Search

Introduction Poorer physical health-related quality of life (HRQoL) has been shown to predict a higher risk of adverse health outcomes including cognitive decline, cardiovascular disease, and mortality among community-dwelling older individuals. However, little is known about how physical HRQoL changes over time in older people and the predictors of this trajectory. This study (a) identified trajectories of physical HRQoL among older people and (b) explored whether economic factors, social health, or recent stressors impact physical HRQoL trajectories. Method A cohort of 12,506 community-dwelling Australians aged ≥70 years (54.4% females), enrolled in the ASPREE Longitudinal Study of Older Persons (ALSOP) study and was followed for six years. Physical HRQoL was assessed by using a validated instrument (SF-12; version-2) at baseline and over up to six annual follow-ups. Economic factors, social health, and recent stressors (i.e. stressful life events in the last 12 months) were assessed through a questionnaire at baseline. Growth mixture and structural equation modelling were used to identify physical HRQoL trajectories and their predictors. Results Four physical HRQoL trajectories were identified—stable low (7.1%), declining (9.0%), stable intermediate (17.9%) and stable high (66.0%). Living in more disadvantaged areas, having economic burden, no voluntary work, loneliness, or recent stressors (i.e. spousal illness, friend/family illness, financial problem, pet died) were associated with a 10%–152% higher likelihood of being in the stable low or declining physical HRQoL trajectory than the stable high group. Conclusion Specific stressors including financial hardship had a greater impact on adverse physical HRQoL trajectories in older people than other factors. This study highlights that grassroots approaches are needed to emphasize economic autonomy and social support networks in order to support the wellbeing of older people. Volunteering may prevent physical HRQoL decline and requires further investigation. [ABSTRACT FROM AUTHOR]

Introduction Poor health-related quality of life (HRQoL) is associated with higher morbidity and mortality in patient populations. However, whether HRQoL is associated with health outcomes among community-dwelling older people requires further investigation. This study aimed to examine whether HRQoL predicts cognitive decline, dementia, cardiovascular disease (CVD), and mortality in community-dwelling older people living in Australia and the United States. Method A cohort of 19,106 individuals from the ASPirin in Reducing Events in the Elderly (ASPREE) study, aged 65–98 years, initially free of dementia or CVD, and who completed the HRQoL 12-item short form (SF-12, version-2) at baseline (2010–2014), were followed until June 2017. The physical (PCS) and mental component scores (MCS) of SF-12 were generated using standardized norm-based method. Results Over a median of 4.7 years, there were 2,412 cognitive declines, 574 dementia, 922 incident CVD events, and 1,052 deaths. Using Cox proportional-hazard regression adjusted for a range of covariates, every 10-unit increase in PCS was associated with a 6% lower risk of cognitive decline, a 14% lower risk of incident CVD, and 17% lower risk of all-cause mortality, but was not associated with incident dementia. In contrast, higher MCS was only associated with a 12% and 15% lower risk of cognitive decline and dementia, respectively. Findings did not differ by sex. Conclusion Our study provides some of the first evidence that HRQoL can be used in combination with clinical data to identify the future risks of health outcomes among older individuals living in the community. Our findings support the decision of the Australian Commission on Safety and Quality in Health Care to incorporate the SF-12 into the annual Patient-Reported Outcome Measures (PROMs assessment. [ABSTRACT FROM AUTHOR]