, Reid CM, Nelson MR, Murray AM, Gasevic D, Stocks NP, Freak-Poli R. Health-related quality of life and all-cause mortality among older healthy individuals in Australia and the United States: a prospective cohort study. Qual Life Res 2021; 30:1037-1048. [PMID: 33389487 PMCID: PMC8005489 DOI: 10.1007/s11136-020-02723-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE Previous research has demonstrated that lower health-related quality of life (HRQoL) is associated with higher morbidity and mortality, especially in-patient groups. The association of HRQoL with all-cause mortality in community samples requires further investigation. This study aimed to examine whether HRQoL predicts all-cause mortality in older healthy community-dwelling people from Australia and the United States (U.S.) enrolled in the Aspirin in Reducing Events in the Elderly (ASPREE) trial. We also explored whether this association varies by gender or country. METHOD A prospective cohort of 19,106 individuals aged 65-98 years, who were without a dementia diagnosis or a known major life-limiting disease, and completed the 12-item short-form-HRQoL at recruitment (2010-2014). They were followed until June 2017. Cox proportional-hazard models were used to determine the association between the physical (PCS) and mental component scores (MCS) of HRQoL and all-cause mortality, adjusting for sociodemographic factors, health-related behaviours and clinical measures. Hazards ratios were estimated for every 10-unit increase in PCS or MCS. RESULTS There were 1052 deaths over a median 4.7-years (interquartile range 3.6-5.7) of follow-up, with 11.9 events per 1000 person-years. Higher PCS was associated with lower all-cause mortality (HR 0.83, 95% CI 0.77, 0.89) in the entire sample, while higher MCS was associated with lower mortality among U.S. participants only (HR 0.78, 95% CI 0.63, 0.95). Gender differences in the association of either PCS or MCS with mortality were not observed. CONCLUSION Our large study provides evidence that HRQoL is inversely associated with all-cause mortality among initially healthy older people.
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Affiliation(s)
- Aung Zaw Zaw Phyo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Joanne Ryan
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
- PSNREC, Univ Montpellier, INSERM, 34000, Montpellier, France
| | - David A Gonzalez-Chica
- Discipline of General Practice, Adelaide Medical School, The University of Adelaide, Adelaide, SA, 5005, Australia
- Adelaide Rural Clinical School, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - Robyn L Woods
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Christopher M Reid
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
- School of Public Health, Curtin University, Perth, WA, 6102, Australia
| | - Mark R Nelson
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia
| | - Anne M Murray
- Berman Center for Outcomes and Clinical Research, Hennepin HealthCare Research Institute, Hennepin HealthCare, Minneapolis, MN, 55415, USA
- Division of Geriatrics, Department of Medicine, Hennepin HealthCare and University of Minnesota, Minneapolis, MN, 55415, USA
| | - Danijela Gasevic
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
- Usher Institute, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, UK
| | - Nigel P Stocks
- Discipline of General Practice, Adelaide Medical School, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - Rosanne Freak-Poli
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
- Department of Epidemiology, Erasmus Medical Centre, 3015 GD, Rotterdam, The Netherlands.
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Choi EPH, Hui BPH, Wan EYF, Kwok JYY, Tam THL, Wu C. COVID-19 and Health-Related Quality of Life: A Community-Based Online Survey in Hong Kong. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063228. [PMID: 33804725 PMCID: PMC8003940 DOI: 10.3390/ijerph18063228] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/07/2021] [Accepted: 03/15/2021] [Indexed: 12/15/2022]
Abstract
The COVID-19 pandemic itself and related public health measurements have had substantial impacts on individual social lives and psychological and mental health, all to the detriment of health-related quality of life (HRQoL). There have been extensive studies investigating the mental health of people in different populations during the COVID-19 pandemic. However, few studies have explored the impact of COVID-19 and its association with HRQoL. To fill this research gap and provide further empirical evidence, this study examined the impact of COVID-19 on Hong Kong people and evaluated its association with HRQoL. A total of 500 participants were randomly recruited to complete an online questionnaire on their concerns related to COVID-19. This entailed responding to the World Health Organization Quality of Life-BREF instrument. Data were collected between 24 April and 3 May 2020. Independent t-tests and multiple linear regressions were used to examine the association between the impact of COVID-19 and HRQoL. Overall, 69.6% of participants were worried about contracting COVID-19, and 41.4% frequently suspected themselves of being infected. Furthermore, 29.0% were concerned by the lack of disinfectants. All of these findings were associated with poorer HRQoL in the physical and psychological health, social relationships, and environment domains. On the other hand, 47.4% of participants were concerned that they may lose their job because of the pandemic, while 39.4% were bothered by the insufficient supply of surgical masks. These two factors were associated with poorer HRQoL in the physical and psychological health and environment domains. The adverse impact of COVID-19 on individuals is multifactorial, affecting all aspects of HRQoL. In addition to enhancing anti-epidemic efforts, it is equally important to implement public health and social welfare measures, thereby diminishing the adverse impact of COVID-19 on overall well-being.
