Medical Outcomes Short-Form Health Survey Research Articles

Determinants of socioeconomic factors for quality of life and depressive symptoms in community-dwelling older people: A cross-sectional study in Brazil and Portugal.

Our aim was to analyze the association between socioeconomic status and quality of life (QoL) among older people with depressive symptoms treated through the Primary Health Care (PHC) system in Brazil and Portugal. This was a comparative cross-sectional study with a nonprobability sample of older people in the PHC in Brazil and Portugal conducted between 2017 and 2018. To evaluate the variables of interest, the socioeconomic data questionnaire, the Geriatric Depression Scale and the Medical Outcomes Short-Form Health Survey were used. Descriptive and multivariate analyses were performed to test the study hypothesis. The sample consisted of n = 150 participants (Brazil n = 100 and Portugal n = 50). There was a predominance of woman (76.0%, p = 0.224) and individuals between 65 and 80 years (88.0%, p = 0.594). The multivariate association analysis showed that in the presence of depressive symptoms, the QoL mental health domain was most associated with the socioeconomic variables. Among the prominent variables, woman group (p = 0.027), age group 65-80 years (p = 0.042), marital status "without a partner" (p = 0.029), education up to 5 years (p = 0.011) and earning up to 1 minimum wage (p = 0.037) exhibited higher scores among brazilian participants. The portuguese participants showed an association between the general health status domain and woman group (p = 0.042) and education up to 5 years (p = 0.045). The physical functioning domain was associated with income of up to 1 minimum wage (p = 0.037). In these domains, the portuguese participants exhibited higher scores than the brazilian participants. We verified the association between socioeconomic profile and QoL in the presence of depressive symptoms, which occurred mainly among woman, participants with low levels of education and low income, with QoL aspects related to mental, physical and social health and self-perceived health. The group from Brazil had higher QoL scores than the group from Portugal.

Pulmonary function, muscle strength, and quality of life have differed between chronic kidney disease patients and healthy individuals

Chronic kidney disease (CKD) patients have lower pulmonary function, respiratory and peripheral muscle strength values when compared to the general population, which reflects negatively in the quality of life (QoL). The aim of this study was to compare the pulmonary function, respiratory and peripheral muscle strength, and QoL between CKD patients and healthy individuals. Cross-sectional study with a consecutive sample of 39 individuals separated into three groups: nondialysis-dependent CKD in stage 5 (CKD-5), HD group (CKD-HD), and healthy individuals. The tests performed were spirometry, manovacuometry, handgrip strength (HGS), and Medical Outcomes Short-Form Health Survey (SF-36). A significant difference between groups was observed in forced expiratory volume in 1second (FEV1 ) and its predicted value (p=0.004 and p < 0.001, respectively), forced vital capacity (FVC), and its predicted value (p=0.008 and p < 0.001, respectively), peak expiratory flow (PEF) and its predicted value (p=0.004 and p < 0.001, respectively), maximal inspiratory pressure (MIP) and its predicted value (p=0.022), maximal expiratory pressure (MEP) and its predicted value (p=0.030 and p=0.009, respectively) in which CKD-5 presented the worst values, followed by CKD-HD and healthy group. The CKD-5 had worse pulmonary function, respiratory muscle strength, and QoL. Moreover, CKD-HD also showed some impairment in pulmonary function and QoL when compared with healthy individuals. Even with the peripheral muscle strength preserved, its decrease is proportional to the pulmonary impairment in the evaluated CKD patients.

Abstract 13633: Predictors of Mental and Physical Health Outcomes of Patients Undergoing an Appointment-based Cardiac Rehabilitation Program

