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Multimorbidity and Health-Related Quality of Life in Old Age: Role of Functional Dependence and Depressive Symptoms
Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI). The Chinese University of Hong Kong (CUHK), China.
Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI). Catholic University of Rome, Italy.ORCID iD: 0000-0002-3099-4830
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Number of Authors: 62019 (English)In: Journal of the American Medical Directors Association, ISSN 1525-8610, E-ISSN 1538-9375, Vol. 20, no 9, p. 1143-1149Article in journal (Refereed) Published
Abstract [en]

Objectives: To examine the associations of multimorbidity patterns with health-related quality of life (HRQL) in rural-dwelling older adults in China, and to explore to what extent their associations were mediated by functional dependence and depressive symptoms. Design: Population-based cross-sectional study. Setting and participants: 1497 participants (age >= 60 years; 66.4% women) in the 2014-2016 examination of the Confucius Hometown Aging Project who were living in a rural community near Qufu, Shandong, China. Measures: Data on demographics, lifestyles, chronic health conditions, and use of medications were collected through interviews, clinical examinations, and laboratory tests. Multimorbidity was defined as co-occurrence of >2 chronic diseases in the same person. The 15-item Geriatric Depression Scale (GDS-15) was used to assess depressive symptoms, and EQ-5D-3L was used to assess HRQL. Results: Multimorbidity was present in 83.8% of the participants (women vs men: 85.5% vs 80.6%, P = .015). Exploratory factor analysis identified 4 patterns of multimorbidity, that is, patterns of cardiovascular-degenerative, respiratory, neurologic-thyroid, and metabolic-cognitive-cerebrovascular diseases. The neurologic-thyroid disease pattern did not show a significant association with HRQL. The 3 other patterns were associated with poor HRQL and had a diverse impact on different dimensions of HRQL. Mediation analysis suggested that functional dependence and the presence of depressive symptoms could mediate 24.8% and 21.8%, respectively, of the association between the number of chronic diseases and poor HRQL. Conclusions/Implications: Multimorbidity is associated with poor HRQL in older adults, in which functional dependence and depressive symptoms partly mediate their associations. Prevention and proper management of dependence and depressive symptoms in older people with multimorbidity may help maintain and improve quality of life.

Place, publisher, year, edition, pages
2019. Vol. 20, no 9, p. 1143-1149
Keywords [en]
Multimorbidity, health-related quality of life, functional dependence, depressive symptoms, older people, population-based study
National Category
Gerontology, specialising in Medical and Health Sciences Geriatrics
Identifiers
URN: urn:nbn:se:su:diva-172977DOI: 10.1016/j.jamda.2019.02.024ISI: 000482555400016PubMedID: 30979676OAI: oai:DiVA.org:su-172977DiVA, id: diva2:1351562
Available from: 2019-09-16 Created: 2019-09-16 Last updated: 2019-09-16Bibliographically approved

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Yan, ZhongruiVetrano, Davide L.Qiu, Chengxuan
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