scholarly journals Maintaining health-related quality of life from 85 to 93 years of age despite decreased functional ability

2019 ◽  
Vol 82 (6) ◽  
pp. 348-356 ◽  
Author(s):  
Maria M Johansson ◽  
Jan Marcusson ◽  
Ewa Wressle

Introduction The ‘oldest-old’ is the most rapidly growing age group in Sweden and in the western world. This group is known to be at great risk of increased functional dependency and the need for help in their daily lives. The aim of this research was to examine how the oldest-old change over time regarding health-related quality of life, cognition, depression and ability to perform activities of daily living and investigate what factors explain health-related quality of life at age 85 and 93 years. Methods In this study, 60 individuals from the Swedish Elderly in Linköping Screening Assessment study were followed from age 85 to 93 years. Measurements used were EQ-5D, Geriatric Depression Scale, Mini Mental State Examination and ability to perform activities of daily living. Nonparametric statistics and regression analyses were used. Results Although the individuals had increased mobility problems, decreased ability to manage activities of daily living, and thus had increased need of assistance, they scored their health-related quality of life at age 93 years at almost the same level as at age 85 years. No depression and low dependence in activities of daily living speaks in favour of higher health-related quality of life. Conclusions Health-related quality of life can be maintained during ageing despite decreased functional ability and increased need of assistance in daily life.

2009 ◽  
Vol 21 (6) ◽  
pp. 1171-1179 ◽  
Author(s):  
Sally Wai-chi Chan ◽  
Helen FK Chiu ◽  
Wai-tong Chien ◽  
William Goggins ◽  
David Thompson ◽  
...  

ABSTRACTBackground: Depression is a common psychological problem among older people. Health-related quality of life (HRQoL) is now recognized by healthcare providers as an important treatment goal for people with depression. This study aimed to identify predictors of change in HRQoL among older people with depression.Methods: In a longitudinal study, data were collected when participants were newly diagnosed with a depressive disorder at a regional outpatient department in Hong Kong and 12 months later. Seventy-seven Chinese participants aged 65 years or older completed the study. Measures included the Physical Health Condition Checklist (PHCC), Geriatric Depression Scale (GDS), Modified Barthel Index (MBI), Instrumental Activities of Daily Living (IADL) scale, Social Support Questionnaire (SSQ), and World Health Organization Quality of Life Scale-Brief Version (WHOQOL).Results: Significant improvements between the first and second assessments were noted in the total WHOQOL scores, GDS scores, and the number of the social support. The results of linear regression models showed that the increases in the IADL scores and decreases in the PHCC and GDS scores were significantly associated with higher final WHOQOL scores.Discussion: Treatment for depression was effective in improving the participants’ overall condition and their perceived HRQoL. The results suggest that interventions to alleviate older people's level of depression, manage their physical ill health and enhance their instrumental activities of daily living ability could help improve their perceived HRQoL.


2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 118-118
Author(s):  
Darryl Alan Outlaw ◽  
Chen Dai ◽  
Mustafa Al-Obaidi ◽  
Smith Giri ◽  
Smita Bhatia ◽  
...  

118 Background: The majority of new cancer diagnoses occur in adults greater than 65 years of age. Polypharmacy is a common and potentially devastating problem amongst older adults; however, its prevalence and impact in older adults with gastrointestinal (GI) malignancy is poorly understood. Our objective was to examine the prevalence of polypharmacy and its association with functional status impairments, frailty, and health-related quality of life (HRQoL) in older adults with GI malignancy. Methods: The Cancer and Aging Resilience Evaluation (CARE) registry at the University of Alabama at Birmingham (UAB) is an ongoing prospective cohort study that uses a brief geriatric assessment (CARE survey) in older adults with cancer. We evaluated older adults diagnosed with GI malignancy prior to starting cancer therapy. Our primary outcomes of interest were functional status impairments, including dependence in activities of daily living (ADL) and instrumental activities of daily living (IADL), frailty (as defined by a frailty index derived using the principles of deficit accumulation), and HRQoL (assessed via PROMIS 10 global that includes physical and mental scores). Patients were dichotomized into those taking ≥9 vs. < 9 medications. Multivariable analyses examined associations between polypharmacy and the above-listed outcomes, adjusted for age, sex, race, cancer type, cancer stage, and comorbidities. Results: Overall, 357 patients met eligibility criteria; mean age: 70.1 years; primary diagnoses: colorectal (33.6%), pancreatic (24.6%), hepatobiliary (16.2%), gastroesophageal (10.9%), other (14.6%). Patients reported taking a mean of 6.2 medications: 27.7% with 0-3 medications, 48.2% with 4-8 medications, and 24.1% with ≥ 9 medications. Patients taking ≥ 9 medications were more likely to report limitations in ADL (adjusted odds ratio [aOR] 3.29, 95% CI 1.72-6.29) and IADL (aOR 2.86, 95% CI 1.59-5.14). Polypharmacy was also associated with frailty (aOR 3.06, 95% CI 1.73-5.41) and lower physical (aOR 2.82, 95% CI 1.70-4.69) and mental (aOR 1.73, 95% CI 1.03-2.91) HRQoL. Conclusions: Independent of comorbid conditions, polypharmacy was associated with functional status limitations, frailty, and reduced HRQoL in older adults with GI malignancy. Further study of specific medications and interactions is warranted in order to reduce the negative consequences of polypharmacy in this growing and vulnerable population.


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