Life Satisfaction and Morbidity among Postmenopausal Women

Long-term life satisfaction in ageing women with work disability due to mental and musculoskeletal disorders

BACKGROUND

Mental disorders (MDs) and musculoskeletal disorders (MSDs) are the major causes of global disability and increase in prevalence with age.

AIMS

To support healthy ageing, we studied how work disability due to MDs or MSDs is related to life satisfaction (LS) cross-sectionally and in 5- and 10-year follow-ups among ageing women.

METHODS

In the population-based OSTPRE cohort (women aged 58-67 in 1999), data on lifetime permanent work disability pensions (DPs) due to 'MDs only' (n = 337), 'MSDs only' (n = 942) and 'MDs + MSDs' (n = 212) and 'no DP' (n = 6322) until 1999 was obtained from the Finnish national register. The OSTPRE postal enquiry included a four-item life satisfaction (LS) scale (range 4-20: satisfied 4-6, intermediate 7-11, dissatisfied 12-20) at 5-year intervals, in 1999-2004 (n = 6548) and in 1999-2009 (n = 5562).

RESULTS

In 1999, the risks of belonging to the dissatisfied LS group (score 12-20) vs. the satisfied group (score 4-6) were higher in 'MDs only' (OR = 4.30; 95%CI 2.95-6.28), 'MSDs only' (OR = 2.69; 2.12-3.40) and 'MDs + MSDs' (OR = 2.72; 1.77-4.16) groups than in the 'no DP' group. In the follow-ups, these risks were OR5yr = 5.59 (3.54-8.84) and OR10yr = 4.94 (2.80-8.73) for 'MDs only', OR5yr = 3.36 (2.58-4.37) and OR10yr = 3.18 (2.40-4.21) for 'MSDs only', and OR5yr = 4.70 (2.75-8.05) and OR10yr = 6.84 (3.53-13.27) for 'MDs + MSDs' (all: p ≤ 0.001). Adjusting for baseline LS did not change the pattern (all p ≤ 0.001).

CONCLUSION

Work disability due to MDs and MSDs undermines healthy ageing among women via life dissatisfaction.

Effect of Brisk Walking on Health-Related Physical Fitness Balance and Life Satisfaction Among the Elderly: A Systematic Review

BACKGROUND

Although the elderly frequently engages in brisk walking as a form of exercise, little has been reported in the literature about the effect of brisk walking on health-related physical fitness, balance, and overall life satisfaction.

OBJECTIVES

The purpose of this systematic review is to determine the effect of brisk walking on the elderly's health-related physical fitness, balance, and life satisfaction.

DESIGN

We conducted a comprehensive search from the PubMed, Web of Science, Scopus, and SPORTDiscus databases from January to September 2021. We selected studies through PICOS and conducted a systematic literature review according to the PRISMA guidelines.

RESULTS

Thirteen studies met all criteria; 11 were classed as low risk of bias, while two were classified as high risk of bias. Generally, brisk walking has been shown to improve cardiorespiratory fitness, muscular strength, and body composition. Limited evidence was presented on flexibility, muscular endurance and development and life satisfaction, and there was conflicting evidence on balance. Moreover, evidence of restriction proves that high-intensity (80-85%) brisk walking is more effective than moderate-intensity (60-75%) brisk walking on the aerobic capacity of the elderly. Furthermore, there was less research conducted on males.

CONCLUSION

Brisk walking has been shown to improve cardiorespiratory fitness, muscular strength, and body composition. Other outcomes (balance, flexibility, muscular endurance, and life satisfaction) and the impact of the intensity of brisk walking on the elderly should be confirmed. Therefore, there remains insufficient research on brisk walking, while single brisk walking cannot meet requirements of elderly in terms of their health-related physical fitness, balance, and life satisfaction. Future research should aim to examine the effectiveness of combining several types of exercises to promote general health in the elderly, as the World Health Organization recommends. Unintelligible FITT (frequency, intensity, time, type) principles of brisk walking training should be trenched for the results of scientific and effective physical exercise.

The relationship between smoking frequency and life satisfaction: Mediator of self-rated health (SRH)

BACKGROUND

It is well-established that smoking is associated with life satisfaction. However, much less is known about how smoking frequency is related to life satisfaction and if self-rated health (SRH) mediates such a relationship. This is important to understand because life satisfaction is related to a lot of outcomes such as morbidity and mortality. The aim of the current study is to test whether smoking frequency relates to life satisfaction via SRH pathway.

