Health-related Quality Of Life In Older Women Research Articles

Does Heavy-Resistance Training Improve Mobility and Perception of Quality of Life in Older Women?

Simple SummaryHeavy-resistance training can offer physicians a viable option for improving functional performance, helping their patients stay independent, active and healthy. The present results clearly demonstrate that circuit weight training is as effective as traditional resistance training for improving functional mobility but is more effective in stimulating positive perception of health-related quality-of-life adaptations in older women.Regular physical exercise has shown great benefits in preventing age-related functional losses and in improving the perception of health-related quality of life (HRQoL) in older people. To optimize these benefits, it would be interesting to evaluate what type of exercise is better. Therefore, the purpose of this study was to assess the effects of heavy-resistance training on mobility and HRQoL in older women. Forty healthy, untrained older women (60–75 years) were randomly assigned to three groups: circuit resistance training (CRT, n = 15), traditional resistance training (TRT, n = 15) or the control group (CG, n = 10). During the 12-week training period, both experimental groups performed training with heavy loads, twice a week. Before and after the training period, the Timed Up and Go test, as a proxy of mobility, and the perception of HRQoL were evaluated. TRT and CRT resulted in a statistically significant improvement in the Timed Up and Go test (−5.4 and −10.3%, respectively; p < 0.05), but only the improvement after CRT was significantly greater than changes in the CG (p < 0.001). Only CRT elicited improvements in several dimensions of the perception of the HRQoL questionnaire, such as: physical functioning (13%, p < 0.001), general health (8.1%; p = 0.048), vitality (17.7%; p < 0.001), role emotional (6.7%; p = 0.044) and physical component summary (6.3%; p = 0.001). The change in the CRT group was greater than in the CG (p < 0.001) in the physical functioning score. The present findings show that CRT might be a time- (and hence cost-) effective alternative to trigger multiple positive functional and psychological adaptations in older women.

Relationship Between Lifestyle Habits and Health-Related Quality of Life of Recently Diagnosed Breast Cancer Patients: A Comparison Between Younger and Older Women in China.

Objective: The aim of this study was to evaluate the relationship between lifestyle habits and health-related quality of life (HRQoL) among different ages who were initially diagnosed with breast cancer (within the first 2 weeks) and to determine the contribution of lifestyle habits factors on HRQoL.Methods: Patients with breast cancer were recruited from 22 hospitals in 11 provinces or municipalities in northern and eastern China. The Functional Assessment of Cancer Therapy-Breast Cancer (FACT-B) was used to measure HRQoL. Chi-square test, ANOVA, and multivariable generalized linear models were conducted to identify the differences in HRQoL between two age groups (age <50 years and ≥50 years) and to evaluate the contribution of lifestyle habits factors on HRQoL of patients with breast cancer.Results: About 1,199 eligible patients with breast cancer were used for analysis. Younger women (aged <50 years) appeared to show lower scores than older women (aged ≥50 years) in HRQoL subscales, including emotional well-being (p = 0.003), functional well-being (p = 0.006), breast cancer subscale (p = 0.038), and FACT-B Total scores (p = 0.028). Tea and alcohol consumption and being very satisfied with sleep and current life were the strongest predictors of higher HRQoL in younger group. Meanwhile, no coffee consumption, frequent participation in physical activities, high sleep satisfaction, and current life satisfaction were the key predictors of higher HRQoL in older women with breast cancer.Conclusion: The relationship of the nine lifestyle habit items with HRQoL differed among younger and older women. The associated variable of low HRQoL can help clinicians take intervention early in order to improve the prognosis of patients with breast cancer.

Effects of Radiation Therapy and Comorbidity on Health-Related Quality of Life and Mortality Among Older Women With Low-Risk Breast Cancer: Protocol for a Retrospective Cohort Study.

