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Association between physical and mental health-related quality of life and adverse outcomes; a retrospective cohort study of 5,272 Scottish adults.

ABSTRACT: BACKGROUND: Health-related quality of life (HRQoL) is associated with adverse outcomes in disease-specific populations. This study examines whether it is also independent predictor of incident cancer, coronary heart disease (CHD) and mortality in the general population. METHODS: The records of adult participants in the Scottish Health Survey 2003 were linked with hospital admissions, cancer registrations and death certificates. Cox proportional hazard models were used to explore the associations between quintiles of physical and mental component summary score (PCS and MCS respectively) of the SF-12 and adverse outcomes. Higher quintiles of both PCS and MCS indicate better health status. RESULTS: Among the 5,272 study participants, the mean PCS score was 49 (standard deviation (SD) 10.3). Participants were followed-up for a mean of 7.6 years. On survival analysis the lowest quintile of PCS was a strong predictor of all-cause death (hazard ratio (HR) 2.81, 95% CI 1.76, 4.49), incident cancer (HR 1.63, 95% CI 1.10, 2.42), and CHD events (HR 1.99, 95% CI 1.00, 3.96), compared to the highest quintile. This association was independent of adiposity and other confounders. The mean MCS score 52 (SD 8.8). MCS quintile was not associated with incident cancer and CHD, and the association between MCS and all-cause death (HR 1.33, 95% CI 1.01, 1.75) became non-significant after adjustment for adiposity. CONCLUSION: Physical HRQoL is a significant predictor of a range of adverse outcomes, even after adjustment for adiposity and other confounders. This study highlights the importance of perceived health in the general population.

SUBMITTER: Ul-Haq Z

PROVIDER: S-EPMC4256892 | biostudies-other | 2014

REPOSITORIES: biostudies-other

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Association between physical and mental health-related quality of life and adverse outcomes; a retrospective cohort study of 5,272 Scottish adults.

Ul-Haq Zia Z Mackay Daniel F DF Pell Jill P JP

BMC public health 20141121

<h4>Background</h4>Health-related quality of life (HRQoL) is associated with adverse outcomes in disease-specific populations. This study examines whether it is also independent predictor of incident cancer, coronary heart disease (CHD) and mortality in the general population.<h4>Methods</h4>The records of adult participants in the Scottish Health Survey 2003 were linked with hospital admissions, cancer registrations and death certificates. Cox proportional hazard models were used to explore the ...[more]

PMID: 25416612

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Project description:PurposeHealth-related quality of life (HRQOL) in older persons is influenced by physical and mental health, as well as by their social contacts and social support. Older women and men have disparate types of social networks; they each value social ties differently and experience loneliness in unique and personal ways. The aim of this study is, therefore, to determine the longitudinal association between loneliness and social isolation with HRQOL in older people-separated by gender.MethodsData stem from the third and fourth follow-up of the ESTHER study-a population-based cohort study of the older population in Germany. A sample of 2171 older women and men (mean age: 69.3 years, range 57-84 years) were included in this study; HRQOL was assessed by using the Short Form-12 questionnaire (SF-12). Data on physical and mental health, loneliness, and social networks were examined in the course of comprehensive home visits by trained study doctors. Gender-specific linear regression analyses were performed to predict physical quality of life (measured by the PCS, physical component score of the SF-12) and mental quality of life (measured by the MCS, mental component score) after three years, adjusted by socioeconomic variables as well as physical, mental, and social well-being.ResultsAt baseline, PCS was 41.3 (SD: 10.0) in women and 42.2 (SD: 9.6) in men (p = .04). MCS was 47.0 (SD: 10.2) in women and 49.6 (SD: 8.6) in men (p < .001). In both genders, PCS and MCS were lower three years later. Loneliness at t0 was negatively associated with both PCS and MCS after three years (t1) among women, and with MCS but not PCS after three years among men. In both genders, the strongest predictor of PCS after three years was PCS at t0 (p < .001), while the strongest predictors of MCS after three years were MCS and PCS at t0.ConclusionHRQOL in elderly women and men is predicted by different biopsychosocial factors. Loneliness predicts decreased MCS after three years in both genders, but decreased PCS after three years only in women. Thus, a greater impact of loneliness on the health of older women can be surmised and should therefore be considered in the context of their medical care.