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Affiliation(s)
- Edmond Pui Hang Choi
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China; (J.Y.Y.K.); (C.W.)
- Correspondence: ; Tel.: +852-3917-6972
| | - Bryant Pui Hung Hui
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China;
| | - Eric Yuk Fai Wan
- Department of Family Medicine and Primary Care, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China;
- Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Jojo Yan Yan Kwok
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China; (J.Y.Y.K.); (C.W.)
| | | | - Chanchan Wu
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China; (J.Y.Y.K.); (C.W.)
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18
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Phyo AZZ, Freak-Poli R, Craig H, Gasevic D, Stocks NP, Gonzalez-Chica DA, Ryan J. Quality of life and mortality in the general population: a systematic review and meta-analysis. BMC Public Health 2020; 20:1596. [PMID: 33153441 PMCID: PMC7646076 DOI: 10.1186/s12889-020-09639-9] [Citation(s) in RCA: 88] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 10/01/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Quality of life (QoL) is multi-dimensional concept of an individual' general well-being status in relation to their value, environment, cultural and social context in which they live. This study aimed to quantitatively synthesise available evidence on the association between QoL and mortality in the general population. METHODS An electronic search was conducted using three bibliographic databases, MEDLINE, EMBASE and PsycINFO. Inclusion criteria were studies that assessed QoL using standardized tools and examined mortality risk in a non-patient population. Qualitative data synthesis and meta-analyses using a random-effects model were performed. RESULTS Of 4184 articles identified, 47 were eligible for inclusion, involving approximately 1,200,000 participants. Studies were highly heterogeneous in terms of QoL measures, population characteristics and data analysis. In total, 43 studies (91.5%) reported that better QoL was associated with lower mortality risk. The results of four meta-analyses indicated that higher health-related QoL (HRQoL) is associated with lower mortality risk, which was consistent for overall HRQoL (HR 0.633, 95% CI: 0.514 to 0.780), physical function (HR 0.987, 95% CI: 0.982 to 0.992), physical component score (OR 0.950, 95% CI: 0.935 to 0.965), and mental component score (OR 0.980, 95% CI: 0.969 to 0.992). CONCLUSION These findings provide evidence that better QoL/HRQoL was associated with lower mortality risk. The utility of these measures in predicting mortality risk indicates that they should be considered further as potential screening tools in general clinical practice, beyond the traditional objective measures such as body mass index and the results of laboratory tests.
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Affiliation(s)
- Aung Zaw Zaw Phyo
- School of Public Health and Preventive Medicine, Monash University, 99 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Rosanne Freak-Poli
- School of Public Health and Preventive Medicine, Monash University, 99 Commercial Road, Melbourne, VIC, 3004, Australia
- Department of Epidemiology, Erasmus Medical Centre, 3015 GD, Rotterdam, The Netherlands
| | - Heather Craig
- School of Public Health and Preventive Medicine, Monash University, 99 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Danijela Gasevic
- School of Public Health and Preventive Medicine, Monash University, 99 Commercial Road, Melbourne, VIC, 3004, Australia
- Usher Institute, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, UK
| | - Nigel P Stocks
- Discipline of General Practice, Adelaide Medical School, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - David A Gonzalez-Chica
- Discipline of General Practice, Adelaide Medical School, The University of Adelaide, Adelaide, SA, 5005, Australia
- Adelaide Rural Clinical School, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, 99 Commercial Road, Melbourne, VIC, 3004, Australia.
- PSNREC, Univ Montpellier, INSERM, 34000, Montpellier, France.
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19
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Hsieh CT, Yamazaki H, Wang J, Kamitani T, Yamamoto Y, Fukuhara S. Quality of Life and Disability-free Survival in the Elderly: The Locomotive Syndrome and Health Outcome in Aizu Cohort Study. J Aging Health 2020; 33:197-204. [PMID: 33124496 DOI: 10.1177/0898264320970323] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Objectives: The Short Form 12 Survey (SF-12) three-component model is used to compute health-related quality of life (QoL): it includes physical, mental, and role-social QoL. We asked whether the SF-12 three-component model is associated with disability-free survival. Methods: People ≥65 years old were included (n = 2634). SF-12 scores were assessed at baseline. The outcome was a composite of loss of independence (LoI) and death. LoI was defined using Japan's long-term care insurance categories. Hazard ratios (HRs) for LoI or death were estimated using Cox proportional hazards models. Results: Better physical QoL was inversely associated with LoI or death (adjusted HR per 10-point increase: .88 [95% CI: .81-.96]), but mental QoL was not. Better role-social QoL was inversely associated with LoI or death only among participants with higher than average physical QoL (adjusted HR per 10-point increase: .79 [95% CI: .65-.96], p for interaction = .04). Discussion: Physical QoL was associated with disability-free survival, and role-social QoL was associated with disability-free survival among those with better physical QoL.