BackgroundThe National Comprehensive Cancer Network Breast Cancer Guidelines Committee suggests that the omission of adjuvant radiation therapy (RT) after breast-conserving surgery can be a reasonable option among older women with low-risk breast cancer (early-stage, estrogen receptor-positive, and node-negative) if they are treated with endocrine therapy. However, RT usage in this group of women still exceeds 50%. Conversely, older women tend to forego RT (even when necessary) due to cost, inconvenience, and potential adverse responses associated with RT. Understanding health-related quality of life (HRQOL) change with receipt of RT among older women in the modern era is limited due to the under-representation of this population in clinical trials.ObjectiveThe proposed study aims to examine the associations of RT with HRQOL trajectories as well as survival outcomes among older women with 5-10 years of follow-up. We will also assess whether prediagnosis comorbidity burden influences receipt of RT and whether the associations between RT and HRQOL trajectory and survival outcomes are modified by the comorbidity burden.MethodsWe will use a retrospective cohort study design with the population-based Surveillance, Epidemiology, and End-Results database linked to the Medicare Health Outcomes Survey (SEER-MHOS). Older women (≥65 years) who were diagnosed with low-risk breast cancer in 1998-2014, received breast-conserving surgery, and participated in MHOS 1998-2016 are eligible for this analysis. The latent class analysis clustering method will be used to identify each patient’s prediagnosis comorbidity burden, and HRQOL will be evaluated using the Short Form 36/Veterans RAND 12-Item Health Survey scales. The inverse-weighted estimates of the probability of treatment will be included to control for treatment selection bias and confounding effects in subsequent analysis. The association of RT with HRQOL trajectory will be evaluated using inverse-weighted multilevel growth mixture models. The inverse-weighted Cox regression model will be used to obtain hazard ratios with 95% CIs for the association of RT with survival outcomes. Differential effects of RT on both outcomes according to comorbidity burden class will also be evaluated.ResultsAs of October 2020, the study was approved by the institutional review board, and SEER-MHOS data were obtained from the National Cancer Institute. Women with low-risk breast cancer who met inclusion and exclusion criteria have been identified, and prediagnosis comorbidity burden class has been characterized using latent class analysis. Further data analysis will begin in November 2020, and the first manuscript will be submitted in a peer-reviewed journal in February 2021.ConclusionsThis research can potentially improve clinical outcomes of older women with low-risk breast cancer by providing them additional information on the HRQOL trajectories when they make RT treatment decisions. It will facilitate informed, shared treatment decision making and cancer care planning to ultimately improve the HRQOL of older women with breast cancer.International Registered Report Identifier (IRRID)DERR1-10.2196/18056

Changes in health-related quality of life in older women after diagnosis with gynecologic cancer

PurposeThe impact of gynecologic cancer on health-related quality of life (HRQOL) is not fully understood. To our knowledge, this is the first longitudinal study to measure HRQOL changes from before to after gynecologic cancer diagnosis in older women. MethodsData were obtained from the Surveillance, Epidemiology, and End Results – Medicare Health Outcomes Survey database. Women aged 65 and older who were diagnosed with cervical, ovarian, or uterine cancer between baseline and follow-up surveys (n = 248; mean time from diagnosis = 12.54 ± 7.11 months) were propensity-matched to cancer-free controls (n = 1240). Logistic regression was used to assess risk of functional impairments and depressive symptoms at follow-up. Changes in HRQOL, as measured by the Medical Outcomes Study Short Form-36 and Veterans RAND 12-Item Survey, were estimated with mixed effects linear models. ResultsWomen who were within 12 months of diagnosis and women diagnosed with regional/distant disease had significantly greater odds than controls of impairment at follow-up. HRQOL declines were greatest in those with advanced disease, with the most notable changes from baseline to follow-up observed for role limitations due to emotional problems (−8.60 vs. −3.42 in controls), general health (−7.76 vs 0.10), and physical functioning (−7.70 vs. −1.67). There were significant decreases in physical functioning and role limitations due to emotional problems for all cancer patients regardless of time since diagnosis. ConclusionsGynecologic cancer has significant impacts on physical and mental aspects of HRQOL in older women. Interventions are needed to reduce pain, provide support, and prepare patients for changes in functioning and health.

