Dataset Information

Relative contributions of geographic, socioeconomic, and lifestyle factors to quality of life, frailty, and mortality in elderly.

ABSTRACT:

Background

To date, few studies address disparities in older populations specifically using frailty as one of the health outcomes and examining the relative contributions of individual and environmental factors to health outcomes.

Methodology/principal findings

Using a data set from a health survey of 4,000 people aged 65 years and over living in all regions of Hong Kong, we examined regional variations in self-rated health, frailty, and four-year mortality, and analyzed the relative contributions of lifestyle, socioeconomic status, and geographical location of residence to these outcomes using path analysis. We hypothesize that lifestyle, socioeconomic status, and regional characteristics directly and indirectly through interactions contribute to self-rated physical and psychological health, frailty, and four-year mortality. District variations directly affect self-rated physical health, and also exert an effect through socioeconomic position as well as lifestyle factors. Socioeconomic position in turn directly affects self-rated physical health, as well as indirectly through lifestyle factors. A similar pattern of interaction is observed for self-rated mental health, frailty, and mortality, although there are differences in different lifestyle factors and district associations. Lifestyle factors also directly affect physical and mental components of health, frailty, and mortality. The magnitude of direct district effect is comparable to those of lifestyle and socioeconomic position.

Conclusions/significance

We conclude that district variations in health outcomes exist in the Hong Kong elderly population, and these variations result directly from district factors, and are also indirectly mediated through socioeconomic position as well as lifestyle. Provision and accessibility to health services are unlikely to play a significant role. Future studies on these district factors would be important in reducing health disparities in the older population.

SUBMITTER: Woo J

PROVIDER: S-EPMC2808254 | biostudies-literature | 2010 Jan

REPOSITORIES: biostudies-literature

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Publications

Relative contributions of geographic, socioeconomic, and lifestyle factors to quality of life, frailty, and mortality in elderly.

Woo Jean J Chan Ruth R Leung Jason J Wong Moses M

PloS one 20100119 1

<h4>Background</h4>To date, few studies address disparities in older populations specifically using frailty as one of the health outcomes and examining the relative contributions of individual and environmental factors to health outcomes.<h4>Methodology/principal findings</h4>Using a data set from a health survey of 4,000 people aged 65 years and over living in all regions of Hong Kong, we examined regional variations in self-rated health, frailty, and four-year mortality, and analyzed the relat ...[more]

PMID: 20098745

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Project description:ObjectivesThe aims of this study were to examine the pattern of changes over time in health status (HS) and quality of life (QoL) in the first year after hip fracture and to quantify the association between frailty at the onset of hip fracture and the change in HS and QoL 1 year later. The major hypothesis was that frailty, a clinical state of increased vulnerability, is a good predictor of QoL in patients recovering from hip fracture.DesignProspective, observational, follow-up cohort study.SettingSecondary care. Ten participating centres in Brabant, the Netherlands.Participants1091 patients entered the study and 696 patients completed the study. Patients with a hip fracture aged 65 years and older or proxy respondents for patients with cognitive impairment were included in this study.Main outcome measuresThe primary outcomes were HS (EuroQol-5 Dimensions questionnaire) and capability well-being (ICEpop CAPability measure for Older people). Prefracture frailty was defined with the Groningen Frailty Indicator (GFI), with GFI ≥4 indicating frailty. Participants were followed up at 1 month, 3 months, 6 months and 1 year after hospital admission.ResultsIn total, 371 patients (53.3%) were considered frail. Frailty was negatively associated with HS (β -0.333; 95% CI -0.366 to -0.299), self-rated health (β -21.9; 95% CI -24.2 to -19.6) and capability well-being (β -0.296; 95% CI -0.322 to -0.270) in elderly patients 1 year after hip fracture. After adjusting for confounders, including death, prefracture HS, age, prefracture residential status, prefracture mobility, American Society of Anesthesiologists grading and dementia, associations were weakened but remained significant.ConclusionsWe revealed that frailty is negatively associated with QoL 1 year after hip fracture, even after adjusting for confounders. This finding suggests that early identification of prefracture frailty in patients with a hip fracture is important for prognostic counselling, care planning and the tailoring of treatment.Trial registration numberNCT02508675.

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Project description:BACKGROUND:Multimorbidity and frailty are relevant conditions among older adult population. There is growing evidence about their association with poor health outcomes like disability, worst quality of life, and death. Nonetheless, the independent associations of both conditions have been studied, and few evidence exists about an interaction between them. Our aims were to assess the association of frailty and multimorbidity with the disability, quality of life and all-cause mortality as well as to analyze a potential interaction between these conditions. METHODS:Analytical samples included 1410 respondents for disability and quality of life, and 1792 for mortality. We performed a longitudinal analysis with older Mexican adults aged 50, using data collected from the WHO's Study on global AGEing and Adult Health Waves 1 and 2. Disability was measured using the World Health Organization Disability Assessment Schedule (WHODAS 2.0), and quality of life using the WHOQOL (WHO Quality of Life) instrument. All-cause mortality was determined by reviewing death certificates. Associations of frailty and multimorbidity with disability, quality of life and mortality were estimated using linear regression and Cox proportional hazards models. RESULTS:Multimorbidity assessed through three patterns (cardiopulmonary, vascular-metabolic, and mental-musculoskeletal) was associated with the three outcomes in this study. Cardiopulmonary and mental-musculoskeletal patterns increased the WHODAS mean score (??=?5.05; p <?0.01 and ??=?5.10; p <?0.01, respectively) and decreased WHOQOL score (??=?-?1.81; p <?0.01 and ??=?-?2.99; p <?0.01, respectively). Vascular-metabolic was associated with mortality (HR?=?1.47; p =?0.04), disability (??=?3.27; p <?0.01) and quality of life (??=?-?1.30; p =?0.02). Frailty was associated with mortality (pre-frail: HR?=?1.48; p?=?0.02 and frail: HR?=?1.68; p =?0.03), disability (pre-frail: ??=?5.02; p <?0.01; frail: ??=?13.29; p <?0.01) and quality of life (pre-frail: ??=?-?2.23; p <?0.01; frail: ??=?-?4.38; p <?0.01). Interaction terms of frailty and multimorbidity were not statistically significant. CONCLUSIONS:Multimorbidity and frailty are important predictors of poor health outcomes. These results highlight the importance of carrying out health promotion and prevention actions as well as specific interventions aimed at older adults who suffer from multimorbidity and frailty, in such a way that deleterious effects on health can be avoided.

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Dataset Information

Relative contributions of geographic, socioeconomic, and lifestyle factors to quality of life, frailty, and mortality in elderly.

Background

Methodology/principal findings

Conclusions/significance

Publications

Relative contributions of geographic, socioeconomic, and lifestyle factors to quality of life, frailty, and mortality in elderly.

Similar Datasets

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