Physical Role Limitations Research Articles

Utility‐based quality of life associated with overweight and obesity: The australian diabetes, obesity, and lifestyle study

This study aimed to estimate utility-based quality of life (UQoL) differences between healthy body weight and excess body weight categories. Cross-sectional analysis of 10,959 adults, participating in baseline data collection of the nationally representative Australian Diabetes, Obesity, and Lifestyle (AusDiab) Study was undertaken. Height and weight were measured by trained personnel. Body weight categories were assigned as healthy weight, overweight, and obesity subclasses I, II and III. UQoL was assessed using the SF-6D, which captures physical functioning, role limitation, social functioning, pain, mental health, and vitality on a score of 0.00-1.00 (worst-best). The relationship between body weight categories and UQoL was assessed using linear regression, adjusting for age, sex, education, and smoking. Relative to the healthy weight group (mean UQoL score 0.77), mean adjusted UQoL differences (95% confidence intervals) were 0.001 (-0.008, 0.010) for overweight, -0.012 (-0.022, -0.001) for class-I obese, -0.020 (-0.041, 0.001) for class-II obese, and -0.069 (-0.099, -0.039) for class-III obese groups. Adding metabolic syndrome markers to the covariates had little impact on these differences. Results confirmed an inverse dose-response relationship between body weight and UQoL in this study of Australian adults. This highlights the need to incorporate UQoL measures which are sensitive to the subclasses of obesity when evaluating obesity interventions.

Quality of Life Assessment in the Randomized PROTECT AF (Percutaneous Closure of the Left Atrial Appendage Versus Warfarin Therapy for Prevention of Stroke in Patients With Atrial Fibrillation) Trial of Patients at Risk for Stroke With Nonvalvular Atrial Fibrillation

This study sought to assess quality of life parameters in a subset of patients enrolled in the PROTECT AF (Percutaneous Closure of the Left Atrial Appendage Versus Warfarin Therapy for Prevention of Stroke in Patients With Atrial Fibrillation) trial. The PROTECT AF (Percutaneous Closure of the Left Atrial Appendage Versus Warfarin Therapy for Prevention of Stroke in Patients With Atrial Fibrillation) trial demonstrated that in patients with nonvalvular atrial fibrillation (AF) and CHADS2 (congestive heart failure, hypertension, age, diabetes mellitus, and prior stroke, transient ischemic attack, or thromboembolism) score ≥1, a left atrial appendage closure device is noninferior to long-term warfarin for stroke prevention. Given this equivalency, quality of life (QOL) indicators are an important metric for evaluating these 2 different strategies. QOL using the Short-Form 12 Health Survey, version 2, measurement tool was obtained at baseline and 12 months in a subset of 547 patients in the PROTECT AF trial (361 device and 186 warfarin patients). The analysis cohort consisted of patients for whom either paired quality of life data were available after 12 months of follow-up or for patients who died. With the device, the total physical score improved in 34.9% and was unchanged in 29.9% versus warfarin in whom 24.7% were improved and 31.7% were unchanged (p = 0.01). Mental health improvement occurred in 33.0% of the device group versus 22.6% in the warfarin group (p = 0.06). There was a significant improvement in QOL in patients randomized to device for total physical score, physical function, and in physical role limitation compared to control. There were significant differences in the change in total physical score among warfarin naive and not-warfarin naive subgroups in the device group compared to control, but larger gains were seen with the warfarin naive subgroup with a 12-month change of 1.3 ± 8.8 versus -3.6 ± 6.7 (p = 0.0004) device compared to warfarin. Patients with nonvalvular AF at risk for stroke treated with left atrial appendage closure have favorable QOL changes at 12 months versus patients treated with warfarin. (WATCHMAN Left Atrial Appendage System for Embolic Protection in Patients With Atrial Fibrillation [WATCHMAN PROTECT]; NCT00129545).