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Affiliation(s)
- Cheng-Tzu Hsieh
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Hajime Yamazaki
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Jui Wang
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Tsukasa Kamitani
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yosuke Yamamoto
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shunichi Fukuhara
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Center for Innovative Research for Communities and Clinical Excellence, Fukushima Medical University, Fukushima.,Shirakawa STAR for General Medicine, Fukushima Medical University, Fukushima
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20
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An assessment of patient-reported long-term outcomes following surgery for cauda equina syndrome. Acta Neurochir (Wien) 2019; 161:1887-1894. [PMID: 31263950 PMCID: PMC6704093 DOI: 10.1007/s00701-019-03973-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Accepted: 05/30/2019] [Indexed: 01/19/2023]
Abstract
Background Data regarding long-term outcomes following surgery for cauda equina syndrome (CES) is scarce. In addition, these studies rely on patient descriptions of the presence or absence of symptoms, with no gradation of severity. This study aimed to assess long-term bladder, bowel, sexual and physical function using validated questionnaires in a CES cohort. Methods A pre-existing ethically approved database was used to identify patients who had undergone surgery for CES between August 2013 and November 2014. Patients were contacted over a 1-month period between August and September 2017 and completed validated questionnaires via telephone, assessing bladder (Urinary Symptom Profile), bowel (Neurogenic Bowel Dysfunction Score), sexual dysfunction (Arizona Sexual Experiences Scale) and physical function (Physical Component Summary of SF-12 Questionnaire), with scores compared between those presenting with incomplete CES (CES-I) and CES with retention (CES-R). Patients were also asked which of their symptoms currently they would most value treatment for and what healthcare services they had accessed post-operatively. Results Forty-six of 77 patients (response rate 72%, inclusion rate 60%) with a mean age of 45 years (21–83) and mean time since admission of 43 months (range 36–60) took part in the follow-up study. The prevalence of bladder dysfunction was 76%, bowel dysfunction 13%, sexual dysfunction 39% and physical dysfunction 48%. Patients presenting with CES-R had significantly worse long-term outcomes in bladder (stream domain), bowel and sexual function in compared to those with CES-I. Pain was chosen as the symptom patients would most value treatment for by 57%, but only 7% reported post-operative pain management referral. Conclusions With a mean follow-up time of 43 months, these findings confirm the high prevalence of long-term bladder, sexual and physical dysfunction in CES patients and that a diagnosis of CES-R confers poorer outcomes. This study provides useful, objective data to guide the expectations of patients and clinicians.
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21
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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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22
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Quality of life assessment in musculo-skeletal health. Aging Clin Exp Res 2018; 30:413-418. [PMID: 28664458 DOI: 10.1007/s40520-017-0794-8] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 06/23/2017] [Indexed: 12/18/2022]
Abstract
Musculoskeletal disorders affect morbidity, quality of life and mortality, and represent an increasing economic and societal burden in the context of population aging and increased life expectancy. Improvement of quality of life should be one of the priorities of any interventions to prevent and treat musculoskeletal disorders in the ageing population. Two main approaches, namely generic and disease-specific instruments, can be applied to measure health-related quality of life. Among the generic tools available in scientific literature, the short form 36 questionnaire (SF-36) and the Euroqol five item questionnaire (EQ-5D) are two of the most popular questionnaires used to quantify the health related quality of life in people with musculoskeletal disorders. However, because generic tools may not always be able to detect subtle effects of a specific condition on quality of life, a specific tool is highly valuable. Specific tools improve the ability to clinically characterize quality of life in subjects with a specific musculoskeletal disorder, as well as the capacity to assess changes over time in the QoL of these subjects. The recent development of specific tools should help to validate preventive and therapeutic interventions in this field.
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23
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Ramatillah DL, Syed Sulaiman SA, Khan AH, Meng OL. Quality of Life among Patients Undergoing Hemodialysis in Penang, Malaysia. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2017; 9:229-238. [PMID: 29456373 PMCID: PMC5810072 DOI: 10.4103/jpbs.jpbs_191_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Quality of life is one of the parameters to check the improvement of hemodialysis treatment among hemodialysed patients. Those patients will be dealing with this treatment in long term if this treatment is the only way for them to replace their kidney function and this thing will affect their quality of life. OBJECTIVE To evaluate the quality of life patients on hemodialysis using kidney disease quality of life-short term 24 (KDQoL-SF24) Malaysian Version. MATERIALS AND METHODS Cohort observational study was conducted in this study. The study included 78 hemodialysed patients in HD center Penang, Malaysia. RESULTS There were 9 components which had the lower of the mean and standard deviation (SD) than the standard form; work status (15.01 ± 35.57), cognitive function (75.66 ± 13.75), quality of life social interaction (76.32 ± 16.11), sleep (55.86 ± 15.30), social support (59.61 ± 22.08), patient satisfaction (43.24 ± 15.32), physical functioning (50.06 ± 42.81), general health (29.62 ± 25.56), and role emotional (54.27 ± 49.92). In this HD center, the group of patient's age who had the lower mean ± SD from the KDQoL-SF Manual Standard were the first and the sixth groups of patient's age (≤20 and 61-70). CONCLUSION The study conducted in HD center, Penang, Malaysia showed that the scoring of work status, cognitive function, quality of social interaction, sleep, social support, patient satisfaction, physical functioning, general health, and role emotional were low than standard form.
