Socioeconomic status and quality of life in population-based Australian men: data from the Geelong Osteoporosis Study

An overview of the use of the fracture risk assessment tool (FRAX) in osteoporosis

FRAX®, a simple-to-use fracture risk calculator, was first released in 2008 and since then has been used increasingly worldwide. By calculating the 10-year probabilities of a major osteoporotic fracture and hip fracture, it assists clinicians when deciding whether further investigation, for example a bone mineral density measurement (BMD), and/or treatment is needed to prevent future fractures. In this review, we explore the literature around osteoporosis and how FRAX has changed its management. We present the characteristics of this tool and describe the use of thresholds (diagnostic and therapeutic). We also present arguments as to why screening with FRAX should be considered. FRAX has several limitations which are described in this review. This review coincides with the release of a version, FRAXplus, which addresses some of these limitations.

Quality of life in south-eastern Australia: normative values for the WHOQOL-BREF in a population-based sample of adults

OBJECTIVES

The abbreviated World Health Organisation Quality of Life tool (WHOQOL-BREF) is a short-form quality of life (QoL) assessment commonly used worldwide in both healthy and ill populations. Normative data for the Australian general population are limited. The objective of this study was to present normative data for the WHOQOL-BREF based on a general population sample. A secondary aim was to explore sociodemographic factors related to QoL.

DESIGN

Population-based cross-sectional study.

PARTICIPANTS

929 men and 830 women aged 24-94 years participating in the Geelong Osteoporosis Study.

OUTCOME MEASURES

The 26-item WHOQOL-BREF.

RESULTS

Means and SD for each domain are presented by age group and sex. Percentile scores were also generated. Mean scores for WHOQOL-BREF domains were 74.52 (SD=16.22) for physical health, 72.07 (SD=15.35) for psychological, 72.87 (SD=18.78) for social relationships and 79.68 (SD=12.55) for environment. We identified significant associations between sociodemographic factors and WHOQOL-BREF domains. Notably, being married or in a relationship was associated with increased odds for high QoL across all four WHOQOL-BREF domains: physical health (women OR 2.46, 95% CI 1.36 to 4.44, p=0.003), psychological (men OR 2.07, 95% CI: 1.20 to 3.55, p=0.009; women OR 2.15, 95% CI 1.21 to 3.81, p=0.009), social relationships (men OR 2.28, 95% CI 1.29 to 4.04, p=0.005; women OR 2.77, 95% CI 1.42 to 5.41, p=0.003) and environment (women OR 2.07, 95% CI 1.13 to 3.80, p=0.019).

CONCLUSIONS

This study provides population norms for the WHOQOL-BREF based on a representative sample of Australian adults. Our results will be useful to researchers and clinicians who can use these data as a reference point for interpreting WHOQOL-BREF scores.

Quality of life and sleep disorders in Tehran Employees Cohort (TEC); Association with secondhand smoking and wealth index

PURPOSE

Second-hand smoke is recognized as a major indoor pollutant. Evidences indicated that Second-hand smoke exposure can influence on not only physical health, but also mental well-being. As the correlation of secondhand smoke exposure with sleep quality and quality of life has not yet been clarified sufficiently, the purpose of this study was to evaluate the association between Second-hand smoke exposure, with sleep quality and quality of life after adjusting for active smoking and other relevant confounders.

METHODS

The participants of this study were 1790 staff in Tehran University of Medical Sciences with different jobs employed in various academic departments (clinical, research, services, educational and technical ones). They participated voluntarily in this research project and completed the informed consent form between 2018 and 2019. A translated questionnaire of Global Adult Tobacco Survey was used to gather information about smoke exposure. When to evaluate the quality of life, the WHOQOL-BREF tool was applied. All statistical analyses were executed using STATA V14 software.

RESULTS

High rate of smoking and also exposure to second-hand smoke significantly increased sleep disorder and reduced the quality of life. In other words, smokers or those who are exposed to second-hand smoke suffer from sleep disturbances and had a poorer physical, psychological, and environmental quality of life. Additionally, the results of multivariate regression analysis demonstrated that the secondhand-smoke group had 1.38 times higher rate of sleep disorder in comparison with non-smokers, that was statistically significant. The women had 2.68 times higher odds of having sleep disorder compared to men. (95 % CI: 2.20 to 3.27). On the other hand, mean score of psychological domain of quality of life in secondhand-smoke group was lower with the size of difference as 0.66 than that in non-smokers, and the difference was statistically significant (p = 0.001).

CONCLUSIONS

Both active smoking and exposure to second hand smoke have a negative impact on sleep quality and quality of life.

Health-related quality of life in diabetes mellitus patients in primary health care

OBJECTIVE

To analyse the relationship between health-related quality of life (HRQoL) and sociodemographic and clinical factors in patients with diabetes mellitus, also comparing with Spanish population-based reference values.