The effect of TNF-alpha blockers on psychometric measures in ankylosing spondylitis patients: a preliminary observation

There is a high co-morbidity between chronic inflammatory disorders and depression. Proinflammatory cytokines like TNF-α seem to play a central role in the pathogenesis of these disorders, and its neutralization provides a potent treatment for inflammatory disorders. Few studies showed that TNF-α blockers also caused an improvement in depressive symptoms associated with these chronic inflammatory disorders. To evaluate the effectiveness of TNF-α blockers on symptoms of ankylosing spondylitis (AS), depression, anxiety and quality of life, 9 AS patients resistant to classical therapy were enrolled and followed-up at 2nd and 6th weeks after a TNF-α blocker was started. Hamilton Depression and Anxiety Scales (HAM-D, HAM-A), Hospital Depression and Anxiety Questionnaire (HAD), Quality of Life Scale (SF36) and AS severity index (BASDAI) were applied to the patients at weeks 0, 2 and 6. ESR and CRP were evaluated to monitor biological disease activity. There was a significant reduction in HAM-D (p = 0.00), HAM-A (p = 0.00), HAD anxiety scores (p = 0.02) and a significant improvement in SF36 physical function (p = 0.00), physical role limitations (p = 0.00), bodily pain (p = 0.05), general health (p = 0.01), vitality (p = 0.03) and emotional role limitations (p = 0.00) subscales, BASDAI scores (p = 0.00), ESR (p = 0.00) and CRP (p = 0.00). Change in clinical disease activity (BASDAI) was not correlated with change in depression-anxiety scores, while change in biological disease activity (CRP) was correlated with change in depression-anxiety scores. TNFα blockers may have a potential antidepressant effect besides its anti-inflammatory effect that seems to be independent of its clinical effect.

The impact of current health-related quality of life on future health outlook in patients with eosinophilic granulomatosis with polyangiitis (Churg–Strauss syndrome)

Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare, autoimmune small and medium vessel vasculitis. EGPA is accompanied by asthma and involves mainly the blood vessels of the lungs, gastrointestinal system, and peripheral nerves; however, the skin, kidneys, and heart may be also affected. To investigate if patients with EGPA experience reduced health-related quality of life (HRQOL), and the effect of this parameter on their own perception of future health outlook. Twenty-six EGPA patients are in disease remission and completed a custom-designed questionnaire and the Medical Outcomes Study Short Form 36 (SF-36). Using the RAND method, eight HRQOL dimensions were calculated: general health, physical functioning, emotional role limitations, physical role limitations, social functioning, mental health, bodily pain, and vitality. Using norm-based scores, the HRQOL of patients was compared with that of the general population. EGPA patients had decreased HRQOL across all eight dimensions of the SF-36. Patients with higher mental component score felt more positive about their future health, while patients with low physical component score were likely not to feel negatively about their future health. Also, 36 % of older patients (>50 years) had a positive outlook compared to 47 % of younger patients (<50 years) and patients with a longer disease course were much less likely to have a positive outlook (30 % positive) than those with a shorter course (50 % positive). Although not statistically significant, these correlations warrant further investigation with a larger patient population. Despite being in disease remission, EGPA patients had decreased quality of life, which in turn influenced their perception of their future health outlook.

Comparative Efficacy of Open-chain and Close-chain Kinematics on Proprioception, Muscles Strength and Functional Performances in Individual with Knee Osteoarthritis

This study was designed to compare effects of open-chain and close-chain kinetics on proprioception, muscles’ strength and functionality on individual with knee osteoarthritis. Eight-week experimental study was conducted on twenty-five participants. Participants were randomized into two groups. The first group was involved in close-chain exercises (kinesthesia and balance exercises). The second group was involved in open-chain exercises in form strengthening exercises. Their knee proprioception, functional performances, severity of osteoarthritis, muscles’ strength and pain were assessed pre-exercise and post-exercise intervention. Twenty-five participants completed this study giving 16.67% attrition rate. Their mean age was 62.7 ± 8.5 years. The close-chain group showed significantly better improvement than the open-chain group in physical function, energy, role limitation, pain and severity of osteoarthritis. The close-chain group performed significantly better in all performances and proprioception after interventions. It was concluded that close-chain kinematics is more effective in improving proprioception functional performances in individuals with knee osteoarthritis.

