Purpose: To investigate how SF-6D utility scores change with age between generations of women, and to quantify the relationship of SF-6D with lifestyle factors across life-stages.Methods: Up to seven waves of self-reported, longitudinal data were drawn for the 1973-78 (young, N=13772), 1946-51 (mid-age, N=12792), 1921-26 (older, N=9972) cohorts from the Australian Longitudinal Study on Women's Health. Mixed effects models were employed for analysis.Results: Young and mid-age women had similar average SF-6D scores at baseline (0.63-0.64), which remained consistent over 16 year period. However, older women had lower scores at baseline at 0.57 which steadily declined over 15 years. Across cohorts, low education attainment, greater difficulty in managing on income, obesity, physical inactivity, heavy smoking, non-drinking and increasing stress levels were associated with lower SF-6D scores. The magnitude of effect varied between cohorts. SF-6D scores were lower amongst young women with high risk drinking behaviours than low-risk drinkers. Mid-age women who were underweight, never married, or underwent surgical menopause also reported lower SF-6D scores. Older women who lived in remote areas, who were ex-smokers, or were underweight reported lower SF-6D scores.
Conclusion:The SF-6D utility score is sensitive to differences in lifestyle factors across adult lifestages. Gradual loss of physical functioning may explain the steady decline in health for older women. Key factors associated with SF-6D include physical activity, body mass index, menopause status, smoking, alcohol use and stress. Factors associated with poorer SF-6D scores vary in type and magnitude at different life stages.3