scholarly journals Longitudinal assessment of the health-related quality of life among older people with diabetes: results of a nationwide study in New Zealand

2020 ◽  
Author(s):  
Seyed Morteza Shamshirgaran ◽  
Christine Stephens ◽  
Fiona Alpass ◽  
Nayyereh Aminisani

Abstract Background: The current work examined experiences of Health Related Quality of Life (HRQOL) among older adults with a diagnosis of Diabetes Mellitus (DM) over time compared to those without a diagnoses DM. Methods: The sample was drawn from six biennial waves of the New Zealand Health, Work and Retirement survey, a prospective population-based cohort study of older adults 55-70 years at baseline. Data on sociodemographic factors, health behaviours, chronic disease diagnoses and physical and mental HRQOL (SF-12v2) were obtained using six biennial surveys administered 2006-2016. Generalised Estimating Equation models, adjusted for time-constant and -varying factors, were employed to compare HRQOL and its determinants over time for older adults with and without a diagnosis of DM. Results: DM was negatively associated with physical HRQOL [β (95% CI) −7.43 (−8.41, −6.44)] with older adults affected by DM reporting scores 7.4 points lower than those without DM. Similarly, the mean Mental HRQOL score was lower among those affected by DM [β = −4.97 (−5.93, −4.01)] however, scores increased over time for both groups ( p <0.001). Greater age, more chronic conditions, sight and sleep problems, obesity, lower annual income, and fewer years of education were predictors of poorer HRQOL among older adults. Conclusions: Older adults affected by diabetes experienced poorer physical and mental HRQOL compared to those not affected when controlling for a range of sociodemographic and health related indices. A management aim must be to minimise the gap between two groups, particularly as people age.

2020 ◽  
Author(s):  
Seyed Morteza Shamshirgaran ◽  
Christine Stephens ◽  
Fiona Alpass ◽  
Nayyereh Aminisani

Abstract Background: The current work examined experiences of Health Related Quality of Life (HRQOL) among older adults with a diagnosis of Diabetes Mellitus (DM) over time compared to those without a diagnoses DM. Methods: The sample was drawn from six biennial waves of the New Zealand Health, Work and Retirement survey, a prospective population-based cohort study of older adults 55-70 years at baseline. Data on sociodemographic factors, health behaviours, chronic disease diagnoses and physical and mental HRQOL (SF-12v2) were obtained using six biennial surveys administered 2006-2016. Generalised Estimating Equation models, adjusted for time-constant and -varying factors, were employed to compare HRQOL and its determinants over time for older adults with and without a diagnosis of DM. Results: DM was negatively associated with physical HRQOL [β (95% CI) −7.43 (−8.41, −6.44)] with older adults affected by DM reporting scores 7.4 points lower than those without DM. Similarly, the mean Mental HRQOL score was lower among those affected by DM [β = −4.97 (−5.93, −4.01)] however, scores increased over time for both groups ( p <0.001). Greater age, more chronic conditions, sight and sleep problems, obesity, lower annual income, and fewer years of education were predictors of poorer HRQOL among older adults. Conclusions: Older adults affected by diabetes experienced poorer physical and mental HRQOL compared to those not affected when controlling for a range of sociodemographic and health related indices. A management aim must be to minimise the gap between two groups, particularly as people age.


2019 ◽  
Author(s):  
Seyed Morteza Shamshirgaran ◽  
Christine Stephens ◽  
Fiona Alpass ◽  
Nayyereh Aminisani

Abstract Background: The current work examined experiences of Health Related Quality of Life (HRQOL) among older adults with a diagnoses of Diabetes Mellitus (DM) over time compared to those without a diagnoses DM. Methods: The sample was drawn from six biennial waves of the New Zealand Health, Work and Retirement survey, a prospective population-based cohort study of older adults 55-70 years at baseline. Data on sociodemographic factors, health behaviours, chronic disease diagnoses and physical and mental HRQOL (SF-12v2) were obtained using six biennial surveys administered 2006-2016. Generalised Estimating Equation models, adjusted for time-constant and -varying factors, were employed to compare HRQOL and its determinants over time for older adults with and without a diagnosis of DM. Results: DM was negatively associated with physical HRQOL [β (95% CI) −7.43 (−8.41, −6.44)] with older adults affected by DM reporting scores 7.4 points lower than those without DM. Similarly, the mean Mental HRQOL score was lower among those affected by DM [β = −4.97 (−5.93, −4.01)] however, scores increased over time for both groups ( p <0.001). Greater age, more chronic conditions, sight and sleep problems, obesity, lower annual income, and fewer years of education were predictors of poorer HRQOL among older adults. Conclusions: Older adults affected by diabetes experienced poorer physical and mental HRQOL compared to those not affected, when controlling for a range of sociodemographic and health related indices. A management aim must be to minimise the gap between two groups particularly as people age.