METHOD

Cross-sectional descriptive-analytical observational study through nonprobability sampling on diabetic patients from San Roque Primary Health Centre (Badajoz, Spain), using a questionnaire regarding sociodemographic and diabetes care data, SF-36 and Duke-UNC questionnaires, and clinical history data.

RESULTS

Sixty patients (55% women) fundamentally with type 2 diabetes and a mean age of 68.67 ± 11.09 years were studied. Women older than 75 presented poorer HRQoL than their reference group. Women showed worse HRQoL than men. Age, evolution of diabetes, presence of acute and chronic complications, and comorbidities, pharmacological treatment, and glycaemic control affect HRQoL in these patients. Living alone, having a low socioeconomic status, and needing help with diabetes-related self-care can negatively affect quality of life.

CONCLUSIONS

HRQoL assessment allows us to detect alterations in the different domains and perform an early intervention. This way, we can incorporate these aspects into the nursing evaluation and interventions in the nursing care plan; allowing us to develop individualized care strategies and diabetes education programmes that contribute to improving HRQoL in patients with diabetes.

Income Inequality in Quality of Life among Rural Communities in Malaysia: A Case for Immediate Policy Consideration

Quality of life (QOL) is a proxy of health and social well-being. Hence, it is vital to assess QOL as it informs the strategies of policymakers to enhance the living conditions in communities. Rural areas in emerging economies are underserved in terms of modern facilities and technologies, which impact QOL. To address this, this study investigated whether income played a role in the QOL of rural residents within emerging economies using a large survey of Malaysian adults above 18 years old. The study extracted data from a sample of 18,607 respondents of a health and demographic surveillance system survey. A generalized linear model was used to estimate the impact of three income groups, the bottom 40%, middle 40% and top 20%, on perceived QOL, controlling for sociodemographic, chronic disease co-morbidities and mental health status. Results of the study showed a statistically significant association between income and the physical, psychological, social and environmental QOL domains. Using the bottom 40% as a reference category, the middle 40% and top 20% income groups showed a significant and positive association across the four domains of QOL. Hence, intervention programs are necessary to escalate the income levels of rural communities, especially the bottom 40%, to uplift perceived QOL among rural residents.

Quality of life of older Chinese adults receiving primary care in Wuhan, China: a multi-center study

BACKGROUND

Quality of life (QOL) is an important primary care outcome, but the QOL of older adults treated in primary care is understudied in China. This study examined QOL and its associated factors in older adults treated in Chinese primary care.

METHODS

A total of 752 older patients (65+ years) were consecutively recruited from 13 primary care centers in Wuhan, China, and interviewed with a standardized questionnaire, concerning socio-demographics, major medical conditions, loneliness, and depression. QOL and depression were measured with the Chinese six-item QOL questionnaire and the shortened Geriatric Depression Scale, respectively. Multiple linear regression was used to identify factors associated with poor QOL.

RESULTS

The average QOL score of primary care older adults was (20.7 ± 2.5), significantly lower than that of the Chinese general population. Factors significantly associated with poor QOL of Chinese primary care older adults included engaging in manual labor before older adulthood (unstandardized coefficient [β]: -0.702, P < 0.001), no living adult children (β: -1.720, P = 0.001), physical inactivity (β: -0.696, P < 0.001), having ≥ four major medical conditions (β: -1.813, P < 0.001), hearing problem (β: -1.004, P = 0.017), depression (β: -1.153, P < 0.001), and loneliness (β: -1.396, P < 0.001).

CONCLUSIONS

Older adults treated in Chinese primary care have poorer QOL than the general population. Addressing psychosocial problems at Chinese primary care settings could be helpful in improving QOL in Chinese older adults.

Poor quality of life and functioning in bipolar disorder

Background

This study explores the association of demographic and clinical features with quality of life and functioning in individuals with bipolar disorder.

Methods

Adult participants (N = 482) with bipolar I or II disorder were enrolled in a comparative effectiveness study across eleven study sites and completed baseline measures of medical and psychiatric history, current mood, quality of life, and functioning. Participants with at least mildly depressive or manic/hypomanic symptomatic severity were randomized to receive lithium or quetiapine in addition to adjunctive personalized treatment for 6 months.

Results

Participants with more severe depressive and irritability symptoms had lower quality of life and higher functional impairment. All psychiatric comorbid conditions except substance use disorder were associated with worse quality of life. On average, females had lower quality of life than males. Patients who were married, living as married, divorced, or separated had worse functional impairment compared with patients who were single or never married. A composite score of social disadvantage was associated with worse functioning and marginally associated with worse quality of life. Symptom severity did not moderate the effect of social disadvantage on quality of life or functioning.

