Machón Mónica, Larrañaga Isabel, Dorronsoro Miren, Vrotsou Kalliopi, Vergara Itziar
Unidad de Investigación de Atención Primaria-OSIS Gipuzkoa, Osakidetza, Instituto Biodonostia, Paseo Doctor Beguiristian s/n, San Sebastián, 20014, Spain.
Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Bilbao, Spain.
BMC Geriatr. 2017 Jan 14;17(1):19. doi: 10.1186/s12877-016-0410-3.
Health-related quality of life (HRQL) is a key indicator of elderly people's health status that can be affected by different factors. However, little is known about which variables are associated with it in functionally independent elderly people. The aim of this project was to study HRQL and a wide variety of health, lifestyle, social and contextual aspects and their relation to HRQL in a sample of functionally independent, non-cognitively impaired community-dwelling adults, over 65 years of age, from a northern region of Spain.
A cross-sectional study for which data was collected by face-to-face interviews with the selected individuals. HRQL was measured with the EuroQol-5D scale, consisting of a 5 item descriptive system and a visual analogue scale (VAS). VAS values lower than 70 were considered poor HRQL. Binary logistic regression was used to identify factors related to the outcome.
Six hundred and thirty-four individuals were included in the study. The mean age was 74.8 (SD 6.7) years, 55% of the participants were women and 46% rated their HRQL as poor. Several variables were found to be significantly associated with a poor HRQL in the multivariate model, adjusted for age and sex: polypharmacy (OR: 2.32, 95% CI: 1.62-3.31), the presence of sensory impairment (OR: 1.83, 95% CI: 1.24-2.69), not being engaged in cognitively stimulating activities (OR: 2.51, 95% CI: 1.03-6.16), or in group social activities (OR: 1.57, 95% CI: 1.11-2.22), low level of social support (OR: 3.12, 95%CI: 1.78-5.46) and the presence of obstacles in the closest home environment (OR: 1.83, 95%CI: 1.11-3.02).
The study identified a set of health, social and contextual variables as strongly related to HRQL in functionally independent community-dwelling older people. The results highlight the multidimensional nature of HRQL. They also reveal the importance of a comprehensive assessment of HRQL when designing adequate health-related programmes aiming to enhance active and healthy ageing and delay the onset of dependence.
健康相关生活质量（HRQL）是老年人健康状况的关键指标，会受到不同因素的影响。然而，对于功能独立的老年人中哪些变量与之相关却知之甚少。本项目的目的是在来自西班牙北部一个地区的65岁以上功能独立、无认知障碍的社区居住成年人样本中，研究HRQL以及各种健康、生活方式、社会和环境方面的因素及其与HRQL的关系。
一项横断面研究，通过对选定个体进行面对面访谈收集数据。使用欧洲五维健康量表（EuroQol - 5D）测量HRQL，该量表由一个5项描述系统和一个视觉模拟量表（VAS）组成。VAS值低于70被认为是HRQL较差。采用二元逻辑回归来确定与结果相关的因素。
634人纳入研究。平均年龄为74.8（标准差6.7）岁，55%的参与者为女性，46%的人将其HRQL评为较差。在多变量模型中，经年龄和性别调整后，发现几个变量与较差的HRQL显著相关：多重用药（比值比：2.32，95%置信区间：1.62 - 3.31）、存在感觉障碍（比值比：1.83，95%置信区间：1.24 - 2.69）、未参与认知刺激活动（比值比：2.51，95%置信区间：1.03 - 6.16）或群体社交活动（比值比：1.57，95%置信区间：1.11 - 2.22）、社会支持水平低（比值比：3.12，95%置信区间：1.78 - 5.46）以及在最近的家庭环境中存在障碍（比值比：1.83，95%置信区间：1.11 - 3.02）。
该研究确定了一组健康、社会和环境变量与功能独立的社区居住老年人中的HRQL密切相关。结果突出了HRQL的多维度性质。它们还揭示了在设计旨在促进积极健康老龄化和延缓依赖发生的适当健康相关计划时，全面评估HRQL的重要性。