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Affiliation(s)
- Diana Laila Ramatillah
- Department Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Syed Azhar Syed Sulaiman
- Department Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Amer Hayat Khan
- Department Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Ong Loke Meng
- Department Nephrology, Physician in Nephrology and Hemodialysis Ward at General Hospital Penang, Penang, Malaysia
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24
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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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25
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Truthmann J, Mensink GBM, Bosy-Westphal A, Hapke U, Scheidt-Nave C, Schienkiewitz A. Physical health-related quality of life in relation to metabolic health and obesity among men and women in Germany. Health Qual Life Outcomes 2017; 15:122. [PMID: 28601090 PMCID: PMC5466792 DOI: 10.1186/s12955-017-0688-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 05/17/2017] [Indexed: 12/20/2022] Open
Abstract
Background This study examined sex-specific differences in physical health-related quality of life (HRQoL) across subgroups of metabolic health and obesity. We specifically asked whether (1) obesity is related to lower HRQoL independent of metabolic health status and potential confounders, and (2) whether associations are similar in men and women. Methods We used cross-sectional data from the German Health Interview and Examination Survey 2008–11. Physical HRQoL was measured using the Short Form-36 version 2 physical component summary (PCS) score. Based on harmonized ATPIII criteria for the definition of the metabolic health and a body mass index ≥ 30 kg/m2 to define obesity, individuals were classified as metabolically healthy non-obese (MHNO), metabolically unhealthy non-obese (MUNO), metabolically healthy obese (MHO), and metabolically unhealthy obese (MUO). Sex-specific analyses including multivariable linear regression analyses were based on PCS as the dependent variable, metabolic health and obesity category as the independent variable with three categories and MHNO as the reference, and age, education, lifestyle and comorbidities as confounders. Results This study included 6860 participants (3298 men, 3562 women). Compared to MHNO, all other metabolic health and obesity categories had significantly lower PCS in both sexes. As reflected by the beta coefficients [95% confidence interval] from bivariable linear regression models, a significant inverse association with PCS was strongest for MUO (men: −7.0 [−8.2; −5.8]; women: −9.0 [−10.2; −7.9]), intermediate for MUNO (men: −4.2 [−5.3; −3.1]; women: −5.6 [−6.8; −4.4]) and least pronounced for MHO (men: −2.2 [−3.6; −0.8]; women −3.9 [−5.4; −2.5]). Differences in relation to MHNO remained statistically significant for all groups after adjusting for confounders, but decreased in particular for MUNO (men:–1.3 [−2.3; −0.3]; women: −1.5 [−2.7; −0.3]. Conclusions Obesity was significantly related to lower physical HRQoL, independent of metabolic health status. Potential confounders including age, educational status, health-related behaviors, and comorbidities explained parts of the inverse relationship. Associations were evident in both sexes and consistently more pronounced among women than men. Electronic supplementary material The online version of this article (doi:10.1186/s12955-017-0688-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Julia Truthmann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
| | - Gert B M Mensink
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Anja Bosy-Westphal
- Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - Ulfert Hapke
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Christa Scheidt-Nave
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Anja Schienkiewitz
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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26
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Quality of life independently predicts long-term mortality but not vascular events: the Northern Manhattan Study. Qual Life Res 2017; 26:2219-2228. [PMID: 28357682 DOI: 10.1007/s11136-017-1567-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2017] [Indexed: 01/01/2023]
Abstract
PURPOSE Cardiovascular disease is a major contributor to morbidity and mortality, and prevention relies on accurate identification of those at risk. Studies of the association between quality of life (QOL) and mortality and vascular events incompletely accounted for depression, cognitive status, social support, and functional status, all of which have an impact on vascular outcomes. We hypothesized that baseline QOL is independently associated with long-term mortality in a large, multi-ethnic urban cohort. METHODS In the prospective, population-based Northern Manhattan Study, Spitzer QOL index (SQI, range 0-10, with ten signifying the highest QOL) was assessed at baseline. Participants were followed over a median 11 years for stroke, myocardial infarction (MI), and vascular and non-vascular death. Multivariable Cox proportional hazards regression estimated hazard ratio and 95% confidence interval (HR, 95% CI) for each outcome, with SQI as the main predictor, dichotomized at 10, adjusting for baseline demographics, vascular risk factors, history of cancer, social support, cognitive status, depression, and functional status. RESULTS Among 3298 participants, mean age was 69.7 + 10.3 years; 1795 (54.5%) had SQI of 10. In fully adjusted models, SQI of 10 (compared to SQI <10) was associated with reduced risk of all-cause mortality (HR 0.80, 95% CI 0.72-0.90), vascular death (0.81, 0.69-0.97), non-vascular death (0.78, 0.67-0.91), and stroke or MI or death (0.82, 0.74-0.91). In fully adjusted competing risk models, there was no association with stroke (0.93, 0.74-1.17), MI (0.98, 0.75-1.28), and stroke or MI (1.03, 0.86-1.24). Results were consistent when SQI was analyzed continuously. CONCLUSION In this large population-based cohort, highest QOL was inversely associated with long-term mortality, vascular and non-vascular, independently of baseline primary vascular risk factors, social support, cognition, depression, and functional status. QOL was not associated with non-fatal vascular events.