Project description:BackgroundSevere neuropsychiatric outcomes have been reported in individuals exposed to isotretinoin, but the evidence is inconclusive and complicated by several methodological limitations.ObjectivesTo establish and quantify the association between isotretinoin use for acne and 1-year incident neuropsychiatric adverse outcomes.MethodsA propensity score-matched cohort study of electronic medical records between the years 2013 and 2019 with patients followed up for 1 year after their index dispensed prescription was conducted. The database included over 12 million patients aged 12-27 years. We analysed data for individuals with acne in this age range with a dispensed prescription for isotretinoin or a control prescription. Outcomes included diagnoses of any incident sleep or mental health disorder, or nonfatal self-harm within 1 year of the index prescription.ResultsWe included 30 866 patients prescribed isotretinoin for their acne, 44 748 prescribed oral antibiotics, 108 367 prescribed topical anti-acne agents and 78 666 patients with acne but without an anti-acne prescription. After propensity score matching for baseline confounders, the odds ratio (OR) for any incident neuropsychiatric outcomes in patients with acne exposed to isotretinoin was 0·80 [95% confidence interval (CI) 0·74-0·87] compared with those on oral antibiotics; 0·94 (95% CI 0·87-1·02) compared with those using topical anti-acne medicines; and 1·06 (95% CI 0·97-1·16) compared with those without a prescription for anti-acne medicines. Patients exposed to isotretinoin experienced significantly more incident physical symptoms than patients in any of the three comparison cohorts.ConclusionsIsotretinoin was not independently associated with excess adverse neuropsychiatric outcomes at the population level. When monitoring potential adverse outcomes during isotretinoin treatment, clinicians should also consider the high mental health burden associated with treatment-resistant acne and the potential contribution of physical side-effects of prescribed medication on mental health.

Project description:Very low birth weight (VLBW: ≤1500 g) is associated with multiple short and long-term complications. This study aimed to examine outcomes and predictors of functioning, mental health, and health-related quality of life in adults born with VLBW. In this prospective longitudinal cohort study, 67 VLBW and 102 control participants were assessed using the Adult Self-Report of the Achenbach System of Empirically Based Assessment and Global Assessment of Functioning at 26 years, and the Hospital Anxiety and Depression Scale and Short Form-36 at 28 years of age. Associations between perinatal and childhood predictors and adult functioning were assessed using linear regression. Compared with controls, the VLBW group had lower mean raw scores on the Function and Symptom subscales of the Global Assessment of Functioning at 26 years, a higher sum score of symptoms of anxiety and depression due to more depressive symptoms, and poorer mental health-related quality of life at 28 years. The mean group differences ranged from 0.42 to 0.99 SD. Within the VLBW group, lower birth weight and gestational age, a higher number of days with respiratory support and poorer motor function at 14 years were associated with a higher sum score of symptoms of anxiety and depression at 28 years. Days with respiratory support and motor function at 14 years were also predictive of Global Assessment of Functioning scores at 26 years, and mental health-related quality of life at 28 years. Poorer motor and cognitive function at five years were associated with poorer physical health-related quality of life at 28 years. Parental socioeconomic status was related to mental and physical health-related quality of life. In this study, VLBW adults reported poorer functioning and mental health-related quality of life, and more depressive symptoms than their term born peers. Days with respiratory support and adolescent motor function predicted most of the adult outcomes. This study explicates perinatal and developmental markers during childhood and adolescence which can be target points for interventions.

Project description:BackgroundMental health conditions are among the leading non-fatal diseases in middle-aged and older adults in Australia. Proximal and distal social environmental factors and physical environmental factors have been associated with mental health, but the underlying mechanisms explaining these associations remain unclear. The study objective was to examine the contribution of different types of physical activity in mediating the relationship of social and physical environmental factors with mental health-related quality of life in middle-aged and older adults.MethodsBaseline data from the Wellbeing, Eating and Exercise for a Long Life (WELL) study were used. WELL is a prospective cohort study, conducted in Victoria, Australia. Baseline data collection took place in 2010. In total, 3,965 middle-aged and older adults (55-65 years, 47.4% males) completed the SF-36 Health Survey, the International Physical Activity Questionnaire, and a questionnaire on socio-demographic, social and physical environmental attributes. Mediation analyses were conducted using the MacKinnon product-of-coefficients test.ResultsPersonal safety, the neighbourhood physical activity environment, social support for physical activity from family or friends, and neighbourhood social cohesion were positively associated with mental health-related quality of life. Active transportation and leisure-time physical activity mediated 32.9% of the association between social support for physical activity from family or friends and mental health-related quality of life. These physical activity behaviours also mediated 11.0%, 3.4% and 2.3% respectively, of the relationship between the neighbourhood physical activity environment, personal safety and neighbourhood social cohesion and mental health-related quality of life.ConclusionsIf these results are replicated in future longitudinal studies, tailored interventions to improve mental health-related quality of life in middle-aged and older adults should use a combined strategy, focusing on increasing physical activity as well as social and physical environmental attributes.

Dataset Information

Association between physical and mental health-related quality of life and adverse outcomes; a retrospective cohort study of 5,272 Scottish adults.

Publications

Association between physical and mental health-related quality of life and adverse outcomes; a retrospective cohort study of 5,272 Scottish adults.

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