Introduction: Cardiac rehabilitation (CR) is an evidence-based program to improve secondary prevention outcomes for patients with cardiovascular disease (CVD). Lower health-related quality of life is a known risk factor for worse CVD outcomes. We examined the effects of a patient-driven appointment-based CR program on health-related quality of life. Methods: We utilized data from the Yale New-Haven Health (YNHH) CR program over a 6-year period (2012-2017). Data was collected on patient demographics, clinical characteristics and socioeconomic status. The Medical Outcome Short-Form General Health Survey (SF-36) was used to measure general health status. We evaluated SF-36 score changes pre and post CR with paired T-tests and conducted logistic regression analysis to examine predictors of improvements in health-related quality of life. Results: Over the 6-year study period, a total of 2,135 patients (27.9% women, mean age 65±12 years) were enrolled in the CR program. Patients demonstrated significant improvements in both the SF-36 physical, mental and health transition components (P&lt;0.001) (Table) . In particular, patients had significant improvement in the social functioning domain (measures limitations patients see in their ability to participate in social activities due to physical/emotional issues), with an increase of 23.3 points out of 100. Physician-reported patient stress and/or depression on intake medical exam were significant negative predictors for improvement in the total SF-36 score (OR 0.23, 95% CI 0.08-0.80, P=0.021), with the effect driven largely by its impact on the physical component of SF-36 (OR 0.27, 95% CI 0.09-0.83, P=0.022). Conclusion: We demonstrated that a novel appointment-based CR program produced improvements in patient-reported health-related quality of life. Appointment-based CR could be a viable alternative for patients who prefer more scheduling flexibility, to optimize health status improvement and CVD outcomes.

Impaired physical function and evaluation of quality of life in normocalcemic and hypercalcemic primary hyperparathyroidism.

Severe primary hyperparathyroidism may be associated with muscle weakness and fatigue, but little is known about this effect in milder forms of the disease. This study aimed to evaluate physical function and quality of life in patients with normocalcemic (NPHPT) and hypercalcemic (HPHPT) primary hyperparathyroidism. This was a case-control study on 40 postmenopausal women. Thirteen patients with NPHPT, 7 patients with HPHPT, and their controls were studied. Mean serum PTH in the control group was 49.10±12.38pg/mL. All of the participants answered the Medical Outcomes Short-Form Health Survey (SF36) and were submitted to 2 strength tests (Hand Grip strength and Chair stand test) and 2 performance tests for physical function (Short physical performance battery and Gait speed). Body composition analysis was performed by dual-energy X-ray absorptiometry (DXA) and multifrequency bioimpedance (BIA). Patients with NPHPT had lower grip strength (p=0.005), a higher mean time of the chair stand test (p=0.012), a lower mean gait speed (p<0.001) and a lower score for the Short Physical Performance Battery (SPPB) (p=0.010) than the control group. Patients with HPHPT had lower handgrip strength (p=0.027), a higher mean time of the chair stand test (p=0.017), and a lower score for the SPPB (p=0.049) than the control group. Patients with NPHPT showed a higher gait speed when compared to HPHPT (p=0.048). There was no difference between BIA and DXA body composition indices between the PHPT groups and their controls. The evaluation of the SF-36 showed significantly less quality of life in the general health domain among the NPHPT group and in the mental health domain among the HPHPT than in the controls. Patients with NPHPT and HPHPT have decreased physical performance and strength.

Impact of multidimensional interventions on quality of life and depression among older adults in a primary care setting in Brazil: a quasi-experimental study

Objective:To evaluate the impact of multidimensional interventions on quality of life (QoL) and depressive symptoms in Brazilian older adults living in the community.Methods:Longitudinal, quasi-experimental study of older adults receiving conventional primary health care (PHC). The interventions were designed in response to a first round of data collection and validated through pilot testing in groups of older adults from another community. The validated interventions were then applied to an intervention group (IG). To measure their effect, we used the Medical Outcomes Short-Form Health Survey (SF-36) quality of life scale and the Geriatric Depression Scale (GDS-30).Results:The sample comprised 118 participants. IG participants exhibited significant improvement in several QoL domains (SF-36): mental health (p = 0.010), general health perceptions (p = 0.016), and physical functioning (p = 0.045). No such improvement occurred in controls (p > 0.050). The prevalence of depression (GDS-30) fell from 36.7 to 23.3% in the IG, despite no significant difference (p = 0.272). Controls also reported a reduction in depressive symptoms, but only from 44.8 to 41.4% (p = 0.112).Conclusions:This multidimensional intervention was associated with significant improvement in mental health, general health perceptions, and physical functioning in a sample of Brazilian older adults.Clinical trial registration:RBR-92dbtx

Anxiety and health-related quality of life after cardiac surgery.

