Health-related quality of life as a predictor of mortality among community-dwelling older persons

Abstract

Health-related quality of life (HRQOL) measures predict cause-specific mortality, but few studies have explored whether generic self-reported HRQOL measures are independently associated with mortality in community-dwelling older persons. We postulated that a general measure of HRQOL, the short form 36-item questionnaire (SF-36), would be independently predictive of mortality among community-dwelling older persons. To evaluate this hypothesis, we followed a fixed cohort of 4,424 community-dwelling older persons recruited from a 2000 population-based survey in Taiwan until 2003 and investigated whether HRQOL was predictive of 3-year mortality, even after adjusting for traditional clinical risk variables. The data were collected via a door-to-door survey, and interviewers collected information on the subjects' demographics, medical history, utilization of health services, functional ability, falls, and self-reported physical and mental symptoms. Of the 6053 eligible subjects, 4,424 residents agreed to participate in the baseline survey and were contacted in 2003. During the 3-year period, the 3-year cumulative mortality rate for the study population was 5%. Mortality was significantly higher among males (5.57% vs. 4.27%, p = 0.049), and cumulative mortality increased with age (chi (2)-test for trend; chi (2) = 7.734, p = 0.001). For all scales except bodily pain, there was a significant relationship between a 10-point lower baseline score and mortality. Our primary multivariate risk model, which included two summary measures of HRQOL and significant clinical variables, demonstrated that a 10-point decrease in either the baseline Physical Component Summary (PCS) score or the baseline Mental Component Summary (MCS) score was associated with higher mortality (PCS: RR: 1.60, 95% CI: 1.39-1.83; p < 0.001; MCS: RR: 1.16, 95% CI: 1.01-1.34; p = 0.036). The findings suggested that low baseline PCS and MCS scores were important independent risk factors for 3-year mortality among community-dwelling older persons, even after adjusting for other risk factors.

Sleep duration and health status self-assessment (SF-36) in the elderly: a population-based study (ISA-Camp 2008)

“…As the self-assessment of health is significantly associated with clinical conditions and mortality 4,50 , beyond the results of objective measures 5,51 , and considers different health dimensions, studies on the association between self-assessed health and sleep duration can provide important information for health management in the elderly. The present study is one of the first to describe this association and broaden knowledge on the relationship between long sleep duration patterns and health outcomes, an area which merits further research.…”

“…This instrument assesses different dimensions of health in individuals or populations such as the physical, emotional and social aspects of quality of life, bodily pain, mental health, vitality and general health 1 . A number of studies report a strong correlation between the health dimensions addressed by the SF-36 and the presence of health conditions and clinical symptoms 2,3 and also suggest that self-assessment may serve to predict mortality 4 . The measurement of health status dimensions provides useful indicators of health conditions and wellbeing that may complement evaluations of illness and mortality indicators 1,5 .…”

Prediction of Mortality in Type 2 Diabetes From Health-Related Quality of Life (ZODIAC-4)

“…However, studies in nondiabetic populations have also found that factors like worse health-related quality of life (HRQOL) are associated with higher mortality (2)(3)(4). If this holds true for patients with type 2 diabetes, clinicians might have to give more attention to HRQOL and perhaps assess HRQOL routinely in these patients.…”

Effectiveness of Traditional Chinese Medicine in Primary Care

“…The MOS Short-form 36-item (SF-36) Health Survey has become a popular HRQOL measure worldwide since its first publication in 1992. Studies have shown that SF-36 can predict the utilization of primary care services [89], and low HRQOL in community-dwelling elderly had higher mortality rates [90]. Patients with gouts were found to have poorer HRQOL (lower functional limitation scores of the SF-36 Health Survey) and higher rates of inpatient utilization and mortality among all US veterans [91].…”