2020 ◽  
Author(s):  
Nayyereh Aminisani ◽  
Chris Stephens ◽  
Fiona Alpass ◽  
Seyed Morteza Shamshirgaran

Abstract Background: This study aimed to examine the association of Health-Related Quality of Life (HRQOL) and multimorbidity (MM) and its correlates over time in New Zealand. Methods: People aged 55 years and over were invited to participate in a nationally representative population-based longitudinal study in 2006 and followed up biennially until 2016. Generalized Estimating Equations (GEE) with an exchangeable correlation matrix and robust standard errors adjusted for both time-constant and time-varying factors using baseline and five subsequent waves of data were used, to compare a range of factors related to changes in MM and HRQOL. Results: Of 2632 participants at baseline, 957 of the participants were classified as “MM participants”; 570 had two, and the rest had three chronic conditions. The results of the GEE regression models demonstrated that SF12-PCS decreased over time, and there was a significant difference in SF12-PCS between MM and Non-MM participants. Having MM was negatively associated with HRQOL-PCS [-3.00 (95 %CI -3.60, -2.49); p <0.001)]. Although the results showed an increase in SF12-MCS over time, the score of the mental dimension of HRQOL was lower among MM participants compared to Non-MM participants [-2.60, 95 %CI -3.09, -2.11]. Conclusions: According to this longitudinal study, there is an inverse association between MM and one of the most important health outcomes; HRQOL, in older adults.


SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A143-A144
Author(s):  
Kelly Showen ◽  
Kathleen O’Hora ◽  
Beatriz Hernandez ◽  
Laura Lazzeroni ◽  
Jamie Zeitzer ◽  
...  

Abstract Introduction Insomnia affects 30–48% of older adults and impairs health-related quality of life (HRQoL). Numerous studies report Cognitive Behavioral Therapy (CBT-I) as an effective non-pharmacological treatment for insomnia symptoms, with few examining the impact of CBT-I on mental and physical aspects of HRQoL. While limited research suggests that CBT-I leads to improvements in HRQoL, the impact of the cognitive versus behavioral components of CBT-I on HRQoL is unknown. Methods 128 older adults with insomnia (mean age=69, 66% female, 19% minority) were randomized to receive cognitive therapy (CT), behavior therapy (BT), or CBT-I. The Short Form (36) Health Survey (SF-36) was collected at baseline, post-treatment and six-month follow-up. Split-plot linear mixed models with age and sex as covariates to assess within and between subject changes were used to test intervention, time, and interaction effects on the mental health and physical well-being domains of HRQoL. Significance for all effects was defined as p &lt; 0.05. The effect size (d) was calculated by dividing the difference between means by the root-mean-squared error of the mixed effects model. Results The mental health-related QoL improved over time independent of treatment (Main effect of time: F(2, 202) = 6.51, p &lt; 0.002). The interaction failed to reach significance (Interaction: F(4, 202) = 1.19, p = .31). Simple effects revealed significant improvements among CBT-I participants at six months (p = .02, d = .53) and CT participants at post-treatment (p = .00, d = .79) and six months (p = .03, d = .66), but not among BT participants for either time point (p = .32, d = .24; p = .16, d = .35). Treatment did not improve physical health-related QoL over time (F(2, 202) = 1.01, p = .37) nor was there a significant interaction (F(4, 202) = .46, p = .76). Conclusion These findings suggest that CBT-I, particularly the CT component, may be effective in improving mental health-related QoL outcomes for older adults with insomnia. In contrast, neither CBT-I nor its component treatments were effective in improving physical health-related QoL. Support (if any) NIMHR01MH101468-01; Mental Illness Research, Education, and Clinical Center (MIRECC) at the VAPAHCS


Author(s):  
Caroline Lang ◽  
Martin Roessler ◽  
Jochen Schmitt ◽  
Antje Bergmann ◽  
Vjera Holthoff-Detto

Abstract Purpose Multimorbidity leads to decreasing health-related quality of life (HRQoL). Telemedicine may help to improve HRQoL. The present study was conducted to show (I) differences in HRQoL and changes in HRQoL over time in elderly, multimorbid individuals with and without depression and/or mild cognitive impairment (MCI) using a telemonitoring application (TMA) and (II) associations between engagement with measurements by study participants using a TMA and changes in their HRQoL. Methods The present feasibility study was part of a longitudinal intervention study. Recruited general practitioners (GPs) enrolled individuals and assigned them to risk groups according to absence/presence of depression and/or MCI. Depression was assessed using the Geriatric Depression Scale (GDS-15), MCI using the Mini-Mental State Examination (MMSE), and HRQoL using the SF-12. The TMA consisted of tablets, software, and measuring devices. Measured vital data were transferred to a care and case manager for monitoring and possible intervention. Results Nine GPs recruited 177 individuals, 97 of whom were included in the HRQoL analysis. Significantly lower physical and mental component summary (PCS/MCS) scores were revealed in study participants with depression, and with both depression and MCI, compared to participants with no mental disorders. PCS scores did not differ between study dates, but MCS scores had significantly increased over time. Participants’ engagement with measurements was significantly associated with an increased MCS score, but not with the PCS score. Discussion Depression and/or MCI are negatively associated with the HRQoL of elderly, multimorbid people using a TMA. Engagement of individuals with vital data measurements via a TMA may increase their mental HRQoL. Mentally impaired people should be closely involved as co-designers and experts in development processes of TMAs to benefit from tailored solutions. An individual’s increased mental HRQoL can be a decisive factor in their engagement with a GP treatment regimen and telemonitoring processes.