IntroductionThe aim of this study was to investigate the effect of elective cardiac surgery on health-related quality of life (HRQoL).Material and methodsOne hundred and eight (35 women and 73 men, mean age 62.3 ±12.7 years) patients undergoing open heart surgery were enrolled in the study. Physical and mental domains of quality of life were measured using the 36-item Medical Outcomes Short-Form Health Survey (SF-36) self-administered questionnaire, and anxiety symptoms were assessed using the Spielberger State-Trait Anxiety Inventory (STAI). At baseline 108 patients filled out the SF-36 and STAI, and 102 patients at 6-month follow-up.ResultsIt was found that there was significant improvement in three out of eight health domains: physical functioning (p < 0.02), role physical (p < 0.01), and social functioning (p < 0.04), at 6-month follow-up. The two STAI sub-scores: the State Anxiety Inventory and the Trait Anxiety Inventory were found to be high (≥ 40) both preoperatively and 6 months postoperatively. Postoperatively there was not any statistically significant decrease in the levels of anxiety.ConclusionsThis study suggests that the assessment of psychosocial factors, particularly the ongoing assessment of anxiety, could help in risk stratification and prediction of functional status and HRQoL in patients after cardiovascular surgery. Furthermore, the assessment of preoperative well-being should be integrated in routine care in order to identify and support patients with higher levels of anxiety.

Assessment of anxiety and health-related quality of life in patients with lower extremity peripheral arterial occlusive disease.

IntroductionThe aim of this study was to investigate the effect of chronic occlusive vascular disease on anxiety with adverse outcome with health-related quality of life (HRQoL).Material and methodsThree hundred and thirty-five patients who were treated for peripheral arterial occlusive disease were enrolled in this study. 187 patients who had undergone percutaneous transluminal angioplasty and 148 patients who had one or more surgical revascularizations enrolled in the study. Mean age of the patients was 62.6 ±10 years. Two hundred and eighty-nine patients were male, 46 patients were female. Physical and mental domains of quality of life were measured using the 36-item Medical Outcomes Short-Form Health Survey (SF-36) self-administered questionnaire and anxiety symptoms were assessed using the Spielberger State-Trait Anxiety Inventory (STAI). At baseline 335 patients filled out the SF-36 and STAI, and 304 patients (90.7 % of the series) filled them out at 6-month follow-up.ResultsThere was no mortality and no significant morbidity after vascular interventions in the series. Significant improvement was found in two of eight health domains. The score of social functioning increased to 60.4 from 52.6 (p < 0.03) and general health perception increased to 75.1 from 60.5 (p < 0.04) at 6-month follow-up. The two STAI sub-scores, the State Anxiety Inventory (STAI-S) and the Trait Anxiety Inventory (STAI-T) were found high (≥ 40) both preoperatively and 6 months postoperatively. Postoperatively there was no significant decrease of the levels of anxiety.ConclusionsThis study suggests that the assessment of psychosocial factors, particularly the ongoing assessment of anxiety, could help in risk stratification and prediction of functional status in patients suffering from lower extremity peripheral arterial occlusive disease.

MENTAL DISORDERS AND QUALITY OF LIFE IN PATIENTS AWAITING LIVER TRANSPLANTATION.

