Quality of Life and Disability-free Survival in the Elderly: The Locomotive Syndrome and Health Outcome in Aizu Cohort Study

2020 ◽  
pp. 089826432097032
Author(s):  
Cheng-Tzu Hsieh ◽  
Hajime Yamazaki ◽  
Jui Wang ◽  
Tsukasa Kamitani ◽  
Yosuke Yamamoto ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Proportional Hazards ◽  
Short Form ◽  
The Elderly ◽  
Cox Proportional Hazards ◽  
Component Model ◽  
Term Care ◽  
Free Survival ◽  
Point Increase

Objectives: The Short Form 12 Survey (SF-12) three-component model is used to compute health-related quality of life (QoL): it includes physical, mental, and role-social QoL. We asked whether the SF-12 three-component model is associated with disability-free survival. Methods: People ≥65 years old were included ( n = 2634). SF-12 scores were assessed at baseline. The outcome was a composite of loss of independence (LoI) and death. LoI was defined using Japan’s long-term care insurance categories. Hazard ratios (HRs) for LoI or death were estimated using Cox proportional hazards models. Results: Better physical QoL was inversely associated with LoI or death (adjusted HR per 10-point increase: .88 [95% CI: .81–.96]), but mental QoL was not. Better role-social QoL was inversely associated with LoI or death only among participants with higher than average physical QoL (adjusted HR per 10-point increase: .79 [95% CI: .65–.96], p for interaction = .04). Discussion: Physical QoL was associated with disability-free survival, and role-social QoL was associated with disability-free survival among those with better physical QoL.

scholarly journals Quality of Life-Repeated Measurements Are Needed In Dialysis Patients

2018 ◽  
Vol 6 (8) ◽  
pp. 1410-1412
Author(s):  
Lada Trajceska ◽  
Daniela Mladenovska ◽  
Pavlina Dzekova-Vidimliski ◽  
Aleksandar Sikole
Keyword(s):  
Quality Of Life ◽  
Mortality Risk ◽  
Proportional Hazards ◽  
Short Form ◽  
Cox Proportional Hazards ◽  
Repeated Measurements ◽  
Physical Component Score ◽  
Component Score ◽  
Cox Analysis

BACKGROUND: There is a general agreement that, besides survival, the quality of life is a highly relevant outcome in the evaluation of treatment in patients with the end-stage renal disease. Moreover, it is very important to determine whether the quality of life impacts survival.AIM: This study aims to assess whether changes or absolute scores of the quality of life (QOL) measurements better predict mortality in dialysis patients.MATERIAL AND METHODS: In a longitudinal study comprising 162 prevalent hemodialysis patients QOL was assessed with the 36-item - Short Form Health Survey Questionnaire (SF-36) at baseline and after 12 months. Patients were followed for 60 months. Mortality risk was assessed using Cox proportional hazards analysis for patients with below and above median levels of both physical and mental QOL component scores (PCS and MCS, respectively).RESULTS: At the beginning of the study the mean Physical Component score was 47.43 ± 26.94 and mean Mental Component Score was slightly higher 50.57 ± 24.39. Comparative analysis of the changes during the first year showed a marked deterioration of all quality of life scores in surviving patients. The 5-point decline for PCS was noted in 39 (24%) patients and 42 (26%) for MCS. In the follow-up period of 60 months, 69 (43%) patients died. In the Cox analysis, mortality was significantly associated with lower PCS: HR = 2.554 [95% confidence interval (CI): 1.533-4.258], (P < 0.000) and lower MCS: 2.452 (95%CI: 1.478-4.065), P < 0.001. The patients who had lower levels of PCS and MCS in the second QOL survey 1 year later, had similarly high mortality risk: 3.570 (95%CI: 1.896-6.727, P < 0.000); 2.972 (95%CI: 1.622-5.490, P < 0.000), respectively. The hazard ratios for mortality across categories for the change of PCS and MCS were not significant. In the multivariate model categorising the first and second scores as predictors and adjusted for age, only the second PCS and MCS score were associated with mortality.CONCLUSION: Low QOL scores are associated with mortality in repeated measurements, but only the more recent overwhelmed the power of the decline.

Self-reported quality of life as a predictor of survival in renal cell carcinoma.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 595-595
Author(s):  
Ridwan Alam ◽  
Hiten Patel ◽  
Phillip M. Pierorazio
Keyword(s):  
Quality Of Life ◽  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Competing Risks ◽  
Renal Cell ◽  
Proportional Hazards ◽  
Predictive Accuracy ◽  
Cox Proportional Hazards ◽  
Group 1

