Abstract
BackgroundWith increasing life expectancy the number of people affected by multimorbidity rises. Knowledge of factors associated with health-related quality of life in multimorbid people is scarce. We aimed to identify the factors that are associated with self-rated health (SRH) in aged multimorbid primary care patients.MethodsCross-sectional study with 3,189 multimorbid primary care patients aged from 65 to 85 years recruited in 158 general practices in 8 study centers in Germany. Information about morbidity, risk factors, resources, functional status and socio-economic data were collected in face-to-face interviews. Factors associated with SRH were identified by multivariable regression analyses.ResultsDepression, somatization, pain, limitations of instrumental activities (iADL), age, distress and Body Mass Index (BMI) were inversely related with SRH. Higher levels of physical activity, income and self-efficacy expectation had a positive association with SRH. The only chronic diseases remaining in the final model were Parkinson’s disease and neuropathies. The final model accounted for 35% variance of SRH. Separate analyses for men and women detected some similarities; however, gender specific variation existed for several factors.ConclusionIn multimorbid patients symptoms and consequences of diseases such as pain and activity limitations, as well as depression, seem to be far stronger associated with SRH than the diseases themselves. High income and self-efficacy expectation are independently associated with better SRH and high BMI and age with low SRH.Trial registrationMultiCare Cohort study registration:ISRCTN89818205.
Highlights
With increasing life expectancy the number of people affected by multimorbidity rises
Important questions remain: Is self-rated health (SRH) in multimorbid patients more strongly affected by the presence of single disease states or by the sequelae of illnesses? What are demographic, lifestyle (i.e. Body Mass Index (BMI), smoking, alcohol consumption, level of physical activity) and psychological factors associated with SRH in this patient group? Is SRH determined by the same factors in men and women or are there gender-specific differences? the aim of this study was twofold: First, to identify the factors that are independently related to SRH in a multimorbid primary care sample of elderly people; and second, to identify possible genderrelated differences in these factors
SRH is a pivotal indicator of quality of life
Summary
With increasing life expectancy the number of people affected by multimorbidity rises. Factors associated with health-related quality of life have been studied in the general population as well as in patient-populations suffering from different chronic diseases. The relationship between age, gender and SRH, is less clear [5,6,7] Modifiable lifestyle factors, such as obesity, smoking, risky alcohol consumption and low levels of physical activity were found to have a negative correlation with health-related quality of life [8,9,10]. With increasing age the prevalence of chronic diseases, disability and limitations of activities of daily living rises, with limitations of daily activities being associated with lower levels of SRH [14]
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