Liver transplantation is the main therapeutic alternative for patients with advanced liver disease. These patients have high prevalence of psychiatric comorbidities that may negatively interfere in clinical outcomes and quality of life. It is not clear in the literature whether the different etiologies of hepatic disease have the same prevalence of psychiatric disorders. The aim of this study was to investigate whether patients in the liver transplant list showed differences in psychiatric characteristics, medical variables and quality of life among different etiological groups. This is a cross-sectional study that evaluates quality of life, psychiatric and clinical comorbidities through the application of validated questionnaires and instruments in 248 patients who were on transplant waiting list from 2010 to 2014, assisted in a University Hospital and in a Private Hospital in Salvador/Bahia, Brazil. The patients were evaluated through the Mini International Neuropsychiatric Interview (M.I.N.I. PLUS 5.0) and Medical Outcomes Short-Form Health Survey (SF-36). The etiology of the most prevalent liver disease was hepatitis C virus. A prevalence of 50.8% of at least one mental disorder was identified. When alcohol abuse/dependence was excluded, the prevalence was 25.8%. Mental health did not show a statistically significant difference in the diverse etiological groups, but a higher prevalence of psychiatric comorbidities was detected among women and younger than 40 years. No cases of psychotic disorders were detected, possibly by exclusion prior to listing. There was no difference in the quality of life domains in the different liver etiological groups. A high-prevalence of psychiatric disorders was found among all clinical conditions most associated with indication for liver transplantation. Attention is drawn to the absence of patients with psychotic disorders, which suggests that transplantation may not have been indicated for this group of patients. For these reasons, professionals caring for liver transplant candidates should be highly vigilant for the presence of mental disorders, regardless of the etiology of liver disease. Specialized care is recommended to minimize the early exclusion of patients with no other therapeutic possibilities, as well as care of all people with mental disorders.

Quality of Life, Depression, Anxiety Symptoms and Mood State of Wheelchair Athletes and Non-athletes: A Preliminary Study.

The present study aims to compare quality of life, depression, anxiety symptoms, and profile of mood state of wheelchair athletes and non-athletes. Thirty-nine basketball and rugby wheelchair athletes (n = 23, nine women, age 36.0 ± 10.0 years; body mass 66.2 ± 13.8 kg; height 170.0 ± 8.5 cm) and non-athletes (n = 16, 4 women, 39.0 ± 14.2 years; body mass 79.6 ± 17.2 kg; height 170.0 ± 6.4 cm) were recruited. Quality of life, anxiety and depressive symptoms and mood disorders were evaluated by the Medical Outcomes Short-Form Health Survey (SF-36), State-Trait Anxiety Inventory, Beck Depression Inventory and Profile of Mood State questionnaire, respectively. Comparison between groups (non-athletes vs. athletes) was performed using Student’s t-test for independent samples. No differences (p > 0.05) were found between non-athletes vs. athletes regards to quality of life, depressive and anxiety symptoms and profile of mood state. Overall, non-athletes and athletes presented medium anxiety symptoms and mild to moderate depressive symptoms. In conclusion, the wheelchair athletes and non-athletes presented similar quality of life, depressive and anxiety symptoms, and profile of mood state.

Study protocol for a multicentre, controlled non-randomised trial: benefits of exercise physiology services for type 2 diabetes (BEST)

IntroductionControlled trials support the efficacy of exercise as a treatment modality for chronic conditions, yet effectiveness of real-world Exercise Physiology services is yet to be determined. This study will investigate...

Development and validation of the pulmonary tuberculosis scale of the system of Quality of Life Instruments for Chronic Diseases (QLICD-PT)

BackgroundGeneric assessments are less responsive to subtle changes due to specific diseases, making it challenging to fully understand the impact of pulmonary tuberculosis (TB) on patient’s quality of life (QOL).MethodsWe applied programmed decision procedures and theories on instrument development to develop the scale. Two hundred patients with pulmonary TB participated in measuring QOL three times before and after treatments. We assessed the validity, reliability, and responsiveness of QLICD-PT using correlation analysis, factor analysis, multi-trait scaling analysis, randomized block analyses of variance with Least Significant Difference post-hoc tests.ResultsWe composed QLICD-PT with 3 domains (28 items) for general QOL and 1 pulmonary TB specific domain (12 items). Correlation and factor analysis confirmed good structure validity and criterion-related validity when using Chinese version of the Medical Outcomes Short-Form Health Survey (SF-36) as a criterion. The internal consistency of α values were higher than 0.70. The score changes after treatment were of statistical significance for the overall scale, physical domain and specific domain with effect size ranging from 0.32 to 0.72. No floor effects but small ceiling effects were observed at domain level.ConclusionsAs the first pulmonary TB-specific QOL scale developed by a module approach in Chinese, QLICD-PT has an acceptable degree of validity, reliability and responsiveness, and can be used to measure the life quality of PT patients specifically and sufficiently.

