TY - JOUR
T1 - Antecedents of global decline in health-related quality of life among middle-aged African Americans
AU - Wolinsky, Fredric D.
AU - Malmstrom, Theodore K.
AU - Miller, J. Philip
AU - Andresen, Elena M.
AU - Schootman, Mario
AU - Miller, Douglas K.
N1 - Funding Information:
This research was supported by a grant from the National Institutes of Health to D.K.M. (R01 AG-10436). The opinions expressed here are those of the authors and do not necessarily reflect those of the funding agencies, academic, research, or governmental institutions involved. F.D.W. conceived of and planned the analyses reported here, performed all data analysis, and wrote the manuscript. T.K.M. contributed to data preparation, review of the analytic approach, and revision of the manuscript. J.P.M., E.M.A., and M.S. contributed to review of the analytic approach and revision of the manuscript. D.K.M. conceived the overall plan for the AAH study and contributed to the review of the analytic approach and revision of the manuscript.
PY - 2009/3
Y1 - 2009/3
N2 - 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.
AB - 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.
KW - African Americans
KW - Epidemiology
KW - Health-related quality of life
KW - Prospective cohort study
UR - http://www.scopus.com/inward/record.url?scp=64149113012&partnerID=8YFLogxK
U2 - 10.1093/geronb/gbn014
DO - 10.1093/geronb/gbn014
M3 - Article
C2 - 19196694
AN - SCOPUS:64149113012
SN - 1079-5014
VL - 64
SP - 290
EP - 295
JO - Journals of Gerontology - Series B Psychological Sciences and Social Sciences
JF - Journals of Gerontology - Series B Psychological Sciences and Social Sciences
IS - 2
ER -