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27
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Baker S, McBeth J, Chew-Graham CA, Wilkie R. Musculoskeletal pain and co-morbid insomnia in adults; a population study of the prevalence and impact on restricted social participation. BMC FAMILY PRACTICE 2017; 18:17. [PMID: 28173767 PMCID: PMC5297165 DOI: 10.1186/s12875-017-0593-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 01/26/2017] [Indexed: 12/20/2022]
Abstract
Background Comorbidity is common in patients consulting in primary care. Musculoskeletal pain and insomnia each increase the risk of the other. Co-occurrence may pose an increased burden on well-being. However, the prevalence and impact of co-existing pain and insomnia in adults living in the community who may present to primary care is unclear. The aim of this study was to report the prevalence of pain and insomnia in adults registered with primary care, and to examine the impact of co-occurrence on social activities. Methods This population-based prospective cohort study of adults aged ≥18 years (n = 1181) used health survey data collected via baseline and 12 month follow-up questionnaires. Baseline data on pain, insomnia (4 symptoms: delayed sleep onset, difficulty maintaining sleep, early waking and non-restorative sleep) and putative confounders and social activity restriction at follow up was collected. Associations between baseline pain, insomnia and restricted social activities (RSA) at 12 months were examined using logistic regression, with adjustment for confounders. Interaction terms between pain and each insomnia symptom were examined in final models. Results Mean respondent age was 49.6 (SD ± 15.2) years, 55.7% were female. At baseline, 880 (74.5%) reported pain, 122 (10.3%) delayed sleep onset, 298 (25.2%) difficulty maintaining sleep, 188 (15.9%) early wakening, and 215 (18.2%) reported non-restorative sleep. At follow-up 200 (16.9%) reported RSA. Pain and each insomnia symptom were associated with RSA at 12 month follow-up; pain [unadjusted odds ratio (OR:2.3;95%CI:1.5,3.5), delayed sleep onset (OR:6.1;95%CI:4.0,9.1), difficulty maintaining sleep (OR:3.2;95%CI:2.3,4.4), early wakening (OR:4.1;95%CI:2.9,5.9), and non-restorative sleep (OR:4.0; 95%CI:2.8,5.8). Only delayed sleep onset (OR:2.6;95%C:1.5,4.5) remained significantly associated with restricted social activities in the fully adjusted model. There was a significant interaction between pain and delayed sleep onset (OR:0.3;95%CI:0.1,0.99; p = .049) and restricted social activity at 12 months in the final multivariable model. Conclusions Pain and insomnia commonly co-occur, resulting in greater impact upon subsequent functional ability. Delayed sleep onset is the insomnia symptom most strongly associated with reduced functional ability. Clinicians should be aware of the common co-occurrence of insomnia symptoms, inquire about sleep in patients consulting with pain, and offer interventions that target both sleep and pain.
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Affiliation(s)
- Shula Baker
- Research Institute for Primary Care & Health Sciences, Keele University, ST5 5BG, Keele, UK.
