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老年人患有稳定的心血管疾病时,会出现呼吸、睡眠、活力和抑郁受损,以及 L-T4 治疗的负面影响,这些都会影响其生活质量。

Impaired breathing, sleeping, vitality, and depression, and negative impact of L-T4 treatment characterize health-related quality of life in older people with stable CVD.

机构信息

Endocrinology, Abdominal Center, Helsinki University Hospital and University of Helsinki, P.O. Box 340, 00290, Helsinki, Finland.

Department of Public Health, University of Helsinki, Helsinki, Finland.

出版信息

Aging Clin Exp Res. 2020 Oct;32(10):2041-2047. doi: 10.1007/s40520-020-01537-9. Epub 2020 Apr 10.

Abstract

BACKGROUND

Cardiovascular disease (CVD) and thyroid dysfunction are common in older people, but little is known about how they affect health-related quality of life (HRQoL).

METHODS

We assessed HRQoL with the 15D instrument in 329 home-dwelling patients aged ≥ 75 years with stable CVD and compared the results to those of an age- and gender-matched general population (n = 103). We also studied the impact of age, BMI, number of medications, thyroid-stimulating hormone (TSH) concentration, levothyroxine (L-T4) substitution and Mini-Mental State Examination (MMSE) on HRQoL.

RESULTS

Overall HRQoL was impaired in older people with stable CVD (mean 15D score 0.777 vs 0.801, p = 0.001), and also on single dimensions of breathing, sleeping, discomfort and symptoms, distress, vitality (all p < 0.001), and depression (p = 0.016) compared to the age- and gender-matched general population. Furthermore, in the patients, L-T4 substitution associated with impaired sleeping (p = 0.018) and sexual activity (p = 0.030). Moreover, MMSE points, number of medications used, age (all p < 0.001) and BMI (p = 0.009) predicted impaired HRQoL.

CONCLUSIONS

Older people with stable CVD are characterized by impaired HRQoL compared to age- and gender-matched controls. We demonstrate that this is the consequence of impaired breathing, sleeping, discomfort and symptoms, distress, vitality, and depression. L-T4 substitution has a negative impact on HRQoL in old patients with stable CVD. MMSE score, number of medications, age and BMI predict worse HRQoL.

摘要

背景

心血管疾病(CVD)和甲状腺功能障碍在老年人中很常见,但人们对它们如何影响健康相关生活质量(HRQoL)知之甚少。

方法

我们使用 15D 工具评估了 329 名年龄在 75 岁以上且患有稳定 CVD 的居家患者的 HRQoL,并将结果与年龄和性别匹配的一般人群(n=103)进行了比较。我们还研究了年龄、BMI、药物数量、促甲状腺激素(TSH)浓度、左甲状腺素(L-T4)替代治疗和简易精神状态检查(MMSE)对 HRQoL 的影响。

结果

患有稳定 CVD 的老年人的整体 HRQoL 受损(平均 15D 得分为 0.777 对 0.801,p=0.001),在呼吸、睡眠、不适和症状、痛苦、活力(均 p<0.001)和抑郁(p=0.016)等方面也低于年龄和性别匹配的一般人群。此外,在患者中,L-T4 替代治疗与睡眠受损(p=0.018)和性功能障碍(p=0.030)相关。此外,MMSE 得分、使用药物的数量、年龄(均 p<0.001)和 BMI(p=0.009)均预测 HRQoL 受损。

结论

与年龄和性别匹配的对照组相比,患有稳定 CVD 的老年人的 HRQoL 受损。我们证明这是由于呼吸、睡眠、不适和症状、痛苦、活力和抑郁受损所致。L-T4 替代治疗对患有稳定 CVD 的老年患者的 HRQoL 有负面影响。MMSE 评分、用药数量、年龄和 BMI 预测 HRQoL 更差。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3598/7532955/d118d82caed8/40520_2020_1537_Fig1_HTML.jpg

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