Change in health-related quality of life as a predictor of mortality in the older adults
Change in health-related quality of life as a predictor of mortality in the older adults
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DOI：
10.1007/s11136-009-9561-4
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发表时间：
2010-02-01
影响因子：
3.5
通讯作者：
Guallar-Castillon, Pilar
中科院分区：
文献类型：
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作者：
Otero-Rodriguez, Andrea;Maria Leon-Munoz, Luz;Guallar-Castillon, Pilar
我们研究了健康相关生活质量（HRQL）的变化是否可以预测西班牙老年人随后的死亡率。2001年和2003年使用SF-36健康问卷测量HRQL。采用考克斯回归模型分析2001年至2003年HRQL的身体和精神成分汇总（PCS和MCS）评分变化与2007年全因死亡率的相关性。不同PCS变化类别的死亡率风险比如下：2.12（95%置信区间[CI] 1.39-3.24）下降> 10点; 1.51（1.01-2.28）下降6至10点; 1为参考类别，变化为-5至+5点; 6- 9分改善为0.83（0.51-1.34），> 10分改善为0.68（0.42-1.09）;线性趋势P < 0.001。MCS的变化与死亡率之间的相关性显示出相同的方向，但幅度较小，只有MCS下降> 10点时才达到统计学显著性（P < 0.05）。HRQL的变化预测老年人的死亡率。HRQL下降应警惕更差的重要预后，并刺激寻找这种下降的可能决定因素。
We examined whether changes in health-related quality of life (HRQL) predict subsequent mortality among the Spanish elderly.Prospective cohort study of 2,373 persons, representative of the Spanish population aged 60 and older. HRQL was measured in 2001 and 2003 using the SF-36 health questionnaire. Cox regression models were used to examine the association of changes in the physical and mental component summary (PCS and MCS) scores of HRQL from 2001 to 2003 with all-cause mortality through 2007.Two hundred twelve deaths were ascertained from 2003 to 2007. The hazard ratios for mortality across categories of PCS change were as follows: 2.12 (95% confidence interval [CI] 1.39-3.24) for a > 10-point decline; 1.51 (1.01-2.28) for a 6- to 10-point decline; 1 for the reference category, a change of -5 to +5 points; 0.83 (0.51-1.34) for a 6- to 9-point improvement and 0.68 (0.42-1.09) for a > 10-point improvement; P for linear trend < 0.001. The associations between changes in the MCS and mortality showed the same direction, but were of a lower magnitude and attained statistical significance (P < 0.05) only for a > 10-point decline in MCS.Changes in HRQL predict mortality in the older adults. A decline in HRQL should alert to a worse vital prognosis and stimulate the search for the possible determinants of such decline.