595 Background: Quality of life (QOL) in cancer patients has gained increasing attention and may provide prognostic value above and beyond traditional demographic and disease parameters. We evaluate the utility of self-reported QOL to predict mortality in patients with renal cell carcinoma (RCC). Methods: The Medicare Health Outcomes Survey was linked to SEER data to identify patients who completed a QOL questionnaire after the diagnosis of RCC from 1998-2014. Mental component summary (MCS) and physical component summary (PCS) scores were classified as high (≥50) or low ( < 50) based on a population mean score of 50 points. Patients were classified into four groups: 1) high MCS, high PCS; 2) high MCS, low PCS; 3) low MCS, high PCS; and 4) low MCS, low PCS. Multivariable Cox proportional hazards regression evaluated associations between QOL and all-cause mortality (ACM). The Harrell’s concordance statistic (C-index) estimated predictive accuracy. Fine and Gray competing risks models adjusted for stage, demographics, and comorbidities evaluated RCC-specific and non-RCC-specific mortality. Results: A total of 1494 patients with a median age of 73.4 years (IQR 68.8-79.3) at survey completion were included. Median follow-up was 5.6 years (IQR 4.0-8.3). There were 747 deaths, of which 139 were due to RCC. Models showed that each additional MCS and PCS point reduced the hazard of ACM by 1.3% (95% CI 0.981-0.993, P< 0.001) and 2.2% (95% CI 0.972-0.985, P< 0.001), respectively. The C-index was 72.1%. In the competing risks model, the subdistribution hazard ratio (SHR) of RCC mortality in Groups 2, 3, and 4 were 2.71 (95% CI 1.18-6.22, P= 0.02), 4.55 (95% CI 1.57-13.18, P= 0.005), and 3.11 (95% CI 1.35-7.16, P= 0.008), respectively, compared to Group 1. The SHR for non-RCC mortality were 1.50 (95% CI 1.16-1.94, P= 0.002), 1.03 (95% CI 0.59-1.78, P= 0.9), and 1.83 (95% CI 1.41-2.38, P< 0.001), respectively, relative to Group 1. Conclusions: Self-reported QOL metrics can be used to predict ACM in RCC patients with good accuracy; lower PCS and MCS scores led to higher rates of ACM, even after accounting for differences in disease, demographics, and comorbidity. Furthermore, non-RCC mortality was associated more with low physical health rather than low mental health.

scholarly journals Fear of Falls & Quality of Life in Community-Dwelling Older Adults: Is Diabetes an Effect Modifier?

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 906-906
Author(s):  
Christina Whitehouse ◽  
Janell Mensinger ◽  
Michelle McKay
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Fear Of Falling ◽  
Short Form ◽  
The Elderly ◽  
Community Dwelling ◽  
Diabetes Diagnosis ◽  
Diabetes Research ◽  
Diabetes Status

Abstract Prior research suggests that diabetes is a risk factor for falling. Moreover, older adults with diabetes are more likely to experience hip fractures when compared to older adults without diabetes. Research has also shown a relationship between fear of falling and quality of life. This study aimed to examine the moderating role of diabetes in the relationship between fear of falling (FoF) and quality of life (QoL) among older adults in a program for all-inclusive care for the elderly (PACE). This was a retrospective single cohort study that included 84 older adults in a PACE program located in the Northeastern United States. Participants were 55 years of age or older (M=70.33; SD=6.46) and cognitively intact. Diabetes diagnosis (n=46) was determined according to chart review. Fear of Falling was assessed with the Falls Efficacy Scale-International, and the Short Form 12v2 (SF-12v2) was used to measure the quality of life, including physical and mental domains. Hayes’ Process Macro was used to conduct moderation analyses (model 1) controlling race, gender, age, and comorbidities. Alpha was set at .10 to account for low power to detect interaction effects with small groups. Our results indicate the interaction between diabetes status and FoF was significant for mental QoL (p=.09) and not significant for physical QoL (p=.99). The association between FoF with lower mental QoL was stronger for patients with diabetes than for patients without diabetes; this finding was not replicated for physical QoL. Regardless of diabetes status, physical QoL significantly decreased as FoF increased.

scholarly journals The associations among individual factors, eHealth literacy, depression symptoms and health related quality of life among Chinese elderly: a cross-section study

2021 ◽  
Author(s):  
Xinhong Zhu ◽  
Fen Yang
Keyword(s):  
Quality Of Life ◽  
Short Form ◽  
The Elderly ◽  
Depression Symptoms ◽  
Health Related Quality ◽  
Component Structure ◽  
Ehealth Literacy ◽  
Related Quality ◽  
Health Related