The health promoting conversations intervention for families with a critically ill relative: A pilot study

BackgroundAfter intensive care unit treatment, patients often have prolonged impairments that affect their physical, cognitive and mental health. Family members can face overwhelming and emotionally challenging situations and their concerns and needs must be addressed. ObjectiveWe investigated the outcomes of pilot randomised control trial, a nurse-led family intervention, Health Promoting Conversations, which focused on family functioning and wellbeing in families with a critically ill member. Study designThis randomised controlled pilot study used a pre-test, post-test design with intervention and control groups to investigate the outcomes of the nurse-led intervention in 17 families. Outcome measuresThe Health Promoting Conversations intervention was evaluated using validated instruments that measure family functioning and family wellbeing: the General Functioning sub-scale from the McMaster Family Assessment Device; the Family Sense of Coherence, the Herth Hope Index, and the Medical Outcome Short-Form Health Survey. Descriptive and analytical statistical methods were used to analyse the data. ResultsAfter 12 months, the intervention group reported better family functioning than the control group. The intervention group also had better social functioning and mental health after 12 months. ConclusionThis intervention may improve family wellbeing by improving family function, reducing stress, and promoting better mental health.

Effects of resistance training in individuals with knee osteoarthritis

Abstract Introduction: Osteoarthritis (OA), the most common form of arthritis, is considered the main cause of pain and disability in the elderly. Objective: To evaluate the effect of systematic muscle strength training on functional performance and quality of life in individuals with knee OA. Methods: Subjects with knee OA (n = 27, 46 - 76 years) completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Medical Outcomes Short-Form 36-item Health Survey (SF-36), and visual analog scale (VAS) questionnaires, musculoskeletal assessments, and 10-repetition maximum and timed 10-meter walk tests both before and after training. The training consisted of an exercise resistance program and stretches for 12 weeks (three sessions of 80 each per week). Results: Twenty-two subjects completed the training. Reduced overall scores and WOMAC physical function indicated improved functional performance (p &lt; 0.001) as well as increased gait speed (p &lt; 0.001). The perception of pain decreased after training, as evidenced by the VAS, WOMAC pain domain, and SF-36 scores (p &lt; 0.001). Quality of life improvements occurred primarily in the areas of pain, functional capacity, and SF-36 physical aspects. No change in body mass index was noted (p = 0.93). Conclusion: Our results indicate that the combination of resistance training for the quadriceps, gluteus, and abdominal muscles could be a viable alternative to improving functionality and quality of life in patients with knee OA. However, more studies are necessary to confirm our findings.

Delayed complications and functional outcome of isolated sternal fracture after emergency department discharge: a prospective, multicentre cohort study

The aim of this study was to determine the incidence of delayed complications, specifically hemothorax, and functional outcome in patients with isolated sternal fracture discharged from the emergency department (ED) compared to patients with other minor thoracic trauma. This prospective cohort study was conducted in four university-affiliated Canadian EDs. Patients ages 16 and older discharged from the ED with an isolated minor thoracic injury were included and categorized as isolated sternal fracture, rib fracture, or no fracture. A standardized clinical and radiological follow-up was performed at 7 and 14 days as well as a phone follow-up at 30 and 90 days post-injury. Functional outcome was determined using the Medical Outcome Short-Form Health Survey (SF-12). A total of 969 patients were included, of whom 32 (3.3%) had an isolated sternal fracture, 304 (31.3%) had rib fracture, and 633 (65.3%) had no fracture. Within 14 days, 112 patients presented with a delayed hemothorax: 12.5% of sternal fracture patients, 23% of rib fracture(s) patients, and 6% of minor thoracic injury patients without fracture (p<0.05). At 90 days, 57.1% of patients with sternal fracture had moderate to severe disability compared to 25.4% and 21.2% for both of the other groups, respectively (p<0.001). In this prospective study, we found that 12.5% (n=4, p<0.05) of patients with sternal fracture developed a delayed hemothorax, but the clinical significance of this remains questionable. The proportion of patients with sternal fracture who had moderate to severe disability was significantly higher than that of patients with other minor thoracic trauma.

