Delgado-Sanz María Concepción, Prieto-Flores Maria-Eugenia, Forjaz Maria João, Ayala Alba, Rojo-Perez Fermina, Fernandez-Mayoralas Gloria, Martínez-Martín Pablo
Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España.
Rev Esp Salud Publica. 2011 Dec;85(6):555-68. doi: 10.1590/S1135-57272011120000005.
Chronic medical conditions represent risk factors for health related quality of life (HRQOL). The aim of this study is to analyze the influence of self-reported chronic health conditions in HRQOL, measured through the EQ-5D dimensions, in non-institutionalized and institutionalized older adults.
Data were obtained from two studies of quality of life in population aged 60 years or over, in Spain, with a sample of 1,106 community-dwelling adults and 234 residents of care facilities. To analyse the influence of the most prevalent chronic health conditions on HRQOL multiple logistic regression models were adjusted using as dependent variable each EQ-5D dimension, controlling for socio-demographic variables.
The chronic health conditions that most influenced the HRQOL of both groups were depression (OR range in the different EQ-5D dimensions: 1.97-6.48), followed by arthrosis/arthritis (OR: 2.81-6.00), sleep problems (OR: 2.81-4.61), diabetes (OR: 1.68-3.44) and hypertension (OR: 1.42-2.45). These problems affected differentially the EQ-5D dimensions and the two groups considered. Pain/discomfort and mobility were the EQ-5D dimensions where more difficulties were reported.
The results of this work indicate that the debilitating effect of chronic health conditions on the HRQOL is different for institutionalized and non-institutionalized older adults. They also highlight the importance of promoting healthy ageing to attenuate the negative impact of chronic health conditions on HRQOL in old age.
慢性疾病是影响健康相关生活质量（HRQOL）的风险因素。本研究旨在分析自我报告的慢性健康状况对非机构化和机构化老年人HRQOL的影响，HRQOL通过EQ-5D维度进行测量。
数据来自西班牙两项针对60岁及以上人群生活质量的研究，样本包括1106名社区居住成年人和234名护理机构居民。为分析最常见的慢性健康状况对HRQOL的影响，使用每个EQ-5D维度作为因变量，调整多元逻辑回归模型，并控制社会人口统计学变量。
对两组人群HRQOL影响最大的慢性健康状况是抑郁症（在不同EQ-5D维度中的OR范围：1.97 - 6.48），其次是关节病/关节炎（OR：2.81 - 6.00）、睡眠问题（OR：2.81 - 4.61）、糖尿病（OR：1.68 - 3.44）和高血压（OR：1.42 - 2.45）。这些问题对EQ-5D维度和所考虑的两组人群的影响存在差异。疼痛/不适和活动能力是报告中困难较多的EQ-5D维度。
这项研究的结果表明，慢性健康状况对机构化和非机构化老年人HRQOL的削弱作用有所不同。研究还强调了促进健康老龄化以减轻慢性健康状况对老年人HRQOL负面影响的重要性。