Associations between health-related quality of life, physical function and pain in older women with osteoporosis and vertebral fracture

BackgroundOsteoporosis and vertebral fractures represent a major health burden worldwide, and the prevalence of osteoporosis is expected to increase as the world’s population ages. Suffering from vertebral fracture has a substantial impact on the individual’s health-related quality of life (HRQoL), physical function and pain. Complex health challenges experienced by older people with osteoporosis and vertebral fractures call for identification of factors that may influence HRQoL, as some of these factors may be modifiable. The objective is to examine the independent associations between HRQoL, physical function and pain in older women with osteoporosis and vertebral fracture.MethodsThis study has a cross-sectional design, using data from 149 home-dwelling Norwegian women with osteoporosis and vertebral fracture, aged 65+. Data on HRQoL (Short Form 36 (SF-36), Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO-41)), physical function (walking speed, balance and strength), pain, as well as sociodemographic information were collected. Simple linear regression analyses were conducted and multivariable regression models were fitted to investigate the associations.ResultsLower levels of HRQoL were significantly associated with lower levels of physical function, measured by walking speed, and higher levels of pain. Pain was significantly associated with all of the subscales in SF-36, with the exception of Mental Health and Mental Component Score, and all the subscales of QUALEFFO-41. Walking speed was significantly associated with 5 of 8 subscales of SF-36 (except Bodily Pain, Vitality, Mental Health and Mental Component Score), and with 4 of 6 subscales of QUALEFFO-41 (except Score Pain and Mood).ConclusionThis study shows that pain and walking speed were, independently of one another, associated with HRQoL in older women with osteoporosis and vertebral fracture. These findings can inform clinicians and health managers about the importance of pain management and exercise interventions in health care for this group. Future research should address interventions targeting both physical function and pain with HRQoL as an outcome.RegistrationClincialTrials.gov Identifier: NCT02781974. Registered 18.05.16. Retrospectively registered.

Physical activity and quality of life in older women with a history of depressive symptoms

Physical activity (PA) is positively associated with health-related quality of life (HRQL) in older adults. It is not evident whether this association applies to older adults with poor mental health. This study examined associations between PA and HRQL in older women with a history of depressive symptoms. Participants were 555 Australian women born in 1921–1926 who reported depressive symptoms in 1999 on a postal survey for the Australian Longitudinal Study on Women's Health. They completed additional surveys in 2002, 2005 and 2008 that assessed HRQL and weekly minutes walking, in moderate PA, and in vigorous PA. Random effects mixed models were used to examine concurrent and prospective associations between PA and each of 10 HRQL measures (eight SF-36 subscales; two composite scales). In concurrent models, higher levels of PA were associated with better HRQL (p<0.001). The strongest associations were found for the bodily pain, physical functioning, general health perceptions, social functioning and vitality measures. Associations were attenuated in prospective models, more so for mental HRQL-related scales than for physical HRQL-related scales. However, strong associations (>3 point differences) were evident for physical functioning, general health, vitality and social functioning. For women in their 70s–80s with a history of depressive symptoms, PA is positively associated with HRQL concurrently, and to a lesser extent prospectively. This study extends previous work by showing significant associations in older women with a history of depressive symptoms. Incorporating PA into depression management of older women may improve their HRQL.

Individualized feedback-based virtual reality exercise improves older women’s self-perceived health: A randomized controlled trial

ObjectivesIndividualized feedback-based virtual reality (IFVR) exercise is gaining attention as a cost-effective self-management strategy, however little is known about whether older adults themselves perceive IFVR exercise effective in improving their health. Therefore, we studied the effect of IFVR exercise on health-related quality of life (HRQoL) in older women. MethodsFifty-four older women aged ≥65 years were randomized to either IFVR exercise group (IFVRG, n=26) or group-based exercise group (GG, n=28). Both groups received a 60-min intervention three times a week for eight weeks. The Short-Form Health Survey (SF-36) was administered. To identify the possible placebo effect, 30-Second Chair Stand Test (30SCST), 8-Foot Up-and-Go Test (8FUGT), and 2-Minute Step Test (2MST) were also administered. Resultsintention-to-treat analysis with adjustment for baseline levels revealed that IFVRG showed greater improvement in mental health (p=0.029) and lower body strength (p=0.042), compared to GG. Within-group analysis for HRQoL revealed that IFVRG showed an increase in role-physical (p=0.015), bodily pain (p=0.017), general health (p=0.004), vitality (p=0.010), role-emotional (p=0.007), and mental health (p<0.001), whereas GG showed an increase in role-physical (p=0.022), general health (p=0.023), and social functioning (p = 0.023). Both groups showed an increase in 30SCST, 2MST and 8FUGT (all p<0.001). ConclusionIFVR exercise improved HRQoL in older women, in addition to improving physical fitness. Therefore, it might be recommended to older women as an effective self-management strategy.