| | - John McBeth
- Research Institute for Primary Care & Health Sciences, Keele University, ST5 5BG, Keele, UK.,Arthritis Research UK Centre for Epidemiology, University of Manchester, Manchester, M13 9PT, UK
| | - Carolyn A Chew-Graham
- Research Institute for Primary Care & Health Sciences, Keele University, ST5 5BG, Keele, UK.,Collaboration for Leadership in Applied Health Research and Care, West Midlands, Birmingham, UK
| | - Ross Wilkie
- Research Institute for Primary Care & Health Sciences, Keele University, ST5 5BG, Keele, UK
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Lahelma E, Pietiläinen O, Rahkonen O, Lahti J, Lallukka T. Mental symptoms and cause-specific mortality among midlife employees. BMC Public Health 2016; 16:1142. [PMID: 27825372 PMCID: PMC5101657 DOI: 10.1186/s12889-016-3816-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 11/03/2016] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Mental symptoms are prevalent among populations, but their associations with premature mortality are inadequately understood. We examined whether mental symptoms contribute to cause-specific mortality among midlife employees, while considering key covariates. METHODS Baseline mail survey data from 2000-02 included employees, aged 40-60, of the City of Helsinki, Finland (n = 8960, 80 % women, response rate 67 %). Mental symptoms were measured by the General Health Questionnaire 12-item version (GHQ-12) and the Short Form 36 mental component summary (MCS). Covariates included sex, marital status, social support, health behaviours, occupational social class and limiting long-standing illness. Causes of death by the end of 2013 were obtained from Statistics Finland (n = 242) and linked individually to survey data pending consent (n = 6605). Hazard ratios (HR) and 95 % confidence intervals (95 % CI) were calculated using Cox regression analysis. RESULTS For all-cause mortality, only MCS showed a weak association before adjustments. For natural mortality, no associations were found. For unnatural mortality (n = 21), there was a sex adjusted association with GHQ (HR = 1.96, 95 % CI = 1.45-2.64) and MCS (2.30, 95 % CI = 1.72-3.08). Among unnatural causes of death suicidal mortality (n = 11) was associated with both GHQ (2.20, 95 % CI = 1.47-3.29) and MCS (2.68, 95 % CI = 1.80-3.99). Of the covariates limiting long-standing illness modestly attenuated the associations. CONCLUSIONS Two established measures of mental symptoms, i.e. GHQ-12 and SF-36 MCS, were both associated with subsequent unnatural, i.e. accidental and violent, as well as suicidal mortality. No associations were found for natural mortality due to diseases. These findings need to be corroborated in further populations. Supporting mental health through workplace measures may help counteract subsequent suicidal and other unnatural mortality among midlife employees.
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Affiliation(s)
- Eero Lahelma
- Department of Public Health, University of Helsinki, PO Box 20 , (Tukholmankatu 8 2B), 00014, Helsinki, Finland.
| | - Olli Pietiläinen
- Department of Public Health, University of Helsinki, PO Box 20 , (Tukholmankatu 8 2B), 00014, Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, PO Box 20 , (Tukholmankatu 8 2B), 00014, Helsinki, Finland
| | - Jouni Lahti
- Department of Public Health, University of Helsinki, PO Box 20 , (Tukholmankatu 8 2B), 00014, Helsinki, Finland
| | - Tea Lallukka
- Finnish Institute of Occupational Health, and Department of Public Health, University of Helsinki, Helsinki, Finland
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Cleland C, Kearns A, Tannahill C, Ellaway A. The impact of life events on adult physical and mental health and well-being: longitudinal analysis using the GoWell health and well-being survey. BMC Res Notes 2016; 9:470. [PMID: 27760568 PMCID: PMC5070029 DOI: 10.1186/s13104-016-2278-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 10/11/2016] [Indexed: 11/16/2022] Open
Abstract
Background It is recognised that life events (LEs) which have been defined as incidents necessitating adjustment to habitual life either permanently or temporarily, not only have the potential to be detrimental to health and well-being, but research suggests some LEs may be beneficial. This study aimed to determine the individual and cumulative occurrence of LEs; and to establish their effect on health and well-being. Results Demographic factors (gender, age and highest educational attainment), LE occurrence and self-reported health data were collected as part of the longitudinal GoWell community health and wellbeing survey (2008–2011). Self-reported health was measured using the SF-12 questionnaire for physical (SF-12 PCS) and mental health (SF-12 MCS) and the Warwick–Edinburgh mental well-being scale (WEMWBS) for well-being. Statistical analysis was performed using SPSSv21 and level of significance was set at p < 0.05. Results showed that the sample was 61.6 % (n = 768) female; 20.4 % (n = 254) were aged 16–39 years, 46.1 % (n = 575) 40–64 years and 33.5 % (n = 418) were over 65 years; 68.8 % (n = 819) had no qualifications/Scottish leaving certificates, with the remaining 31.2 % (n = 372) having their highest educational qualification above Scottish leaving certificates. Health score means were 49.3 SF-12 mental health component score (SF-12 MCS); 42.1 SF-12 physical health component score (SF-12 PCS); and 49.2 WEMWBS. Participants experienced 0–7 LEs over a three year period, with the most common being: housing improvement (44.9 %), house move (36.8 %), health event (26.3 %) and bereavement (25.0 %). Overall, an increase in LEs was associated with a health score decrease. Five LEs (relationship breakdown, health event, bereavement, victimisation and house move) had negative impacts on SF-12 MCS and two (new job/promotion and parenthood) had positive impacts. For SF-12 PCS only three (health event, bereavement and housing improvement) had a negative impact. Six (health event, victimisation, bereavement, relationship breakdown housing move and improvement) had negative impacts on well-being and two (new job/promotion, marriage) had positive effects. Conclusions Findings from the current study confirm LEs have both detrimental and beneficial impacts on health and well-being. Further research is required to disentangle the complexity of LEs and the ways they affect health and well-being.