Depressive Symptoms in Patients with Cancer

The purpose of this survey was to investigate depressive symptoms in cancer patients and the differences based on gender, quality of life and social support. Sixty-eight patients diagnosed with cancer participated in the research, with ages varying between 25 and 83 years (A = 55.4; SD = 13.3) and 85.3% were female. The instruments used were Identification Questionnaire, Perceived Social Support Scale—adult version (EPSUS-A), Medical Outcomes Short-Form Health Survey (SF-36) and the Baptista Depression Scale Hospital—clinic version (EBADEP-HOSP-AMB). It was verified that most of the patients reported not having depression diagnosis before the cancer, nor in the current moment, besides not using anti-depressive medication. The scores obtained in the EBADEP-HOSP-AMB suggest light depressive symptoms. It is concluded that the depressive symptoms were mostly presented in women, in patients with worse mental health condition and in those less satisfied with the social support.

Socio-demographic and Health Aspects Associated with the Quality of Life in the Elderly of the Family Health Strategy. An Analytical Study

Objective: to analyze the association between the socio-demographic and health aspects to the quality of life (QOL) of elderly people linked to the ESF. Methods: this is an analytical, cross-sectional study with a quantitative approach, carried out in two communities ascribed to the ESF of Rio Grande do, Brazil, between December 2015 and March 2016. The data collection instruments were: a socio-demographic and pain characteristics questionnaire; Mini-Mental State Examination (MMSE), the Medical Outcomes Short-Form Health Survey (SF-36 Brazilian version). A descriptive and inferential analysis with 5.0% significance level were performed. The study followed the ethical precepts of research. Results: In this age group studied, there is a significant association between younger elderly with the domains of functional capacity (Average 67.2 and ρ-value 0.032), emotional health (Average 82.0 and ρ-value 0.040) and physical size (Average 51.4 and ρ-value 0.042). Among the aspects of health and QOL there was a statistical significance between the variable “pain in the last week”, with the absence of pain associated with functional capacity (Average 76.7 and ρ-value 0.013) and emotional health (Average 96.1 and ρ-value (0.019) These statistically significant differences occurred in the elderly of Santa Cruz. Conclusion: regarding the association between socio-demographic and health aspects and QOL of the elderly, there was a significant between different variables and domains, with a strong association of QOL with age, marital status, pain and medication use.

Care and quality of life evaluation of people with venous ulcers in primary health care

Background: To identify the sociodemographic characteristics and care of people with UV as their place of care and housing, allowing to plan and develop a holistic and individualized care, increasing the chances of adherence and positive results in the quality of life. Objective: Care and quality of life evaluation of people with venous ulcers treated with the primary health care, according to the health district. Methods: This is a cross-sectional study with 101 people in 42 mix and family health units, in Natal, Rio Grande do Norte, Brazil. The data were collected through an instrument to characterize the sociodemographic and service issues, and the Medical Outcomes Short-Form Health Survey (SF-36). Statistical analysis used descriptive statistics, Fisher's Exact test, Chi-Square test, and Mann-Whitney test, with p- value < 0.05. Results: The study population was composed mostly of women, older, married or in a stable relationship, with low income and education level and prevalence of individuals with inadequate care. About the quality of life, there was a statistically significant difference for the social function domain comparing the locations (p = 0.035). Conclusion: Knowing profile differences that impact the quality of life of people with a venous ulcer in different locations can support health care according to specific needs.

Facets of Dispositional Mindfulness and Health Among College Students.

The purpose of the current study was to examine the relationship between the facets of trait mindfulness with psychological and physical health while controlling for health behaviors in college students. 310 students from a small, private college in the Northeastern United States. Students completed self-report measures, including the Perceived Stress Scale (PSS-14), the Five Facet Mindfulness Questionnaire (FFMQ), Medical Outcomes Short-Form Health Survey (SF-36), and the Rutgers Alcohol Problems Index (RAPI). After controlling for other health behaviors, the observation facet of mindfulness was negatively associated with physical health. Both acting with awareness and nonjudging facets were positively associated with emotional well-being. For social functioning, nonjudging was a significant positive facet for this domain of health. Tailoring mindfulness-based interventions to enhance these facets may be beneficial to young adults.

