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

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Abstract

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 (χ 2-test for trend; χ 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.

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Acknowledgments

This study was supported by a grant from the Taipei Veterans General Hospital (VGH89-404-1, VGH90-445-1, and VGH91-382-1) and DOH-MD-MI9001.

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Authors and Affiliations

  1. Department of Health Management, I-Shou University, No. 1, Sec. 1, Syuecheng Rd., Dashu Township, Kaohsiung Country 840, Kaohsiung, Taiwan ROC

    Su-Ying Tsai

  2. Faculty of Dentistry, National Yang-Ming University, Taipei, Taiwan ROC

    Lin-Yang Chi

  3. Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan ROC

    Chen-hsen Lee

  4. Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan ROC

    Pesus Chou

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  1. Su-Ying Tsai
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  2. Lin-Yang Chi
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  4. Pesus Chou
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Correspondence to Su-Ying Tsai.

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Tsai, SY., Chi, LY., Lee, Ch. et al. Health-related quality of life as a predictor of mortality among community-dwelling older persons. Eur J Epidemiol 22, 19–26 (2007). https://doi.org/10.1007/s10654-006-9092-z

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  • DOI: https://doi.org/10.1007/s10654-006-9092-z

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