METHOD

Data were extracted from Wave 7 (collected between 2015 and 2016), Understanding Society: the UK Household Longitudinal Study (UKHLS). After removing non-smokers and participants with missing variables of interest, 5, 519 smokers out of 39, 293 participants remained for further analysis. Correlation coefficients were calculated between smoking frequency, SRH, and life satisfaction. Mediation analysis was performed by taking smoking frequency as the predictor, SRH as the mediator, life satisfaction as the outcome variable, and demographics as covariates using the mediation toolbox on MATLAB 2018a with 10000 bootstrap sample significance testing (https://github.com/canlab/MediationToolbox).

RESULTS

The current study found a negative correlation between smoking frequency and life satisfaction [r = -0.09, 95% C.I (-0.12, -0.06), p < 0.001] and between smoking frequency and SRH [r = -0.17, 95% C.I (-0.14, -0.19), p < 0.001], and a positive correlation between SRH and life satisfaction [r = 0.44, 95% C.I (0.41, 0.46), p < 0.001]. Results from the mediation analysis revealed that there is a significant effect of Path a [i.e., smoking frequency to SRH; β = -0.02, p < 0.001, 95% C.I. (-0.02, -0.02)], Path b [SRH to life satisfaction; β = 0.68, p < 0.001, 95% C.I. (0.66, 0.69)], Path c' [direct effect; β = -0.01, p < 0.01, 95% C.I. (0.66, 0.69)], Path c [total effect; β =-0.02, p < 0.001, 95% C.I. (-0.02, -0.02)], and Path a^*b [mediation effect; β = -0.01, p < 0.001, 95% C.I. (-0.01, -0.014)].

CONCLUSION

SRH partially mediated the negative relationship between smoking frequency and life satisfaction. Findings from the current study may imply that antismoking campaigns and pamphlets are needed to counter the promotion of smoking by the tobacco industry. Moreover, interventions are needed for current smokers to reduce their smoking frequency to improve their life satisfaction, which can promote life satisfaction and positive outcomes associated with better life satisfaction.

Comorbidity of mental and musculoskeletal disorders in ageing women: A data linkage study using national registries

BACKGROUND

Mental disorders (MDs) and musculoskeletal disorders (MSDs) are the main causes of disability. Yet, their comorbidity has not received the deserved attention.

OBJECTIVE

To investigate the extent of the comorbidity between MDs and MSDs in ageing women using national registries on prescription medications and work disability pensions (DPs).

METHODS

The study included 7,809 Finnish women, born during 1932-41, from the population-based Kuopio Osteoporosis Risk Factor and Prevention Study (OSTPRE) cohort, established in 1989. Lifetime permanent DPs due to: 1) 'MDs only' (n = 359), 2) 'MSDs only' (n = 954), 3) 'MDs + MSDs' (n = 227), were recorded till 2003. The reference group was 'no DP' (n = 6,269). Data from the OSTPRE questionnaires was obtained in 1994. Use of medications was recorded in 1995 and 2003. The use of musculoskeletal or psychotropic medications by women having a DP or medication due to MD, or MSD diagnoses, respectively, was considered as an indicator of comorbidity.

RESULTS

In 1995, all DP groups had used psychotropic and musculoskeletal medications more often than the referents. Use of musculoskeletal medications was associated with a higher use of psychotropic medications, and vice versa (OR=2.45; 95% CI 2.17-2.77), compared with non-use. The 'MSDs only' group was more likely to use psychotropic (OR=1.79; 95% CI 1.50-2.12), and the 'MDs only' group musculoskeletal medications (OR=1.38; 95% CI 1.09-1.74), compared with those without DPs. The proportions of medication users were similar in 1995 and 2003; however, the amounts used increased.

CONCLUSIONS

There was strong evidence for comorbidity between MDs and MSDs in ageing women. Further research concerning their longitudinal relationships is warranted.

Subjective well-being predicts health behavior in a population-based 9-years follow-up of working-aged Finns

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Subjective well-being predicts subsequent health behavior in a 9-years of follow-up.

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Neither direction of influence was stronger as compared to the other one.

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Enhancing subjective well-being could serve as an additional support for health behavior change.

The cross-sectional association between measures of subjective well-being (SWB) and various health behaviors is well-established. In this 9-year (2003–2012) follow-up study, we explored how a composite indicator of SWB (range 4–20) with four items (interest, happiness, and ease in life, as well as perceived loneliness) predicts a composite health behavior measure (range 0–4) including dietary habits, physical activity, alcohol consumption, and smoking status. Study subjects (n = 10,855) originated from a population-based random sample of working-age Finns in the Health and Social Support study (HeSSup). According to linear regression analysis, better SWB predicted better health behavior sum score with a β = 0.019 (p < 0.001) with a maximum effect of 0.3 points after adjusting for age (p = 0.038), gender (p < 0.001), education (p = 0.55), baseline self-reported diseases (p = 0.020), baseline health behavior (β = 0.49, p < 0.001), and the interaction between SWB and education (p < 0.001). The results suggest that SWB has long-term positive effect on health behavior. Thus, interventions aiming at health behavioral changes could benefit from taking into account SWB and its improvement in the intervention.

