Abstract
BackgroundCardiovascular disease (CVD) and thyroid dysfunction are common in older people, but little is known about how they affect health-related quality of life (HRQoL).MethodsWe assessed HRQoL with the 15D instrument in 329 home-dwelling patients aged ≥ 75 years with stable CVD and compared the results to those of an age- and gender-matched general population (n = 103). We also studied the impact of age, BMI, number of medications, thyroid-stimulating hormone (TSH) concentration, levothyroxine (L-T4) substitution and Mini-Mental State Examination (MMSE) on HRQoL.ResultsOverall HRQoL was impaired in older people with stable CVD (mean 15D score 0.777 vs 0.801, p = 0.001), and also on single dimensions of breathing, sleeping, discomfort and symptoms, distress, vitality (all p < 0.001), and depression (p = 0.016) compared to the age- and gender-matched general population. Furthermore, in the patients, L-T4 substitution associated with impaired sleeping (p = 0.018) and sexual activity (p = 0.030). Moreover, MMSE points, number of medications used, age (all p < 0.001) and BMI (p = 0.009) predicted impaired HRQoL.ConclusionsOlder people with stable CVD are characterized by impaired HRQoL compared to age- and gender-matched controls. We demonstrate that this is the consequence of impaired breathing, sleeping, discomfort and symptoms, distress, vitality, and depression. L-T4 substitution has a negative impact on HRQoL in old patients with stable CVD. MMSE score, number of medications, age and BMI predict worse HRQoL.
Highlights
Cardiovascular disease (CVD) and mild thyroid dysfunction are common in older people
There were no significant differences in age, sex, education, Mini-Mental State Examination (MMSE) points or Zung scale distribution between different thyroid-stimulating hormone (TSH) ranges
We found that overall health-related quality of life (HRQoL) is impaired in older people with stable CVD on L-T4 compared to those not on LT-4 therapy, this was not statistically significant
Summary
Cardiovascular disease (CVD) and mild thyroid dysfunction are common in older people. Even when hypertension is excluded, the prevalence of CVD in men and women aged 60–79 increases from 18–25 to 34–43% in individuals over 80 years [1]. Mild thyroid dysfunction is found in over 10% of older people, and the prevalence of subclinical hypothyroidism, i.e., mildly elevated thyroid-stimulating hormone (TSH) concentrations is even higher, i.e., 21% in women and 16% in men aged 74 years or older [2, 3]. Data on how stable CVD or mild thyroid dysfunction affect health-related quality of life (HRQoL) in older individuals is scarce. We wanted to study HRQoL in a cohort of older people (> 75 years) with stable CVD with the 15D instrument for assessment, of overall HRQoL, and of 15 different single dimensions, and compare the results to those of an age- and gender-matched general population. We searched for possible predictors of impaired HRQoL within the patient group
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