The Relationship Between Physical Function And Health-related Quality Of Life In Older Copd Patients

Abstract

The measurement of health-related quality of life (HRQL) among chronically ill older adults has gained considerable attention in recent years. The SF36 is widely used for subjective measurement of HRQL in healthy and chronically ill elderly. However, few studies have compared subjective measurement techniques such as the SF36 with objective measures of health relevant to quality of life, such as physical function. PURPOSE: To compare objective measurement of physical function with subjective measures of HRQL using the SF36. METHODS: Forty older (70.1 ± 7.3) men (n = 20) and women (n = 20) with COPD (FEV1% = 36.7%; GOLD Stage III) referred to pulmonary rehabilitation completed an extensive battery of tests including the SF36 [constructs: Physical Function (PF), Role-Physical (RP), Bodily Pain (BP), General Health (GH), Vitality (V), Social Functioning (SF), Role-Emotional (RE), and Mental Health (MH)]; the Senior Fitness Test (SFT) battery [6 Minute Walk (6MW), Chair Stands (CS), 8-Foot Up and Go (UNG), Arm Curl (AC), Modified Sit and Reach (MSR), Scratch Test (ST)]; the Lift and Reach Test (LNR), a separate measure of upper body function; and one repetition maximum (1RM) incline chest press (CP) and seated leg press (LP) to measure maximal dynamic strength of the upper and lower limbs. Objective measures were counterbalanced to control for an order effect. RESULTS: Four objective measures were positively correlated with subjective measurement of physical function (PF); namely CP (r = 0.35; p =.036), LP (r = 0.50; p = 0.001), CS (r = 0.34; p = 0.037), and 6MW (r = 0.46; p = 0.003). These objective measures were also positively correlated with several other subjective measures of HRQL. Of particular interest is the relationship between CP (r = 0.35; p =.036), LP (r = 0.45; p =.005), CS (r = 0.35; p =.035), and 6MW (r = 0.31, p =.055) to SF, which relates to the impact physical health has on one's ability to participate in social activities. CONCLUSION: The positive and consistent relationship between objective measures of physical function and self-reported HRQL suggests that physical function may positively influence HRQL in older, chronically ill men and women. Further research needs to examine the impact of improving physical function on patients' perceptions of their HRQL.