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Affiliation(s)
- Claire Cleland
- School of Natural and Built Environment, David Keir Building, Stranmillis Road, Belfast, UK. .,MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 200 Renfield Street, Glasgow, UK.
| | - Ade Kearns
- Urban Studies, School of Social and Political Sciences, University of Glasgow, Glasgow, UK
| | | | - Anne Ellaway
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 200 Renfield Street, Glasgow, UK
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Jacobs BL, Lopa SH, Yabes JG, Nelson JB, Barnato AE, Degenholtz HB. Association of functional status and treatment choice among older men with prostate cancer in the Medicare Advantage population. Cancer 2016; 122:3199-3206. [PMID: 27379732 DOI: 10.1002/cncr.30184] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Revised: 06/05/2016] [Accepted: 06/07/2016] [Indexed: 11/12/2022]
Abstract
BACKGROUND There are several effective treatments for prostate cancer. To what extent a patient's functional status influences the treatment decision is unknown. This study examined the association between functional status and treatment among older men with prostate cancer. METHODS Surveillance, Epidemiology, and End Results-Medicare Health Outcomes Survey data were used to identify men who were 65 years old or older and were diagnosed with prostate cancer between 1998 and 2009. The primary outcome was treatment choice: conservative management, surgery, or radiation within 1 year of the diagnosis. The exposure was the functional status assessed as 4 measures within 3 domains: 1) physical function (activities of daily living [ADLs] and physical component summary score), 2) cognitive function (survey completer: self vs proxy), and 3) emotional well-being (mental component summary score). A multivariate, multinomial logistic regression was fitted with adjustments for several patient, tumor, and regional characteristics. RESULTS This study identified 508 conservative management patients, 195 surgery patients, and 603 radiation patients. Compared with men with no ADL dependency, those with any ADL dependency had lower odds of receiving surgery (odds ratio [OR], 0.61; 95% confidence interval [CI], 0.38-0.99) or radiation (OR, 0.58; 95% CI, 0.43-0.78) versus conservative management. ADL dependency did not differ when surgery and radiation were compared. Patients with a proxy survey response were less likely to receive surgery or radiation versus conservative management. CONCLUSIONS Functional status is associated with treatment choice for men with prostate cancer. Future research should examine whether this is due to physician recommendations, patient preferences, or a combination. Cancer 2016;122:3199-206. © 2016 American Cancer Society.
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Affiliation(s)
- Bruce L Jacobs
- Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania. .,Center for Research on Health Care, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
| | - Samia H Lopa
- Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jonathan G Yabes
- Center for Research on Health Care, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.,Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Joel B Nelson
- Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Amber E Barnato
- Center for Research on Health Care, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.,Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Health Policy Management, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Howard B Degenholtz
- Department of Health Policy Management, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
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Frandsen LS, Villumsen LB, Hjorth CF, Nielsen BJ, Ullits LR, Torp-Pedersen C, Bøggild H, Overgaard C. The relationship between self-reported mental health and redeemed prescriptions of antidepressants: a register-based cohort study. BMC Psychiatry 2016; 16:189. [PMID: 27267897 PMCID: PMC4897872 DOI: 10.1186/s12888-016-0893-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 05/30/2016] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND Poor mental health is a major problem in most western societies, especially predominant among young adults. However, associations of self-reported poor mental health with subsequent psychiatric or medical treatment are unknown. We examined the relation between self-reported mental health and redeeming prescriptions of antidepressants among three age groups. METHODS We analyzed data from 16,233 individuals aged 16 years and over randomly selected to participate in the 2010 North Denmark Region Health Survey completed in February 2010. Mental health was defined according to the Short-Form 12 instrument (SF-12) and dichotomized into poor and good. Outcome data were retrieved from administrative information on redeemed prescriptions of antidepressants between February 2010 and December 2012. Crude cumulative incidence curves were produced to illustrate the probability of redeeming new prescriptions of antidepressants over time. Cox regression analysis was used to estimate risk of redeeming prescriptions of antidepressants when having poor mental health, adjusted for preselected explanatory covariates. RESULTS Among the young (16-29 years-old), 620 (23 %) participants suffered from poor mental health. Among the adults (30-59 years-old) and elderly (60 years-old or over), 1592 (18 %) participants and 723 (15 %) reported poor mental health, respectively. Overall, women were more likely than men to rate their mental health as poor. For all age groups, there was an increased probability for redeeming prescriptions of antidepressants when having poor mental health. The hazard ratio [HR] for redeeming prescriptions of antidepressants for those reporting poor versus good mental health, adjusted for sex, ethnicity, marital status, education level, occupational status, smoking and physical activity was 3.1 (95 % confidence interval [CI] 2.20-4.29) for young participants. For adults, the HR was 2.3 (95 % CI 1.86-2.78) and for elderly, it was 3.5 (95 % CI 2.66-4.57). CONCLUSION Self-reported poor mental health was more frequent among younger than older participants. Overall, antidepressants were the most often used treatment. An increased probability of redeeming antidepressant prescriptions when having self-reported poor mental health was observed in all age groups. These findings suggest that frequent reporting of poor mental health is a common issue for all age groups that needs more attention.
