Trajectories of Health-Related Quality of Life (HR-QoL) in Older Adults with Diabetes

Abstract

Background: Health-related quality of life (HR-QoL)—a major outcome of diabetes management interventions—is a general self-rated concept regarding one’s biological functions, symptoms, and functional status. However, there is limited information on the longitudinal changes in HR-QoL of older adults over time. Objective: To identify different patterns of HR-QoL changes in longitudinal data and reveal potential predictors of these trajectories among older adults with diabetes Methods: Subjects were older adults over 65 years with diabetes (n = 440), who participated in the Korea Health Panel survey for five consecutive years (2009-2013). HR-QoL longitudinal data were measured using Euro-QoL 5-Dimension Questionnaire. Growth mixture modeling was used to estimate distinct patterns, and binary and logistic regressions were used to determine factors affecting different trajectories of HR-QoL patterns using STATA 14.0. Results: Four distinct trajectories of HR-QoL were found to be the best based on the Bayesian information criterion. High decrease HR-QoL indicates older adults with diabetes (10.0%) whose HR-QoL remained stable in the high score and began decreasing four years post-estimation. High stable HR-QoL indicates constantly high HR-QoL of older adults with diabetes (52.8%). Medium stable HRQoL indicates constantly medium HR-QoL of older adults with diabetes (36.0%). Medium increase indicates (1.3% of subjects) an HR-QoL trajectory pattern, which decreased from a medium level and increased three years post-estimation. Distinct trajectories of HR-QoL significantly associated with decrease vs. stable were age, having a spouse, impaired vision, subjective health status, and medication compliance. Conclusion: It is suggested that although most participants had stable HR-QoL, comprehensive assessment and individualized management programs are needed to improve HR-QoL of older adults with diabetes. Disclosure S. Park: None. T. Lee: None.