Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
PSNREC, Univ Montpellier, INSERM, 34000, Montpellier, France.
Qual Life Res. 2021 Apr;30(4):1037-1048. doi: 10.1007/s11136-020-02723-y. Epub 2021 Jan 3.
Previous research has demonstrated that lower health-related quality of life (HRQoL) is associated with higher morbidity and mortality, especially in-patient groups. The association of HRQoL with all-cause mortality in community samples requires further investigation. This study aimed to examine whether HRQoL predicts all-cause mortality in older healthy community-dwelling people from Australia and the United States (U.S.) enrolled in the Aspirin in Reducing Events in the Elderly (ASPREE) trial. We also explored whether this association varies by gender or country.
A prospective cohort of 19,106 individuals aged 65-98 years, who were without a dementia diagnosis or a known major life-limiting disease, and completed the 12-item short-form-HRQoL at recruitment (2010-2014). They were followed until June 2017. Cox proportional-hazard models were used to determine the association between the physical (PCS) and mental component scores (MCS) of HRQoL and all-cause mortality, adjusting for sociodemographic factors, health-related behaviours and clinical measures. Hazards ratios were estimated for every 10-unit increase in PCS or MCS.
There were 1052 deaths over a median 4.7-years (interquartile range 3.6-5.7) of follow-up, with 11.9 events per 1000 person-years. Higher PCS was associated with lower all-cause mortality (HR 0.83, 95% CI 0.77, 0.89) in the entire sample, while higher MCS was associated with lower mortality among U.S. participants only (HR 0.78, 95% CI 0.63, 0.95). Gender differences in the association of either PCS or MCS with mortality were not observed.
Our large study provides evidence that HRQoL is inversely associated with all-cause mortality among initially healthy older people.
先前的研究表明，健康相关生活质量（HRQoL）较低与发病率和死亡率较高相关，尤其是住院患者群体。HRQoL 与全因死亡率之间的关联在社区样本中需要进一步研究。本研究旨在检验 HRQoL 是否可预测澳大利亚和美国（美国）参加阿司匹林减少老年人事件（ASPREE）试验的健康社区居住的老年人群中的全因死亡率。我们还探讨了这种关联是否因性别或国家而异。
前瞻性队列研究纳入了 19106 名年龄在 65-98 岁之间、无痴呆诊断或已知重大生命限制疾病的个体，他们在招募时（2010-2014 年）完成了 12 项简短形式 HRQoL 量表。他们一直随访到 2017 年 6 月。使用 Cox 比例风险模型来确定 HRQoL 的身体（PCS）和心理成分评分（MCS）与全因死亡率之间的关联，调整了社会人口统计学因素、与健康相关的行为和临床指标。每增加 10 个单位的 PCS 或 MCS 来估计风险比。
中位随访 4.7 年（四分位距 3.6-5.7）期间发生了 1052 例死亡，每 1000 人年发生 11.9 例事件。在整个样本中，较高的 PCS 与全因死亡率降低相关（HR 0.83，95%CI 0.77，0.89），而较高的 MCS 仅与美国参与者的死亡率降低相关（HR 0.78，95%CI 0.63，0.95）。在 PCS 或 MCS 与死亡率之间的关联中没有观察到性别差异。
我们的大型研究提供了证据，表明 HRQoL 与最初健康的老年人的全因死亡率呈负相关。
