Health-related quality of life as a predictor of mortality among community-dwelling older persons

被引:111
作者
Tsai, Su-Ying
Chi, Lin-Yang
Lee, Chen-hsen
Chou, Pesus
机构
[1] I Shou Univ, Dept Hlth Management, Kaohsiung 840, Taiwan
[2] Natl Yang Ming Univ, Fac Dent, Taipei 112, Taiwan
[3] Natl Yang Ming Univ, Community Med Res Ctr, Taipei 112, Taiwan
[4] Natl Yang Ming Univ, Inst Publ Hlth, Taipei 112, Taiwan
[5] Taipei Vet Gen Hosp, Dept Surg, Taipei, Taiwan
关键词
elderly; mortality; health-related quality of life; SF-36; SELF-RATED HEALTH; SURVEY SF-36; CARE UTILIZATION; HOSPITALIZATION; QUESTIONNAIRE; ASSOCIATION; RELIABILITY; POPULATION; DISEASE; TESTS;
D O I
10.1007/s10654-006-9092-z
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Health-related quality of life (HRQOL) measures predict cause-specific mortality, but few studies have explored whether generic self-reported HRQOL measures are independently associated with mortality in community-dwelling older persons. We postulated that a general measure of HRQOL, the short form 36-item questionnaire (SF-36), would be independently predictive of mortality among community-dwelling older persons. To evaluate this hypothesis, we followed a fixed cohort of 4,424 community-dwelling older persons recruited from a 2000 population-based survey in Taiwan until 2003 and investigated whether HRQOL was predictive of 3-year mortality, even after adjusting for traditional clinical risk variables. The data were collected via a door-to-door survey, and interviewers collected information on the subjects' demographics, medical history, utilization of health services, functional ability, falls, and self-reported physical and mental symptoms. Of the 6053 eligible subjects, 4,424 residents agreed to participate in the baseline survey and were contacted in 2003. During the 3-year period, the 3-year cumulative mortality rate for the study population was 5%. Mortality was significantly higher among males (5.57% vs. 4.27%, p = 0.049), and cumulative mortality increased with age (chi(2)-test for trend; chi(2) = 7.734, p = 0.001). For all scales except bodily pain, there was a significant relationship between a 10-point lower baseline score and mortality. Our primary multivariate risk model, which included two summary measures of HRQOL and significant clinical variables, demonstrated that a 10-point decrease in either the baseline Physical Component Summary (PCS) score or the baseline Mental Component Summary (MCS) score was associated with higher mortality (PCS: RR: 1.60, 95% CI: 1.39-1.83; p < 0.001; MCS: RR: 1.16, 95% CI: 1.01-1.34; p = 0.036). The findings suggested that low baseline PCS and MCS scores were important independent risk factors for 3-year mortality among community-dwelling older persons, even after adjusting for other risk factors.
引用
收藏
页码:19 / 26
页数:8
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