Health-related quality of life and mental health in older women with urinary incontinence

Objectives: The purpose of this cross-sectional study was to compare health-related quality of life (QOL) and mental health between older women with and without urinary incontinence. Method: This study is a secondary data analysis using raw data from 1874 women aged 65 years or older who participated in the Korea National Health and Nutrition Examination Survey (KNHANES) IV (2008–2009), a nationally representative sample. Results: In the pain/discomfort dimension of the EuroQol-5, 25.4% of the participants experienced urinary incontinence and 14.7% did not (p = .001). In the anxiety/depression dimension, urinary incontinence was present in 8.3% of the participants and absent in 3.6% (p = 0.012). In addition, the results of an ANCOVA showed that scores in both the EuroQol visual analogue scale and the EQ-5D index were significantly lower in participants with urinary incontinence relative to those without. The risk of stress and depression in older women with urinary incontinence was approximately 2 and 1.5 times higher, respectively, than that of participants without urinary incontinence. Conclusion: Health-related QOL in older women with urinary incontinence was relatively low, while levels of stress and depression were high. Therefore, in order to improve QOL and mental health in older women, the understanding and management of urinary incontinence interventions is required.

Weighted multimorbidity indexes predicted mortality, health service use, and health-related quality of life in older women

Objective To develop indexes of multimorbidity, based on self-reported data, to predict mortality, health service use, help with activities of daily living (ADL), and health-related quality of life (HRQOL) in older women. Study Design and Setting Cross-sectional survey of 10,434 women, aged 73–78 years, in the Australian Longitudinal Study of Women's Health in 1999, with mortality follow-up to 2005. For analysis, the sample was equally split into a development and validation sample. Weighted and unweighted multimorbidity indexes were developed and tested. Results Outcomes ranged from 14% for mortality to 47% for specialist doctor visits. Mortality was predicted by heart disease, stroke, low iron, diabetes, cancer (nonskin), bronchitis/emphysema, and Alzheimer's disease. Different patterns of morbidities were associated with the other outcomes. Weighted and unweighted multimorbidity index scores were linearly related to increasing risk of each outcome. For each outcome, the weighted scores fitted the data better and had a wider range of possible values. Conclusion These multimorbidity indexes predict mortality, health service use, help with ADL, and HRQOL in older women. The indexes could be used as covariates in research with weighted scores having a better chance of discriminating between patient groups than unweighted scores.

Effect of coronary artery bypass graft surgery on older women's health-related quality of life

Objective: The purpose of this study was to determine if health-related quality of life (HRQL) improves after coronary artery bypass graft (CABG) surgery in older women. Design: The study design was longitudinal observational. Setting: The study took place in a tertiary-care teaching hospital in Hamilton, Ontario, Canada. Patients: Study participants included 34 women 61 years or older who had elective or urgent CABG surgery for the first time. Outcome Measures: The 2 measures of HRQL were the Medical Outcomes Study Short Form 36 and the Feeling Thermometer (FT). The Short Form-36 is composed of 8 subscales that are summarized into the Physical and the Mental Composite Scores. The FT is a utility measure that rates patients' preferences for different health states. Results: HRQL of older women was improved after CABG surgery: 7.79 points in the physical composite scores (P =.001), 7.26 in the mental composite scores (P =.008), and 29.77 points in the FT scores (P <.001). Age was a predictor of HRQL, with older women demonstrating poorer physical and better mental HRQL 3 months after the operation. Conclusions: HRQL of older women is improved significantly as early as 3 months after CABG surgery. (Heart Lung® 2002;31:421-31.)