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Affiliation(s)
- Louise Sjørslev Frandsen
- Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 14, DK-9220, Aalborg, Denmark.
| | - Line Bilgrav Villumsen
- Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 14, DK-9220 Aalborg, Denmark
| | - Cathrine Fonnesbech Hjorth
- Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 14, DK-9220 Aalborg, Denmark
| | - Berit Jamie Nielsen
- Department of Clinical Epidemiology, Aalborg University Hospital, Sdr. Skovvej 15, DK-9000 Aalborg, Denmark
| | - Line Rosenkilde Ullits
- Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 14, DK-9220 Aalborg, Denmark
| | - Christian Torp-Pedersen
- Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 14, DK-9220 Aalborg, Denmark ,Department of Clinical Epidemiology, Aalborg University Hospital, Sdr. Skovvej 15, DK-9000 Aalborg, Denmark
| | - Henrik Bøggild
- Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 14, DK-9220 Aalborg, Denmark
| | - Charlotte Overgaard
- Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 14, DK-9220 Aalborg, Denmark
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Quality of Life and Mortality of Long-Term Colorectal Cancer Survivors in the Seattle Colorectal Cancer Family Registry. PLoS One 2016; 11:e0156534. [PMID: 27253385 PMCID: PMC4890809 DOI: 10.1371/journal.pone.0156534] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 05/15/2016] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND AND AIM Because most colorectal cancer patients survive beyond five years, understanding quality of life among these long-term survivors is essential to providing comprehensive survivor care. We sought to identify personal characteristics associated with reported quality of life in colorectal cancer survivors, and sub-groups of survivors potentially vulnerable to very low quality of life. METHODS We assessed quality of life using the Veterans RAND 12-item Health Survey within a population-based sample of 1,021 colorectal cancer survivors in the Seattle Colorectal Cancer Family Registry, approximately 5 years post-diagnosis. In this case-only study, mean physical component summary scores and mental component summary scores were examined with linear regression. To identify survivors with substantially reduced ability to complete daily tasks, logistic regression was used to estimate odds ratios for "very low" summary scores, defined as a score in the lowest decile of the reference US population. All cases were followed for vital status following QoL assessment, and mortality was analyzed with Cox proportional hazards regression. RESULTS Lower mean physical component summary score was associated with older age, female sex, obesity, smoking, and diabetes or other co-morbidity; lower mean mental component summary score was associated with younger age and female sex. Higher odds of very low physical component summary score was associated with older age, obesity, less education, smoking, co-morbidities, and later stage at diagnosis; smoking was associated with higher odds of very low mental component summary score. A very low physical component score was associated with higher risk of mortality (hazard ratio (95% confidence interval): 3.97 (2.95-5.34)). CONCLUSIONS Our results suggest that identifiable sub-groups of survivors are vulnerable to very low physical components of quality of life, decrements that may represent meaningful impairment in completing everyday tasks and are associated with higher risk of death.
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Hardt J. A new questionnaire for measuring quality of life - the Stark QoL. Health Qual Life Outcomes 2015; 13:174. [PMID: 26503323 PMCID: PMC4621869 DOI: 10.1186/s12955-015-0367-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 10/17/2015] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The Stark questionnaire measures health-related quality of life (QoL) using pictures almost exclusively. It is supplemented by a minimum of words. It comprises a mental and a physical health component. METHODS A German sample of n = 500 subjects, age and gender stratified, filled out the Stark Qol questionnaire along with various other questionnaires via internet. RESULTS The physical component shows good reliability (Cronbach's alpha = McDonalds Omega = greatest lower bound = .93), the mental component can be improved (Cronbach's alpha = .63, McDonalds Omega = .72, greatest lower bound = .77). Confirmatory factor analysis shows a good fit (Bentlers CFI = .97). Construct validity was proven. CONCLUSION The Stark QoL is a promising new development in measuring QoL, it is a short and easy to apply questionnaire. Additionally, it is particularly promising for international research.
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Affiliation(s)
- Jochen Hardt
- Medical Psychology and Medical Sociology, Clinic for Psychosomatic Medicine and Psychotherapy, Universitätsmedizin Mainz, Johannes Gutenberg Universität, Duesbergweg 6, 55128, Mainz, Germany.
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