Saarni Samuli I, Suvisaari Jaana, Sintonen Harri, Koskinen Seppo, Härkänen Tommi, Lönnqvist Jouko
National Public Health Institute, Department of Mental Health and Alcohol Research, Mannerheimintie 166, 00300 Helsinki, Finland.
J Clin Epidemiol. 2007 Dec;60(12):1288-97. doi: 10.1016/j.jclinepi.2007.03.004. Epub 2007 Jul 25.
To estimate the individual- and population-level impact of major chronic conditions on health-related quality of life (HRQoL) at different ages, to test whether the HRQoL impact of conditions varies with age, and to predict future changes of quality-adjusted life years (QALYs) lost due to morbidity.
HRQoL was measured using two preference-based instruments, the 15D and the EQ-5D, in a representative sample of 8,028 Finns. Information on chronic somatic conditions was obtained by interviews. Psychiatric disorders were diagnosed using a structured interview (Munich version of the Composite International Diagnostic Interview).
The impact of chronic conditions on HRQoL increased fourfold when comparing people aged 30-44 years to people over 75 years. This was mostly due to increase in prevalence, but the severity of some conditions also varied with age. Musculoskeletal disorders had the largest and rather stable impact across ages on the population level. Psychiatric disorders placed the largest burden on HRQoL at 30-44 years, but their impact declined after 55 years. The aging of the Finnish population was predicted to increase annual QALYs lost due to morbidity by one quarter by year 2040.
The impact of conditions on HRQoL varied with age for each condition.
评估主要慢性病在不同年龄段对健康相关生活质量（HRQoL）的个体和人群水平影响，检验疾病对HRQoL的影响是否随年龄变化，并预测因发病导致的质量调整生命年（QALY）的未来变化。
在8028名芬兰人的代表性样本中，使用两种基于偏好的工具（15D和EQ-5D）测量HRQoL。通过访谈获取慢性躯体疾病信息。使用结构化访谈（慕尼黑版综合国际诊断访谈）诊断精神障碍。
将30 - 44岁人群与75岁以上人群相比，慢性病对HRQoL的影响增加了四倍。这主要是由于患病率增加，但某些疾病的严重程度也随年龄变化。肌肉骨骼疾病在人群水平上对各年龄段的影响最大且相当稳定。精神障碍在30 - 44岁时对HRQoL的负担最大，但在55岁后其影响下降。预计到2040年，芬兰人口老龄化将使因发病导致的年度QALY损失增加四分之一。
每种疾病对HRQoL的影响随年龄而异。
