Antecedents of global decline in health-related quality of life among middle-aged African Americans

Fredric D. Wolinsky, Theodore K. Malmstrom, J. Philip Miller, Elena M. Andresen, Mario Schootman, Douglas K. Miller

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Objective We examined global declines in health-related quality of life (HRQoL) for a period of 3 years among the 998 participants in the African American Health (AAH) project.MethodsThe AAH is a population-based sample from two areas of metropolitan St. Louis. Global declines were defined as clinically important differences (CIDs) on four or more of the eight Short Form 36-Item scales. Individual CIDs were defined as drops of 0.5 SD or more from the baseline score. Multivariable logistic regression was used to identify antecedents of global decline.ResultsFourteen percent (n = 117) of the 846 AAH subjects in the analysis demonstrated global declines in HRQoL. Five statistically significant risk factors were identified, including sampling strata (inner-city vs. suburban residence; adjusted odds ratio [AOR] = 2.06), cancer (AOR = 3.56), chronic obstructive pulmonary disease (AOR = 2.19), clinically relevant levels of depressive symptoms (AOR = 1.96), and incident (postbaseline) health conditions (1 [AOR = 1.71] and ≥2 [AOR = 3.09] vs. none).ConclusionAlthough these risk factors are for the most part nonmalleable, they can serve as markers of impending global HRQoL declines among late-middle-aged African Americans.

Original languageEnglish
Pages (from-to)290-295
Number of pages6
JournalJournals of Gerontology - Series B Psychological Sciences and Social Sciences
Issue number2
StatePublished - Mar 2009


  • African Americans
  • Epidemiology
  • Health-related quality of life
  • Prospective cohort study


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