Quality of Life and Functionality of Patients with Heel Reconstruction after Landmine Explosions

INTRODUCTION: Landmine injuries cause extensive soft and bony tissue loss of the weight bearing areas, particularly the heel. The aim of this study is to determine the quality of life and long term functionality of the patients who had heel reconstruction with free muscle flap following after landmine injuries (1–3). METHODS: Nineteen male patients who had heel reconstruction with free muscle flap were included in the study. Nine male volunteers without any gait disorder were included in the study as the control group. Functional Ambulation Scale (FAS), Energy Expenditure Index (EEI), 6-minute walking test (6MWT), 10-meter walking test (10MWT), Short Form 36 (SF-36) and Visual Analogue Scale (VAS) were used for evaluation (4). In patients with heel reconstruction, we also performed Freiburg ankle evaluation test and Graves radiologic evaluation test. RESULTS: There were no statistically significant differences between the two groups in terms of FAS, EEI, 6 MWT and 10 MWT. Regarding SF-36 scores, all subgroup values were lower in the reconstruction group whereas only those of general health, vitality and physical-emotional role limitation subgroups showed statistical significance. Mean VAS scores were found to be statistically different between groups (p<0.05). Mean Freiburg ankle scores showed moderate functionality. CONCLUSION: Although some physical and emotional role limitations, patients with heel reconstruction have adequate and functional ambulation at long term follow up. Considering the fact that our patient group comprised young men, we think that further studies can be conducted in similar subjects at older ages as well.

Exploring motivation for exercise and its relationship with health-related quality of life in adults aged 70 years and older

ABSTRACTThe health benefits of regular exercise participation have been widely acknowledged. Drawing upon self-determination theory, the purpose of our study was to identify the motivational profiles for exercise among older adults aged 70 years and older who regularly participated in sporting programmes, and to relate the motivational profiles to health-related quality of life measures (HRQoL). A random sample of 100 older adults (mean age = 75.34 years, standard deviation = 4.89; 57 women and 43 men) belonging to French sports clubs was recruited for the aim of the study. Participants completed a survey including measures of motivation and health-related quality of life, and socio-demographic and health variables. Cluster analyses revealed two distinct motivational profiles among participants: ‘highly self-determined’ (high levels of self-determined motivation and introjected regulation as well as low levels of external regulation and amotivation), and ‘moderately introjected’ (low levels of self-determined motivation, moderate level of introjected regulation and low levels of external regulation and amotivation). Multivariate analysis of covariance (MANCOVA) results revealed that the most self-determined group reported significantly higher values in four domains of HRQoL, namely role limitations due to physical health, bodily pain, social functioning and role limitations due to emotional health (p = 0.01). These data suggest the importance of taking into account the motivational perspective and considering exercise maintenance among older adults as an important public health challenge.

QUALITY OF LIFE IN PATIENTS WITH THALASSEMIA MAJOR AND INTERMEDIA IN KERMAN-IRAN (I.R.)

Thalassemia is the most common hemoglobin disorder in the world and thalassemia major and intermedia stand among the most severe forms. Due to recent improvements in treatment, patients with thalassemia have longer life expectancies; hence it is of utmost importance to pay careful attention to their quality of life together with life expectancy. This study was conducted to assess the quality of life in patients with thalassemia and also to compare it between thalassemia major and intermedia. In this cross-sectional study, patients who referred for blood transfusion or follow-up visits were evaluated for their quality of life (QOL). Short Form-36 questionnaire was applied to evaluate QOL. In this study, 308 patients with a mean age of 22.95±4.82 years were evaluated. The scores of QOL were regarded as moderate in eight domains under evaluation; the least score was given to General Health (53.05±16.96) whereas the highest score was given to Physical Functioning (67.95±22.68). The QOL in the patients with thalassemia major was better than those with thalassemia intermedia regarding Physical Functioning and Role Limitation Emotional domains. Compared to injecting chelators, patients who received oral chelators showed to have a better QOL considering Social Functioning and Mental Health domain. The patients under study didn’t have a satisfying QOL ; the QOL of patients with thalassemia major was better than that of patients with thalassemia intermedia in only 2 domains of sf-36(Physical Functioning & Role limitation-Emotional). It is then essential that experts pay proper attention to improve QOL among patients.