Longitudinal stability and interrelations between health behavior and subjective well-being in a follow-up of nine years

BACKGROUND

The bidirectional relationship between health behavior and subjective well-being has previously been studied sparsely, and mainly for individual health behaviors and regression models. In the present study, we deepen this knowledge focusing on the four principal health behaviors and using structural equation modeling with selected covariates.

METHODS

The follow-up data (n = 11,804) was derived from a population-based random sample of working-age Finns from two waves (2003 and 2012) of the Health and Social Support (HeSSup) postal survey. Structural equation modeling was used to study the cross-sectional, cross-lagged, and longitudinal relationships between the four principal health behaviors and subjective well-being at baseline and after the nine-year follow-up adjusted for age, gender, education, and self-reported diseases. The included health behaviors were physical activity, dietary habits, alcohol consumption, and smoking status. Subjective well-being was measured through four items comprising happiness, interest, and ease in life, and perceived loneliness.

RESULTS

Bidirectionally, only health behavior in 2003 predicted subjective well-being in 2012, whereas subjective well-being in 2003 did not predict health behavior in 2012. In addition, the cross-sectional interactions in 2003 and in 2012 between health behavior and subjective well-being were statistically significant. The baseline levels predicted their respective follow-up levels, the effect being stronger in health behavior than in subjective well-being.

CONCLUSION

The four principal health behaviors together predict subsequent subjective well-being after an extensive follow-up. Although not particularly strong, the results could still be used for motivation for health behavior change, because of the beneficial effects of health behavior on subjective well-being.

Health behavior of working-aged Finns predicts self-reported life satisfaction in a population-based 9-years follow-up

BACKGROUND

Previous studies have shown positive association between health behavior and life satisfaction, but the studies have mostly been cross-sectional, had follow-up times up to 5 years or focused on only one health behavior domain. The aim of the study was to explore how principal health behavior domains predict life satisfaction as a composite score in a previously unexplored longitudinal setting.

METHODS

The present study tested whether a health behavior sum score (range 0-4) comprising of dietary habits, smoking, alcohol consumption, and physical activity predicted subsequent composite score of life satisfaction (range 4-20). Data included responses from 11,000 working-age Finns who participated in the Health and Social Support (HeSSup) prospective population-based postal survey.

RESULTS

Protective health behavior in 2003 predicted (p < .001) better life satisfaction 9 years later when sex, age, education, major diseases, and baseline life satisfaction were controlled for. The β in the linear regression model was - 0.24 (p < .001) corresponding to a difference of 0.96 points in life satisfaction between individuals having the best and worst health behavior.

CONCLUSION

Good health behavior has a long-term beneficial impact on subsequent life satisfaction. This knowledge could strengthen the motivation for improvement of health behavior particularly on an individual level but also on a policy level.

Racial differences in lifestyle, demographic, and health factors associated with quality of life (QoL) in midlife women

Previously, quality of life (Qol) has been defined as an individual's evaluation of a satisfactory life as a whole (i.e. physically, mentally, psychologically, and socially). Only a few studies have examined the racial differences between QoL and risk factors associated with health, demographics, and lifestyle in midlife women. Thus, the purpose of our study was to determine racial differences in QoL in menopausal women due to lifestyle, demographic, and health related risk factors. A stratified ordinal logistic regression model was applied to self-reported questionnaire data from the Midlife Women's Health Study (MWHS) to determine risk factors associated with QoL differences between White and Black women during the menopausal transition. In multivariable models, our results showed Black women who had 3 or 4 comorbidities were about 4 times as likely to have higher QoL compared to women who had 0 to 2 comorbidities (95% CI: 1.65,10.78). However, the number of comorbidities was not significantly associated with QoL in White women in univariate or multiple regression. Further, body mass index and income were not significant factors in QoL in Black women but were in White women. Overall, our results illustrate that differences in health, demographic, and lifestyle factors are associated with QoL during menopause. Also, we suggest that future studies evaluate stratified models between racial groups to determine race-specific risk factors related to quality of life.

Personality Disorder and Physical Health Comorbidities: A Link With Bone Health?

