Kimiko Tomioka1, Midori Shima2, Keigo Saeki2. 1. Nara Prefectural Health Research Center, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan. tkimiko@naramed-u.ac.jp. 2. Nara Prefectural Health Research Center, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan.
Abstract
PURPOSE: Previous studies have reported a positive association between poor health-related quality of life (HRQOL) and disability mainly in relation to the physical component of HRQOL. Given the mental component's responsivity to interventions, this study aimed to investigate whether the mental component of HRQOL independently predicted functional disability. METHODS: We targeted all residents aged ≥ 65 years in one municipality and analyzed 3858 men and 4475 women without disability at baseline (November 2016). HRQOL was measured using the physical component summary (PCS) and mental component summary (MCS) of the SF-8 Health Survey. At 3-year follow-up (October 2019), incident functional disability was measured, defined as a new certification according to the Japanese long-term care insurance system. Multivariable Poisson regression models stratified by gender were used to estimate adjusted cumulative incidence ratio (CIR) and 95% confidence interval (CI) for functional disability. RESULTS: Among both genders, there was a significant dose-response relationship between better MCS and lower risk of functional disability, independent of potential confounders including the PCS (P for trend = 0.026 in men and 0.003 in women). Compared with the worst MCS group, the CIRs (95% CIs) for functional disability in the second worst, the middle, the second best, and the best MCS quintile groups were 1.09 (0.80-1.48), 0.58 (0.40-0.85), 0.90 (0.59-1.37), and 0.70 (0.48-1.02) for men, and 0.76 (0.58-1.00), 0.62 (0.46-0.84), 0.73 (0.53-0.99), and 0.63 (0.48-0.85) for women, respectively. CONCLUSION: The MCS is an independent predictor of functional disability among high-functioning older adults. This suggests that strategies focused on mental HRQOL are important for realizing a healthy, long-lived society.
PURPOSE: Previous studies have reported a positive association between poor health-related quality of life (HRQOL) and disability mainly in relation to the physical component of HRQOL. Given the mental component's responsivity to interventions, this study aimed to investigate whether the mental component of HRQOL independently predicted functional disability. METHODS: We targeted all residents aged ≥ 65 years in one municipality and analyzed 3858 men and 4475 women without disability at baseline (November 2016). HRQOL was measured using the physical component summary (PCS) and mental component summary (MCS) of the SF-8 Health Survey. At 3-year follow-up (October 2019), incident functional disability was measured, defined as a new certification according to the Japanese long-term care insurance system. Multivariable Poisson regression models stratified by gender were used to estimate adjusted cumulative incidence ratio (CIR) and 95% confidence interval (CI) for functional disability. RESULTS: Among both genders, there was a significant dose-response relationship between better MCS and lower risk of functional disability, independent of potential confounders including the PCS (P for trend = 0.026 in men and 0.003 in women). Compared with the worst MCS group, the CIRs (95% CIs) for functional disability in the second worst, the middle, the second best, and the best MCS quintile groups were 1.09 (0.80-1.48), 0.58 (0.40-0.85), 0.90 (0.59-1.37), and 0.70 (0.48-1.02) for men, and 0.76 (0.58-1.00), 0.62 (0.46-0.84), 0.73 (0.53-0.99), and 0.63 (0.48-0.85) for women, respectively. CONCLUSION: The MCS is an independent predictor of functional disability among high-functioning older adults. This suggests that strategies focused on mental HRQOL are important for realizing a healthy, long-lived society.
Authors: Luigi Grassi; Rosangela Caruso; Chiara Da Ronch; Martin Härter; Holger Schulz; Jana Volkert; Maria Dehoust; Susanne Sehner; Anna Suling; Karl Wegscheider; Berta Ausín; Alessandra Canuto; Manuel Muñoz; Mike J Crawford; Yael Hershkovitz; Alan Quirk; Ora Rotenstein; Ana Belén Santos-Olmo; Arieh Shalev; Jens Strehle; Kerstin Weber; Hans-Ulrich Wittchen; Sylke Andreas; Martino Belvederi Murri; Luigi Zerbinati; Maria Giulia Nanni Journal: Health Qual Life Outcomes Date: 2020-03-06 Impact factor: 3.186