Quality of life in persons with spinal cord injury: comparisons with other populations

The aim of this study was to identify the quality of life (QOL) measures commonly used to assess patients with spinal cord injury (SCI) and to summarize studies using common QOL measures that have been validated in SCI populations to compare scores in persons with SCI with those in a control population. A systematic search of PubMed was conducted to identify studies using common QOL measures in persons with SCI and those comparing scores for QOL measures in an SCI population with scores in other populations. The authors sought comparative studies utilizing QOL measures for which validity and reliability analyses had been done. Of 28 QOL measures found, validity and reliability studies had been conducted in patients with SCI for 5 measures. Twelve comparative studies compared QOL in SCI patients with QOL in healthy controls or in patients with other disabilities, or with normative data. The 36-Item Short Form Health Survey (SF-36) and the short version of the WHOQOL (WHOQOL-BREF) were the most widely used QOL instruments. Patients with SCI had a decreased QOL as compared with that in healthy controls or normative data, with the most pronounced deficits in the domains of physical functioning and physical role limitations. In 3 studies, patients with tetraplegia had a lower physical domain QOL than did those with paraplegia. Overall, however, the impact of injury level and injury completeness on QOL after SCI remains unclear due to a lack of longitudinal studies. The SF-36 and WHOQOL-BREF are validated instruments that should be considered for use in SCI QOL studies. Future analysis of deficits in QOL among patients with SCI would benefit from the development of a QOL instrument specifically targeted to SCI. Longitudinal studies to assess the impact of injury level and injury completeness on SCI QOL are also needed.

Effect of aerobic training on hot flushes and quality of life—a randomized controlled trial

Background and objective. To estimate whether aerobic training has an effect on frequency of hot flushes or quality of life.Design. A randomized controlled trial.Participants and setting. Symptomatic, sedentary women (n = 176), 43–63 years, no current use of hormone therapy.Intervention. Unsupervised aerobic training for 50 minutes four times per week during 6 months.Outcomes. Hot flushes as measured with Women's Health Questionnaire (WHQ) and Health-Related Quality of Life (HRQoL, SF-36), daily reported hot flushes on phone-based diary, cardiorespiratory fitness (CRF), and body composition.Results. Intervention group had larger decrease in the frequency of night-time hot flushes based on phone diary (P for month × group = 0.012), but not on WHQ scale. Intervention group had less depressed mood (P = 0.01) than control women according to change in WHQ score. Changes in WHQ score in depressed mood (P = 0.03) and menstrual symptoms (P = 0.01) in the intervention group were significantly dependent on frequency of training sessions. HRQoL was improved among the intervention group women in physical functioning (P = 0.049) and physical role limitation (P = 0.017). CRF improved (P = 0.008), and lean muscle mass increased (P = 0.046) significantly in the intervention group as compared to controls.Conclusions. Aerobic training may decrease the frequency of hot flushes and improve quality of life among slightly overweight women.

Effects of Pilates exercises on pain, functional status and quality of life in women with postmenopausal osteoporosis

The present study aimed to evaluate the effects of Pilates exercise program on pain, functional status and quality of life in women with postmenopausal osteoporosis. The study was performed as a randomized, prospective, controlled and single-blind trial. PARTICIPATIONS: Seventy women (age range, 45-65 years) with the diagnosis of postmenopausal osteoporosis were included. Patients were randomly allocated into two groups (home and Pilates exercise groups). Patients in the Pilates exercise group underwent a supervised Pilates exercise program twice a week for one year. Patients in the home exercise group were asked to perform a home exercise program consisting of thoracic extension exercises. Patients were evaluated at baseline and after one year of participation in the exercise programs. Visual Analog Scale for pain, six-minute walking and sit-to-stand tests for functional status, and the Qualeffo-41 Questionnaire and the Short Form-36 (SF-36) for quality of life. Patients were also asked to report the number of falls during the intervention. At the end of the study, the results of 60 patients were analyzed. A significant improvement was noted in all evaluation parameters at the end of the exercise program in the Pilates exercise group. Except for Qualeffo- Leisure Time Activities, SF-36 physical role limitation and emotional role limitation subscales, a significant improvement was noted in all other evaluation parameters at the end of the exercise program in the home exercise group. Improvement was significantly greater in the Pilates exercise group compared to the home exercise group in all parameters. Pilates exercises may be a safe and an effective treatment alternative for the quality of life in patients with postmenopausal osteoporosis.