Abstract Background: The higher level of eHealth literacy the elderly has, the easier it is to acquire benefits of health-seeking information online. The aim of this study is to evaluate the psychometric properties of the eHealth Literacy Scale (eHEALS) and examine the associations of eHEALS scores with depression, health-related quality of life (HRQoL), lifestyles among the elderly. Methods: A survey of 6183 participants (age 60 years and above) from 17 communities were conducted in June, 2019. Participants answered questions related to socio-demographics, eHEALS, geriatric depression scale and the short-form health survey (SF-36, assessing health-related quality of life). Two mediation models were conducted. A multi-linear regression analysis was performed to explore the association between the eHEALS scores and associated factors using Statistical Package for Social Science version 20.0. Significance was obtained at 95% CI and P < 0.05.Results: Exploratory factor analysis identified one component structure, accounting for 78.52% of the total variance. The factor loadings of eHEALS ranked from 0.832 to 0.905. The Cronbach α of overall scale was 0.961. eHEALS was significant higher in men (B = 0.616, 95%CI 0.235~0.997, P = 0.002), those with living in the city (B = 1.471, 95%CI 1.064~1.878, P < 0.000), those with high educated (B = 1.713, 95%CI 1.581~1.844, P < 0.000), and those with living with family (B = 6.436, 95%CI 4.574~8.298, P < 0.000), as compared to their counterparts, respectively. Moreover, chronic diseases (B = -2.218, 95%CI -2.632~-1.804, P < 0.000) and depression symptoms (B = -0.116, 95%CI 0.153~0.078, P < 0.000) were found negatively associated with eHEALS, while actively obtaining health information positively influenced eHEALS (B = 3.350, 95%CI 2.950~3.749, P < 0.000) after adjusting socio-demographics, lifestyles and HRQoL. Furthermore, depression symptoms had direct and indirect effects on HRQoL, as mediated by eHealth literacy.Conclusions: The eHEALS was a valid and reliable survey tool. As eHealth literacy was a protector for the aged, efforts to improve the older adults’ eHEALS scores can help to main health status. Therefore, healthcare providers formulate effective programs to improve eHealth literacy for the elderly, which can bring benefits for health aging.

scholarly journals Urinary incontinence in institutionalized elderly: prevalence and impact on quality of life

2015 ◽  
Vol 28 (3) ◽  
pp. 583-596 ◽  
Author(s):  
Javier Jerez Roig ◽  
Dyego Leandro Bezerra de Souza ◽  
Kenio Costa Lima
Keyword(s):  
Quality Of Life ◽  
Urinary Incontinence ◽  
Short Form ◽  
The Elderly ◽  
Geriatric Syndrome ◽  
Negative Consequences ◽  
Data Set ◽  
International Consultation ◽  
The Impact

AbstractIntroduction Urinary incontinence is a geriatric syndrome that generates strong economic and social impacts as well as emotional changes and negative consequences for the health of the elderly.Objective The objective of this work was to identify the prevalence of urinary incontinence and its associated factors, as well as its impact on quality of life of institutionalized elderly.Materials and methods A cross-sectional study was conducted herein, with 10 long-term institutions for the elderly of the municipality of Natal (Northeast Brazil). The Minimum Data Set was completed by caregivers to determine the presence of incontinence, and the Short Form of the International Consultation on Incontinence Questionnaire was answered by the elderly, to assess the frequency and amount of urinary leakage, the impact on quality of life, and the type of incontinence. The chi-square test and Fisher’s exact test were applied in the bivariate analysis, and logistic regression was utilized for multivariate analysis.Results The prevalence of urinary incontinence was 42.7% (95% CI: 34.8–50.8). The impact of this condition on daily life was mild in 46.5% of cases, moderate for 29.3% of cases, and severe in 24.1% of cases. The condition was associated with functional impairment (p < 0.001; RP: 4.13).Final considerations The prevalence of urinary incontinence in this sample, which presented cognitive ability to answer questionnaires, was over 40% with a high degree of severity. Approximately half of the incontinents referred a moderate-severe impact of incontinence. Control measures for this geriatric syndrome within the institutions are important to delay the decline of health and improve the quality of life of the residents.

scholarly journals Effects of resistance training in individuals with knee osteoarthritis

2016 ◽  
Vol 29 (3) ◽  
pp. 589-596 ◽  
Author(s):  
Grazielle Cordeiro Aguiar ◽  
Samira Gonçalves Rocha ◽  
Gisele Aparecida da Silva Rezende ◽  
Marcela Rêgo do Nascimento ◽  
Paula Luciana Scalzo
Keyword(s):  
Quality Of Life ◽  
Resistance Training ◽  
Functional Performance ◽  
Short Form ◽  
The Elderly ◽  
Womac Pain ◽  
Abdominal Muscles ◽  
Knee Oa ◽  
Sf 36

Abstract Introduction: Osteoarthritis (OA), the most common form of arthritis, is considered the main cause of pain and disability in the elderly. Objective: To evaluate the effect of systematic muscle strength training on functional performance and quality of life in individuals with knee OA. Methods: Subjects with knee OA (n = 27, 46 - 76 years) completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Medical Outcomes Short-Form 36-item Health Survey (SF-36), and visual analog scale (VAS) questionnaires, musculoskeletal assessments, and 10-repetition maximum and timed 10-meter walk tests both before and after training. The training consisted of an exercise resistance program and stretches for 12 weeks (three sessions of 80 each per week). Results: Twenty-two subjects completed the training. Reduced overall scores and WOMAC physical function indicated improved functional performance (p < 0.001) as well as increased gait speed (p < 0.001). The perception of pain decreased after training, as evidenced by the VAS, WOMAC pain domain, and SF-36 scores (p < 0.001). Quality of life improvements occurred primarily in the areas of pain, functional capacity, and SF-36 physical aspects. No change in body mass index was noted (p = 0.93). Conclusion: Our results indicate that the combination of resistance training for the quadriceps, gluteus, and abdominal muscles could be a viable alternative to improving functionality and quality of life in patients with knee OA. However, more studies are necessary to confirm our findings.

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