Medical outcomes short-form health survey (SF-36) questionnaire in elderly hypertensive patients: effect of exercise training

Medical outcomes short-form health survey (SF-36) questionnaire in elderly hypertensive patients: effect of exercise training

Do Older Patients With Moderate-Severe Chronic Graft-Versus-Host Disease Differ From Younger Patients?

IntroductionOlder patients undergoing allogeneic stem cell transplantation may experience a higher degree of morbidity and limitations from transplant related complications. Chronic graft-versus –host disease (GVHD) causes a significant reduction in patients' quality of life (QOL), physical functioning, and functional status. However, it is not known if moderate to severe chronic GVHD has a worse impact on QOL, or survival outcomes for older patients. MethodsWe analyzed data of patients with moderate or severe chronic GVHD (N=522, 1661 follow-up visits, a total of 2,183 visits) from the Chronic GVHD Consortium, a prospective observational multicenter cohort. Moderate or severe chronic GVHD was defined by the National Institutes of Health global severity score at the time of enrollment. We examined the relationship between age group (adolescent and young adult “AYA” 18-40, “middle-aged” 41-59, and “older” ≥ 60 years) and clinical manifestations of chronic GVHD, patient-reported outcomes, functional status, non-relapse mortality and overall survival. Clinical manifestations of chronic GVHD were determined by the clinician-reported individual organ scores. Patient-reported outcomes included (1) QOL as measured by Functional Assessment of Cancer Therapy Bone Marrow Transplantation (FACT-BMT) and the Medical Outcome Short-Form Health Survey (SF-36) (2) chronic GVHD symptom burden as measured by the Lee Symptom Scale; and (3) physical fitness as measured by the Human Activity Profile (HAP). Functional status was assessed using the 2-minute walk test (2MWT). Because of multiple testing, p-values <0.01 were considered significant. ResultsThere were 115 (22%) AYA, 279 (53%) middle-aged and 128 (25%) older patients with moderate (58%) or severe (42%) chronic GVHD included. At study enrollment, older patients (≥60) were similar to younger patients in sex, time from transplant (median 12 months), prior acute GVHD, percentage of severe chronic GVHD, and current co-morbidity scores but differed in disease distribution and conditioning regimen intensity. At enrollment, in unadjusted analyses using all available data, older patients had similar rates and severity of global and organ-specific manifestations of chronic GVHD compared to younger patients, except for genital involvement, which was more prevalent and severe in AYA patients. Although older patients reported worse physical functioning [SF-36 Physical Functioning (p=0.01)], shorter 2MWT (p=0.002), and lower HAP scores (p=0.001) than AYA and middle-aged patients suggesting they have more physical limitations, older patients had better QOL [FACT-BMT (p=0.01)] scores compared to middle-aged patients and similar to AYA patients. Older patients had better psychological [Lee Psychological Scale (p<0.001), SF-36 Mental Health (p=0.01)] and emotional functioning [FACT-Emotional Well-being (p=0.001)] and less pain [SF-36 Bodily Pain (p=0.006)] than AYA and middle-aged patients but similar chronic GVHD symptom burden [Lee Symptom Scale (p=0.47)]. In multivariable linear mixed models utilizing all visit data and adjusted for clinical covariates, older patients had QOL (FACT-BMT) that was comparable to AYA patients (estimate -0.04, p=0.99) and better than middle-aged patients (estimate 5.7, p=0.004), while the SF36 physical and mental component scores and symptom burden were not different between the groups. Non-relapse mortality and overall survival were similar between the age groups in unadjusted analyses (p=0.23, p=0.17) and after adjusting for clinical covariates (p=0.17, p=0.15) in Cox models. In a subgroup analysis, we found that there were no differences in overall and organ-specific chronic GVHD manifestations, QOL and survival between patients in the 60-64 (n=73), 65-70 (n=39), and >70 (n=16) age groups, except for more moderate-severe skin involvement in the 65-70 year olds. ConclusionDespite higher physical and functional limitations, older patients with moderate or severe chronic GVHD have preserved QOL, comparable disease manifestations and symptom burden, and similar overall survival and non-relapse mortality when compared to younger patients. Therefore we did not find evidence that older age itself is associated with worse QOL or survival in patients with moderate or severe chronic GVHD. Disclosures:No relevant conflicts of interest to declare.