Quality of Life Assessment in Patients with Multiple Sclerosis Receiving Interferon Beta-1a: A Comparative Longitudinal Study of Avonex and Its Biosimilar CinnoVex.

Background. Multiple sclerosis (MS) is an autoimmune inflammatory disease of central nervous system (CNS). MS affects quality of Life (QOL) due to physical disability and other associated problems. Disease-modifying agents like interferon beta (IFNB) have been widely utilized in this patient population; however, their frequency, route of administration, side effects, high cost, and also the question of whether they are truly beneficial for longer-term outcomes and QOL need to be further investigated. Objectives. To assess QOL in patients with multiple sclerosis receiving interferon beta-1a (Avonex or CinnoVex) and in order to compare QOL in groups receiving Avonex and CinnoVex, respectively, also, to evaluate whether the more cost-effective biosimilar form of IFNB (CinnoVex) has the same effect on QOL and can be substituted for Avonex. Methods. We conducted a 30-month, nonrandomized longitudinal study and recruited a total of 92 patients diagnosed with relapsing-remitting MS. The patients were distributed in Avonex and CinnoVex groups with 46 patients in each group. Quality of life was assessed by means of MSQOL-54 questionnaire, four times a year, at baseline and at months 4, 8, and 12 of the study. Results. Mean age ± SD was 30.5 ± 8.9 and 32.3 ± 9.0 years in Avonex and CinnoVex groups, respectively, and P value of gender was different (P value : 0.036). The physical health composite scores were 61.8 and 59.8 (P values 0.677 and 0.884) for Avonex and CinnoVex groups, in that order. The results of the study revealed no significant difference between the two groups with regard to physical health, health perception, energy, and role limitations due to physical problems, pain, sexual and social function, and physical health distress scores. Further, interferon therapy did not significantly impact patients' QOL after a year of treatment with either Avonex or CinnoVex. Conclusions. According to the present study, treatment with IFNB (Avonex or CinnoVex) did not affect QOL during a year of therapy. Further studies with longer follow-up periods are required to assess the value of interferons on long-term outcomes and patient's QOL.

Relationship between Kt/V urea-based dialysis adequacy and nutritional status and their effect on the components of the quality of life in incident peritoneal dialysis patients

BackgroundIt is well known that the quality of life of patients with chronic kidney disease can be improved by dialysis. While previous studies have used retrospective designs and adhered to a standard target prescribed by clinical guidelines, our study prospectively investigates the association between the adequacy of peritoneal dialysis (PD) and measures of nutritional status on quality-of-life domains in a cohort of incident PD patients.MethodsIt was a prospective 6-month observational study. Eighty incident PD participants who were treated in a hospital-based PD center were enrolled. The period of enrollment was January 2009–June 2010; follow-up continued until December 2010. PD adequacy indices, including Kt/V urea, weekly Ccr (WCcr), measures of nutritional status (albumin, BMI), and nPCR were measured at 1 month and 6 months after PD initiation. SF-36 health survey questionnaires were used to measure the quality of life. The outcomes were used to measure the changes in the domains of the SF-36 after 6 months of PD therapy.ResultsSeventy-seven incident patients who underwent PD for 6 months were included in the study. The mean age was 47.3 years, and the male-to-female ratio was 38:39. A peritoneal Kt/V urea value of 1.2, which was also the baseline cutoff value, was found to have the highest influence on SF-36 domains. Patients with baseline peritoneal Kt/V urea value of <1.2 showed improvement in the physical functioning and role limitation of physical functioning components after 6 months of PD. In contrast, patients with baseline peritoneal Kt/V urea values of ≥1.2 showed remarkable improvement in the general health, physical functioning, role limitation caused by physical problems, and bodily pain components. However, the trend of improvement decreased in patients with baseline nPCR of <1.2. Baseline renal WCcr did not influence the improvement in the SF-36 domains.LimitationsA small cohort and a short observation period.ConclusionsThe baseline level of peritoneal Kt/V urea affected the components of the quality of life after PD initiation. In contrast, a lower baseline nPCR level was associated with deterioration in the quality of life after PD therapy.