We examined whether personality disorders (PDs) (any, cluster A/B/C) were associated with bone mineral density (BMD) in a population-based sample of Australian women (n = 696). Personality and mood disorders were assessed using semi-structured diagnostic interviews. BMD was measured at the spine, hip, and total body using dual-energy x-ray absorptiometry (GE-Lunar Prodigy). Anthropometrics, medication use, physical conditions, and lifestyle factors were documented. The association between PDs (any, cluster A/B/C) and BMD (spine/hip/total body) was examined with multiple linear regression models. The best models were identified by backward elimination including age, weight, physical activity, smoking status, alcohol consumption, dietary calcium intake, mood disorders, physical multimorbidity, socioeconomic status, and medications affecting bone. The variables were retained in the model if p < 0.05. All potential interactions in final models were tested. Those with cluster A PD, compared to those without, had 6.7% lower hip BMD [age, weight adjusted mean 0.853 (95% CI 0.803-0.903) vs. 0.910 (95% CI 0.901-0.919) g/cm², p = 0.027] and 3.4% lower total body BMD [age, weight, smoking, alcohol, calcium adjusted mean 1.102 (95% CI 1.064-1.140) vs. 1.139 (95% CI 1.128-1.150) g/cm², p = 0.056]. No associations were observed between cluster B/C PDs and hip/total body BMD or between any of the PD clusters and spine BMD. To our knowledge, this study is the first to investigate the bone health of women with PD in a population-based sample. Given the paucity of literature, replication and longitudinal research including the examination of underlying mechanisms and sex differences are warranted.

Role of musculoskeletal disorders in falls of postmenopausal women

We aimed to investigate the role of musculoskeletal disorders (MSDs) as risk factors for falls among postmenopausal women. Our results indicate that MSDs are common and are associated with increased falling risk, especially nonslip falls. Excess number of falls due to MSDs is greater than that due to any other disease class.

PURPOSE

Falls are a major public health problem worldwide. The aim of the study was to investigate the role of MSDs as risk factors for falls among postmenopausal women.

METHODS

This cohort study utilized data from a population-based, prospective cohort study (OSTPRE). The study population consisted of 8656 women aged 57-66 years (in 1999) living in Kuopio Province, Eastern Finland, who responded to postal enquiries in 1999 and 2004. Information on MSDs and other morbidities was obtained from the 1999 enquiry and information on falls from the 2004 enquiry. Women were classified as fallers or non-fallers according to their falling events in the preceding 12 months. The fallers were further divided into women with slip and nonslip falls.

RESULTS

Of the study sample, 53.3% reported a MSD and 39.2% reported a fall during the preceding 12 months. MSDs predicted falls (OR = 1.38; 95% CI 1.26-1.50) and the association was stronger for nonslip (OR = 1.56; 95% CI 1.39-1.75) than slip falls (OR 1.22; 95% CI 1.08-1.38) compared to the women without MSDs. The risk of falls increased with increasing number (1, 2, ≥ 3) of MSDs: 1.25 (95%CI 1.13-1.38), 1.48 (95%CI 1.30-1.68), and 1.92 (95%CI 1.60-2.31), respectively. After adjustments, the risk of falling related to MSDs reduced by about 5% (adjusted p < 0.001). The population attributable fraction of falls due to MSDs was 10.3% of all falls, greater than that due to any other disease class.

CONCLUSION

MSDs are common and an important risk factor for falls and especially nonslip falls among postmenopausal women. The number of excess falls due to MSDs in this population group is greater than that due to any other disease class.

Determinants of Quality of Life and Satisfaction with Life in Women with Polycystic Ovary Syndrome

The purpose of the study was to assess the quality of life (QoL) and satisfaction with life (SwL) of women with polycystic ovary syndrome (PCOS) in comparison with those of healthy controls, and to identify and analyze factors determining QoL and SwL in women with PCOS. The cross-sectional study was performed between January and November 2016 in 504 women using health care services in Poland. The study group comprised women with PCOS, the control group women without PCOS. The study used a diagnostic survey with questionnaires. Research instruments included the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire, the satisfaction with life scale (SWLS), and a standardized interview questionnaire comprising questions on the participants’ characteristics. Women with PCOS have lower QoL and SwL than healthy controls (p < 0.05). Factors affecting QoL in PCOS patients included socio-economic standing, time from PCOS diagnosis, BMI, age, and professional activity (p < 0.05). Factors affecting SwL in PCOS patients included socio-economic standing, having children, BMI, and time from PCOS diagnosis (p < 0.05). The higher the PCOS patients’ QoL, the higher their SwL (p < 0.05). Further studies are required, focusing both on PCOS and its etiology, and on its impact on the women diagnosed with the disease.

Personality disorder is an excess risk factor for physical multimorbidity among women with mental state disorders

We examined whether mental state disorders (lifetime mood, anxiety, eating, substance misuse) with comorbid personality disorder are associated with physical multimorbidity in a population-based sample of women. Mental state and personality disorders were assessed using semi-structured diagnostic interviews. Clinical measures were performed and medical conditions, medication use and lifestyle factors were documented by questionnaire. Mental state disorders were associated with higher odds of physical multimorbidity; risk was especially high for those with comorbid personality disorder. These findings suggest that mental state and physical comorbidity might be worsened by the additional comorbidity of personality disorder.