Institute of Social and Preventive Medicine (IUMSP), University of Lausanne Hospital Centre, Route de la Corniche 10, 1010, Lausanne, Switzerland.
Service of Geriatric Medicine and Geriatric Rehabilitation, University of Lausanne Hospital Centre, Lausanne, Switzerland.
Qual Life Res. 2019 May;28(5):1305-1314. doi: 10.1007/s11136-019-02108-w. Epub 2019 Jan 16.
This population-based study aimed to determine 5-year change in multidimensional QoL among community-dwelling older people, and to identify predictors of QoL change among demographic, socioeconomic, and health characteristics.
Data of the 2011 and 2016 annual assessments of 1845 older men and women (age range 68-77 years) from the Lc65 + cohort study were used. QoL was assessed using a 28-item instrument yielding a QoL overall score and seven domain-specific QoL subscores. Additional ratings of QoL included a single item (excellent; very good; good; fair; poor), expected QoL in 1 year (better; worse; same as today), and retrospective assessment of QoL 5-year change (better; worse; same as 5 years ago). The predictors of 5-year change in the QoL score were assessed using linear regression, controlling for baseline QoL score.
All prospective and retrospective indicators of QoL converged towards a slight deterioration over 5 years. QoL subscores significantly decreased in domains "Close entourage" (P = 0.004), "Social and cultural life" (P < 0.001), "Esteem and recognition" (P = 0.001), "Health and mobility" (P < 0.001), and "Autonomy" (P < 0.001), whereas "Material resources" (P = 0.345) and "Feeling of safety" (P = 0.380) remained stable. A stronger decrease in QoL was observed in the most vulnerable profiles at baseline in terms of demographic, socioeconomic, and health characteristics. Changes in depressive symptoms and in disability-either worsening or improving-predicted QoL change in the expected direction.
Age-related decline in QoL may be limited through the prevention of disability and depressive symptoms, and more generally by devoting special attention to vulnerable profiles.
本基于人群的研究旨在确定社区居住的老年人多维生活质量（QoL）在 5 年内的变化，并确定人口统计学、社会经济学和健康特征中 QoL 变化的预测因素。
使用来自 Lc65+队列研究的 1845 名年龄在 68-77 岁的男性和女性（年龄范围）的 2011 年和 2016 年年度评估数据。使用 28 项问卷评估 QoL，得出 QoL 总体评分和七个特定领域的 QoL 子评分。QoL 的其他评估包括一个单项（优秀；很好；好；尚可；差）、对未来 1 年 QoL 的预期（更好；更差；与今天相同）和对过去 5 年 QoL 变化的回顾性评估（更好；更差；与 5 年前相同）。使用线性回归评估 QoL 评分的 5 年变化的预测因素，控制基线 QoL 评分。
所有前瞻性和回顾性的 QoL 指标均朝着 5 年内的轻微恶化趋势发展。“亲密圈子”（P=0.004）、“社会文化生活”（P<0.001）、“尊重和认可”（P=0.001）、“健康和行动能力”（P<0.001）和“自主性”（P<0.001）等领域的 QoL 子评分显著下降，而“物质资源”（P=0.345）和“安全感”（P=0.380）保持稳定。在人口统计学、社会经济学和健康特征方面，基线时最脆弱的人群的 QoL 下降幅度更大。抑郁症状的变化和残疾状况的改善或恶化都预测了 QoL 朝着预期方向的变化。
通过预防残疾和抑郁症状，以及更普遍地通过特别关注脆弱人群，可以限制与年龄相关的 QoL 下降。