Assessing the effects of oral health-related variables on quality of life in Taiwanese adults

The impact of oral health status on Taiwanese adults' quality of life has not been measured definitively. This study evaluated the effects of oral health-related variables on quality of life among adults in Taiwan. A cross-sectional study design with secondary database analysis was adopted. Information about oral health-related variables in adults aged 18-64 years was collected from the National Health Interview Survey and quality-of-life data from the Short-Form Health Survey (SF-36). Univariate and multivariate regression analysis was used to determine risk factors for oral health and associations between oral health and eight domains of quality of life defined by the SF-36. Gender (P < 0.001), marital status (P < 0.001), monthly income (P < 0.001), disease history (P < 0.001), betel nut chewing (P < 0.001), oral hygiene (P < 0.001), oral health status (P < 0.001), and dental care utilization (P = 0.001) had significant effects on general health as an aspect of quality of life; gender (P < 0.001), marital status (divorced, P < 0.001), income level (20,000-80,000 NTD, P < 0.001), disease history (P < 0.001), oral hygiene, oral health-related food choice limitations (P < 0.001), and dental care utilization (P < 0.001) had significant effects on general mental health. Subjects who practiced dental self-care with tooth brushing had significantly higher social functioning scores than those who did not (P < 0.001). Significant differences were also found in scale items for physical functioning, role limitations due to physical health, bodily pain, vitality, and role limitations due to emotional problems (all P < 0.001). Demographic (i.e., age, gender, and marital status and income levels) and oral health-related factors (i.e., oral hygiene, dental visits, disease history, and lifestyle factors such as cigarette smoking, alcohol use, and betel nut chewing) are all significantly associated with oral health-related quality of life in Taiwanese adults.

Personality Disorders and Physical Health: A Longitudinal Examination of Physical Functioning, Healthcare Utilization, and Health-Related Behaviors in Middle-Aged Adults

Personality disorders (PDs) have significant, long-term effects in many areas, including physical health outcomes such as increased risk for chronic disease and mortality. Although research has documented this detrimental impact in relation to long-term physical health, no one has explored the more immediate influence of disordered personality on aspects of physical functioning, such as pain level, or health-related behaviors, such as medication use. The present study examined the unique effects of PD features on physical functioning, medical resource utilization, and prescription medication use to determine potential risk associated with PDs. We studied an epidemiologically-based sample (N = 608) of Saint Louis residents (ages 55-64) over two time points (6 months apart). We found that disordered personality was significantly predictive of worse physical functioning, role limitations, fatigue, and pain at both time points, even when current health problems, the presence of depression, and health behaviors (i.e., smoking, drinking, exercise) were controlled. PD features were also predictive of increased healthcare utilization and medication use at follow-up. These results suggest that the presence of disordered personality may be an important risk factor for worse functioning, regardless of actual health status.

PTU-150 Quality of life before and after intestinal transplantation

IntroductionSurvival following intestinal transplantation has substantially improved over the last decade and if this trend continues quality of life (QOL) may be considered as a major indication for transplantation. It...

Health-related quality of life and anemia in hospitalized patients with heart failure

BackgroundAnemia is a serious and highly prevalent co-morbidity in chronic heart failure (HF) patients. Its influence on health-related quality of life (HR-QoL) has rarely been studied, and no data is available regarding the role it plays in hospitalized HF patients. MethodsBaseline data from the COACH study (Coordinating study evaluating Outcomes of Advising and Counselling in Heart Failure) were used. HR-QoL was assessed by means of generic and disease-specific questionnaires. Analyses were performed using ANOVA and ANCOVA, with covariates of age, gender, eGFR, diabetes, and NYHA class. ResultsIn total, 1013 hospitalized patients with a mean age of 71 (SD 11) years were included; 70% of these patients had no anemia (n=712), 14% had mild anemia (n=141), and 16% had moderate-to-severe anemia (n=160). Independent associations were found between anemia and physical functioning (p=0.019), anemia and role limitations due to physical functioning (p=0.002), anemia and general health (p=0.024), and anemia and global well-being (p=0.003). ConclusionIn addition to the burden of HF itself, anemia is an important factor which influences HR-QoL in hospitalized HF patients, and one that is most pronounced in the domain related to physical functioning and general health.