Conclusions

Our findings highlight that depression, irritability, and psychiatric comorbid conditions negatively impact quality of life and functioning in bipolar disorder. The study suggests that individuals with social disadvantage are at risk for functional impairment.

Trial Registration This study is registered with ClinicalTrials.gov. Identification number: NCT01331304

Periodontitis and health-related quality of life in hemodialysis patients

Periodontitis is common among dialysis patients. The current cross-sectional study aimed to explore associations between periodontitis and health-related quality of life (HRQoL) among hemodialysis patients. Data from 188 dentate patients undergoing hemodialysis between May and July 2008 at a medical center in Kitakyushu city, Japan, were analyzed while applying modified Centers for Disease Control and Prevention/American Academy of Periodontology periodontitis case definitions to categorize the participants into the following three groups: severe, moderate, and no/mild periodontitis, respectively. HRQoL was assessed by the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) where a higher score indicates better health status. Associations between periodontitis groups and the eight health domains of SF-36 were evaluated using general linear models that were adjusted for age, sex, underlying cause of dialysis, duration of dialysis, comorbidities, serum biomarkers, body mass index, smoking status, and alcohol use. Among the 188 participants, 18 (9.6%) had severe periodontitis, 100 (53.2%) had moderate periodontitis, and the remaining 70 (37.2%) had no/mild periodontitis. Compared with the participants with no/mild periodontitis, those with severe periodontitis had worse scores in the following five of eight SF-36 health scales: physical functioning, role physical, vitality, social functioning, and mental health (P < 0.05). The findings suggest an independent relationship between severe periodontitis and decreased HRQoL among dialysis patients.

Self-care behavior when suffering from the common cold and health-related quality of life in individuals attending an annual checkup in Japan: a cross-sectional study

Background

The World Health Organization and several governments encourage medical self-care (including self-medication) for minor illnesses. Accordingly, the factors that influence self-care have received research attention, with socioeconomic status identified as one such predictor. Although studies have examined the relationship between socioeconomic status and quality of life (QOL) in patients suffering from respiratory allergies or chronic illnesses, the relationship between QOL and self-care behavior for the common cold, the most common illness seen in primary care, has not been examined. Therefore, we investigated the relationship between QOL and self-care behavior in individuals suffering from the common cold.

Methods

We distributed questionnaires to 499 people who attended an annual public health checkup in Kasama city, Japan. Valid questionnaires were received from 398 participants (mean age = 59.0, SD = 15.8, range = 24–87 years; 61.4 % women). The materials included a question relating to typical actions taken when treating a common cold (self-care or visiting a health clinic), demographics, and the Short Form-8™ (SF-8™)—an 8-item survey that assesses health-related quality of life (HRQOL). The association of care action and HRQOL were investigated using Mann–Whitney U tests with a significance level of p < 0.05.

Results

The mean scores for the Physical Functioning, Role-Physical, Bodily Pain, Social Functioning, Role-Emotional, and Physical Component Summary score of the SF-8™ were significantly higher among the self-care group than the group that preferred visiting a clinic.

Conclusions

HRQOL among individuals who engage in self-care when treating the common cold was observed to be significantly higher than among individuals who preferred to attend a health clinic. It is unclear whether self-care behavior affects QOL, or whether QOL affects self-care behavior; however, this finding highlights the importance of the relationship between QOL and self-care behavior. Additional studies should be conducted in order to investigate the direction of causality between self-care behaviors and QOL further.

Quality of Life Is Related to Social Support in Elderly Osteoporosis Patients in a Chinese Population

OBJECTIVE

To explore the association between quality of life and social support in elderly osteoporosis patients in a Chinese population.

METHODS

A total of 214 elderly patients who underwent bone mineral density screening were divided into two groups: elderly patients with primary osteoporosis (case group, n = 112) and normal elderly patients (control group, n = 102). Quality of life and social support were compared between the two groups.

RESULTS

Quality of life and social support were significantly different between the case and control groups. The physical function, role-physical, bodily pain, general health, vitality, social-functioning, role-emotional and mental health scores in case group were significantly lower than those in the control group (P < 0.01). The objective support, subjective support, utilization of support, and total scores in case group were significantly lower than those in the control group (P < 0.01). Quality of life and social support were positively correlated in the case group (r = 0.672, P < 0.01).

CONCLUSION

Quality of life and social support in elderly patients with osteoporosis in China were poorer than in elderly patients without osteoporosis and were positively correlated. Our findings indicate that increased efforts to improve the social support and quality of life in elderly osteoporosis patients are urgently needed in China. Further longitudinal studies should be conducted to provide more clinical evidence to determine causative factors for the observed association between risk factors and outcomes.