2020 ◽  
Author(s):  
Shaojie Li ◽  
Yongtian Yin ◽  
Lijun Chen ◽  
Guanghui Cui ◽  
Jiaqin Li ◽  
...  

BACKGROUND Older adults’ health literacy levels are crucial to improving health outcomes and health-related quality of life (HRQoL). However, the impact of eHealth literacy on HRQoL in older adults is unclear. OBJECTIVE The aim of this study was to examine the association between eHealth literacy and HRQoL of older adults and provide reference for the development of network intervention measures related to the health quality of life of the older adults. METHODS An anonymous cross-sectional survey was conducted among 1,201 adults aged 60 or older from Jinan, China. The eHealth Literacy Scale and Short-Form Health Survey (SF-12) were used to measure eHealth literacy and HRQoL. We used linear regression to test the adjusted association between eHealth literacy and HRQoL. RESULTS Most participants (88.9%) had inadequate eHealth literacy. Lower eHealth literacy was related to older age ( F=12.618, P<.001), female gender( t=3.303, P<.01), living in rural areas( F=11.356, P<.001), having less education( F=59.084, P<.001), being unmarried, divorced or widowed( t=4.416, P<.001), having a lower family income( F=38.017, P<.001), living with others(χ2=4.319, P<.05), and not having health insurance( F=12.713, P<.001). There were significant differences across physical functioning( t=-4.862, P<.001), role- physical( t=-2.485, P<.05), bodily pain( t=-3.470, P<.01), general health( t=-4.449, P<.001), vitality( t=-3.498, P<.001), role-emotional( t=-2.654, P<.01), mental health( t=-4.150, P<.001), physical component summary( t=-6.350, P<.001) and mental component summary( t=-4.483, P<.001) between adequate eHealth literacy and inadequate eHealth literacy. After controlling for age, gender, and other covariates, adequate eHealth literacy was positively related to physical component summary ( beta=7.6, P<.001) and mental component summary(beta=4.6, P=.001). CONCLUSIONS This study showed that Chinese older adults with higher eHealth literacy were more likely to contribute to higher HRQoL. Thus, Older adults’ eHealth literacy levels need to be taken into account when formulating health education and promotion programs for older adults, especially when the expected outcome is to improve HRQoL.


Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Andrew Smith ◽  
Bishma Saqib ◽  
Rebecca Lee ◽  
Wendy Thomson ◽  
Lis Cordingley

Abstract Background Juvenile idiopathic arthritis (JIA) is a heterogeneous group of arthritic conditions presenting in children and young people, in which physical limitations and associated complications can have detrimental effects on physical and psychosocial wellbeing. This study aims to investigate the impact of living with JIA on different aspects of health-related quality of life (HRQoL) and to explore how this changes over time, using data from the Childhood Arthritis Prospective Study (CAPS). Methods Longitudinal data collected as part of CAPS were analysed. HRQoL was assessed at baseline, 1 year and 3 years’ post-diagnosis using the Child Health Questionnaire (CHQ), a parent-completed form for children from 5 years of age. The CHQ measures physical, emotional and social components of child health status. Raw domain scores were transformed via algorithm into values ranging from 0-100, with higher scores indicating better health status. Mean (standard deviation) and median (interquartile range) for each domain were determined, both for the full cohort and by gender. Differences between median scores at baseline and 3 years were assessed using the Wilcoxon signed-rank test. Mean scores of each domain were visually compared with a reference population sample of healthy children from the United States. Results 184 participants completed the questionnaire at all 3 time points. At baseline, compared to the reference population, children with JIA scored lower in every domain although scores were closer between the 2 groups at 3 years. Median scores improved over time, the exception being the general health perceptions domain which decreased after baseline. Domains with the greatest improvement were physical functioning,“bodily pain and social-physical. The largest changes occurred from baseline to 1 year. Statistically significant differences between baseline and 3-year scores were found for all domains. Domain scores for male and female participants were very similar at baseline, though scores for male participants indicated slightly better health at 1 and 3 years for both physical and psychosocial domains. Conclusion JIA has significant impact on HRQoL, which improves within 3 years of diagnosis with the greatest improvement occurring within the first year. Physical health domains show greater improvement over time than psychosocial domains, although psychosocial scores were generally higher throughout the study. Male participants tend to score slightly higher than female participants in both physical and psychosocial domains after baseline. Further research should explore measurable patient, age or disease-related drivers of HRQoL. Disclosures A. Smith None. B. Saqib None. R. Lee None. W. Thomson None. L. Cordingley None.


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