A cross-cultural validation of patient-reported outcomes measures: a study of breast cancers survivors

Psychometric inadequacy interferes with the assessment of patient-reported health outcomes. This study examined the psychometric properties of several standardized measures in health research. Participants completed health outcomes measures including the FACT-G, SF-36, MOS Social Support Survey, and CES-D. Psychometric properties examined include reliability, and construct and concurrent validity. 320 BCS including 88 African-, 95 English-proficient Latina-, and 137 Limited English-proficient Latina-Americans participated. The findings demonstrate acceptable reliability (α > 0.70) and consistent factor structures for most measures with the variance ranging from 56 to 84%. The FACT-G physical well-being and SF-36 role limitations subscales had the best fitting structures. Concurrent validity showed the FACT-G subscales correlated with their appropriate counterparts. Despite being commonly used instruments in HRQOL (e.g., FACT-G, SF-36) and QOL (e.g., CES-D, MOS) research, few studies reported the psychometric properties of these and when applied cross-culturally. However, evaluating the psychometric properties of measures in health outcomes research should be done routinely.

The influence of subcortical ischemic lesions on cognitive function and quality of life in late life depression

Subcortical ischemic lesions (SIL) are known to contribute to the pathogenesis of late life depression. The present study examined the influence of SIL on cognitive function and quality of life in elderly Koreans with major depressive disorder (MDD). MDD patients (n=86) underwent CT scans and were classified as having SIL if they had a score of 2 or above on age-related white matter changes (ARWMC) scale. Demographic data, psychiatric, medical history, neuropsychological test, quality of life, and depressive symptomatology were compared between MDD patients with and without SIL. SIL with grade 2 or above were found in deep white matter of 22 (25.6%) depressed patients and in basal ganglia of 9 (10.5%) depressed patients. Depressed patients with deep white matter lesions showed poor performance on MMSE-KC and decreased quality of life, particularly in physical function and physical role limitation, as compared to depressed patients without deep white matter lesions. These data support that SIL may cause general cognitive dysfunction and poor physical health. More attention should be paid to detection and management of SIL in late life depression in clinical setting.

Health-related quality of life and biomarkers in breast cancer survivors participating in tai chi chuan

Breast cancer survivors experience diminished health-related quality of life (HRQOL). We report on the influence of tai chi chuan exercise (TCC) on HRQOL and explore associations between changes in HRQOL and biomarkers. Breast cancer survivors (N = 21) were randomly assigned to TCC or standard support therapy (SST) for 12weeks (three times/week; 60min/session). Interleukin-6, interleukin-8 (IL-8), insulin-like growth factor-1 (IGF-1), insulin-like growth factor-binding protein (IBFBP)-1, IGFBP-3, glucose, insulin, and cortisol were measured pre- and postintervention. Overall HRQOL and subdomains were assessed at preintervention (T1), midintervention (T2) and postintervention (T3) and biomarkers at T1 and T3. The TCC group improved in total HRQOL (T1-T2:CS = 8.54, P = 0.045), physical functioning (T1-T2:CS = 1.89, P = 0.030), physical role limitations (T1-T2 CS = 1.55, P = 0.023), social functioning (T1-T3:CS = 1.50, P = 0.020), and general mental health (T1-T2:CS = 2.67, P = 0.014; T1-T3:CS = 2.44, P = 0.019). The SST improved in social functioning (T1-T2:CS = 0.64, P = 0.043) and vitality (T1-T2:CS = 0.90, P = 0.01). There were relationships between changes in IGF-1 and overall HRQOL (r = -0.56; P < 0.05), physical role limitation (r = -0.68; P < 0.05), and social functioning (r = -0.56; P < 0.05). IGFBP-1 changes were associated with physical role limitations changes (r = 0.60; P < 0.05). IGFBP-3 changes were associated with physical functioning changes (r = 0.46; P ≤ 0.05). Cortisol changes were associated with changes in physical role limitations (r = 0.74; P < 0.05) and health perceptions (r = 0.46; P < 0.05). Glucose changes were associated with emotional role limitation changes (r = -0.70; P < 0.001). IL-8 changes were associated with emotional role limitation changes (r = 0.59; P < 0.05). TCC may improve HRQOL by regulating inflammatory responses and other biomarkers associated with side effects from cancer and its treatments. TCC may be an intervention capable of improving HRQOL in breast cancer survivors.