Konagaya Yoko, Watanabe Tomoyuki, Ohta Toshiki, Takata Kazuko
Obu Dementia Care Research and Training Center, Japan.
Nihon Ronen Igakkai Zasshi. 2010;47(4):308-14. doi: 10.3143/geriatrics.47.308.
Chronic illnesses are common among elderly people, and may considerably affect to their quality of life (QOL). We investigated the impact of chronic conditions on QOL among community-dwelling elderly people, and the stability of QOL over time.
A total of 2,762 community-dwelling elderly persons (men: 47.0%, age 76.7±5.8 [mean±SD]) completed postal QOL questionnaires twice over 4 years. Chronic illnesses were selected from the following 9 conditions: cerebrovascular disease, hypertension, heart disease, cancer, diabetes mellitus, bone fracture, chronic digestive disease, chronic respiratory disease, and the diseases of joints or muscles. The QOL questionnaire was developed based on the QOL components proposed by Lawton, and consisted of 6 subscales: daily activity, health satisfaction, human support satisfaction, economic state satisfaction, symptoms of depression, and positive mental attitude. The subjects were divided into 3 groups regardless of the presence of chronic illnesses. QOL subscale scores were compared among the 3 groups, and fluctuations over 4 years were also evaluated.
The baseline QOL scores showed significant differences among the 3 groups, especially regarding health satisfaction, but not in satisfaction with human support. There were significant differences among the 3 groups in fluctuations over 4 years in health satisfaction, daily activity, and positive mental attitude.
Chronic illnesses have a negative impact on the QOL of elderly people, and also influence fluctuations in QOL over time. Degrees of impacts differed according to each QOL subscale. Therefore, evaluation of QOL in community-dwelling elderly needs multi-dimensional assessment.
慢性病在老年人中很常见,可能会对他们的生活质量(QOL)产生相当大的影响。我们调查了慢性病对社区居住老年人生活质量的影响,以及生活质量随时间的稳定性。
共有2762名社区居住老年人(男性:47.0%,年龄76.7±5.8[平均值±标准差])在4年时间里分两次完成了邮寄的生活质量问卷。慢性病从以下9种疾病中选取:脑血管疾病、高血压、心脏病、癌症、糖尿病、骨折、慢性消化系统疾病、慢性呼吸系统疾病以及关节或肌肉疾病。生活质量问卷是根据劳顿提出的生活质量组成部分编制的,由6个分量表组成:日常活动、健康满意度、人际支持满意度、经济状况满意度、抑郁症状和积极心态。受试者无论是否患有慢性病都被分为3组。比较了3组之间的生活质量分量表得分,并评估了4年期间的波动情况。
3组之间的基线生活质量得分存在显著差异,尤其是在健康满意度方面,但在人际支持满意度方面没有差异。3组在健康满意度、日常活动和积极心态方面4年期间的波动存在显著差异。
慢性病对老年人的生活质量有负面影响,也会影响生活质量随时间的波动。不同生活质量分量表的影响程度不同。因此,对社区居住老年人生活质量的评估需要进行多维度评估。