Quality of life and mortality in the general population: a systematic review and meta-analysis

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.

Terminal decline in objective and self-reported measures of motor function before death: 10 year follow-up of Whitehall II cohort study

“…The evidence on physical functioning scales such as the physical component summary score from SF-36 is more limited; a recent meta-analysis of four studies with a mean follow-up of 1.8 years showed better scores to be associated with lower mortality risk (odds ratio for 1 unit increase: 0.95). 40 In our study, both of these selfreported measures were associated with mortality, irrespective of the age at assessment. As with the objective measures of motor function, the hazard ratios of associations with mortality were higher when selfreported function was assessed closer to death.…”

“…The association of self-reported measures of motor function with mortality has mostly been examined using limitations in ADL in older adults, in whom it has a robust association with mortality,373839 with follow-up ranging from one to >15 years. The evidence on physical functioning scales such as the physical component summary score from SF-36 is more limited; a recent meta-analysis of four studies with a mean follow-up of 1.8 years showed better scores to be associated with lower mortality risk (odds ratio for 1 unit increase: 0.95) 40. In our study, both of these self-reported measures were associated with mortality, irrespective of the age at assessment.…”

Association between Levels of Physical Activity, Sarcopenia, Type 2 Diabetes and the Quality of Life of Elderly People in Community Dwellings in Lebanon

“…Our study has certain strengths. Principally, to the best of our knowledge, it is one of the few studies which assesses the association of levels of PA and three important clinical outcomes, shown to be predictors of mortality among older adults in community dwellings [ 14 , 15 , 16 ]. Secondly, the instrument used for the assessment of HRQoL was a validated questionnaire, suitable for the population under study [ 20 ].…”

“…Accordingly, we aimed to assess the association between these cut-off points relating to the amount of PA (≥600 MET-min/week) with three important health-related outcomes, that have recently been shown to be independent predictors of mortality among older adults in community dwellings [ 14 , 15 , 16 ], namely, sarcopenia [ 14 ], cardiovascular risk factors [ 15 ], and HRQoL [ 16 ]. The hypothesis that we formulate is the existence of a significant association between suitable levels of PA and a lower risk of sarcopenia and cardiovascular risk factors, as well as better HRQoL among elderly people in community dwellings in Lebanon.…”

Interactions of Comorbidity and Five Simple Environmental Unhealthy Habits Concerning Physical and Mental Quality of Life in the Clinical Setting

“…An unhealthy lifestyle pattern was considered as an aggregate accounting the five unhealthy habits: smoking, absence of consumption of raw nuts, unhealthy dietary habits considered as the consumption of ultra-processed products such as pastries or carbonated beverages according to the Mediterranean dietary pattern adherence questionnaire, absence of reported specific weekly time devoted to physical activity and sleeping time less than 7 h. These habits were selected according to previous evidence showing the association of these factors with the development of chronic diseases, mainly in the European population. Moreover, these items are part of the validated Mediterranean dietary pattern adherence questionnaire as well as the GPAQ [7,26]. The association between SF-36 subscales and summaries and habits was assessed in both univariate and multivariate analysis, adjusted by age, sex, physical and mental comorbidities.…”