Gender differences in health-related quality of life among the elderly: The role of objective functional capacity and chronic conditions
Gender differences in health-related quality of life among the elderly: The role of objective functional capacity and chronic conditions
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DOI：
10.1016/j.socscimed.2006.06.017
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发表时间：
2006-11-01
影响因子：
5.4
通讯作者：
Alonso, Jordi
中科院分区：
文献类型：
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作者：
Orfila, Francesc;Ferrer, Montserrat;Alonso, Jordi
虽然妇女的健康相关生活质量（HRQL）普遍较差，但尚不清楚这是由于不同的报告模式，还是健康状况存在真实的差异。本研究的目的是评估在多大程度上的性别差异，在老年人HRQL可能是由不同的性能为基础的功能能力和慢性疾病，使用的概念模型，健康结果威尔逊和Cleary提出的解释。数据来自对872名幸存者的横断面家庭调查，这些人来自代表巴塞罗那一般人群的老年队列。从62%的受试者（n = 544）中获得了这些分析的完整有效数据。评估包括诺丁汉健康概况（NHP），HRQL的通用测量;三个基于性能的功能能力测试（平衡，椅子站立和步行测试）;和自我报告的慢性疾病的标准化列表。以NHP总分为因变量，以性别、社会人口学信息、运动功能和慢性病为自变量，建立多元线性回归模型。女性（65.4%）在HRQL（NHP总分平均值28.3 vs 16.7，p < 0.001）和功能能力（总分平均值7.1 vs 8.3，p < 0.001）方面的结果比男性差。在最终的回归模型中，功能能力、关节炎、背痛、糖尿病和抑郁症与NHP总分显著相关，解释了42%的方差。NHP总分的性别原始差异为11.5分（p < 0.001），但在调整所有其他变量后降至不显著的3.2分（p = 0.18）。总之，我们的数据表明，老年妇女的HRQL报告较差，主要是由于残疾和慢性疾病的患病率较高。(c)2006爱思唯尔有限公司保留所有权利。
Although worse Health-Related Quality of Life (HRQL) among women has been widely described, it remains unclear whether this is due to differential reporting patterns, or whether there is a real difference in health status. The objective of this study was to evaluate to what extent gender differences in HRQL among the elderly might be explained by differences in performance-based functional capacity and chronic conditions, using the conceptual model of health outcomes as proposed by Wilson and Cleary. Data are from a cross-sectional home survey of 872 surviving individuals from an elderly cohort representative of Barcelona's general population. Complete valid data for these analyses were obtained from 62% of the subjects (n = 544). The evaluation included the Nottingham Health Profile (NHP), a generic measure of HRQL; three performance-based functional capacity tests (balance, chair-stand, and walking tests); and a standardized list of self-reported chronic conditions. A series of multiple linear regression models were built with the total NHP score as the dependent variable, with gender, socio-demographic information, performance-based functional capacity and chronic conditions included sequentially, as independent variables. Women (65.4%) showed worse results than men on HRQL (mean of NHP total score 28.3 vs 16.7, p < 0.001) and functional capacity (mean of summary score 7.1 vs 8.3, p < 0.001). Functional capacity, arthritis, back pain, diabetes, and depression were significantly associated to the NHP total score in the final regression model, which explained 42% of the variance. Raw differences by gender in the total NHP score were 11.5 points (p < 0.001), but decreased to a non-significant 3.2 points (p = 0.18) after adjusting for all the other variables. In conclusion, our data suggest that worse reported HRQL in elderly women is mainly due to a higher prevalence of disability and chronic conditions. (c) 2006 Elsevier Ltd. All rights reserved.