Sex Differences In Health-related Quality Research Articles

Sex differences in health-related quality of life among older Korean adults with type 2 diabetes mellitus: a cross-sectional study

Objectives: This cross-sectional study examined sex differences in Health-Related Quality of Life (HRQoL) among seniors with Type 2 Diabetes Mellitus (T2DM).Methods: Data from the Korea National Health and Nutrition Examination Survey (2008–2020) were analyzed. The EuroQol-5 Dimensions (EQ-5D), a measure of HRQoL, was used. It comprises five dimensions: mobility, self-care, usual activity, pain/discomfort, and anxiety/depression, each with three levels.Results: Analysis of 3,826 older adults with T2DM showed a significant increasing trend in the EQ-5D Index from the 4th survey phase onwards (P for trend < 0.001 for both men and women). Men consistently reported higher EQ-5D levels than women across all survey years. Women’s EQ-5D levels remained lower than men’s, maintaining a decade-old disparity (P < 0.05). Men scored significantly higher (P < 0.05) in most EQ-5D domains, except for self-care and anxiety/depression, resulting in a higher total EQ-5D Index (P = 0.001). Increased comorbidities were strongly associated with lower EQ-5D levels in both sexes. Additionally, there was a negative correlation between the EQ-5D Index and refined grain intake for both sexes (P for trend < 0.001), with high-EQ-5D groups consuming fewer refined grains. Women in the high-EQ-5D group consumed more nuts, vegetables, and meat compared to men (P for trend < 0.05).Conclusions: Our study highlights the sex disparities in HRQoL among older adults with T2DM. The findings suggest the need for tailored treatment guidelines aimed at improving the HRQoL of elderly T2DM patients, with a focus on their sex-specific characteristics. Implementing these tailored guidelines could enhance the HRQoL of older women with T2DM and promote more equitable healthcare outcomes. This underscores the importance of considering sex differences to comprehensively improve the well-being of this population.

Sex differences in health-related quality of life and psychological distress among colorectal cancer patients: a 2-year longitudinal study.

While sex differences in the incidence and mortality of colorectal cancer (CRC) are well documented, less is known about sex differences in patients' health-related quality of life (HRQoL) and psychological distress. To enhance patient-tailored care, we aimed to longitudinally examine sex differences in HRQoL and psychological distress among CRC patients from diagnosis up until 2-year follow-up. Newly diagnosed CRC patients from four Dutch hospitals were eligible for participation. Patients (N = 334) completed questions on HRQoL (EORTC QLQ-C30) and psychological distress (HADS) before initial treatment (baseline), 4 weeks after surgery, and at 1 and 2 years after diagnosis. Also, HRQoL and psychological distress were assessed in a sex- and age-matched reference population. When directly comparing female (N = 126, 38%) and male (N = 208, 62%) CRC patients, female patients reported significantly worse HRQoL, such as more insomnia at baseline, worse physical and role functioning 4 weeks after surgery, more diarrhea at 1 year, and more pain and constipation at 2-year follow-up. However, a comparison with the reference population revealed larger differences between patients and reference in males than in females. For example, at 1- and 2-year follow-up, male patients reported significantly worse cognitive and social functioning, more insomnia, and more anxiety compared with a reference population. Especially male CRC patients reported worse HRQoL and more psychological distress when compared with a reference population. Knowledge of sex-specific differences in HRQoL and psychological distress among CRC patients may help healthcare providers anticipate and appropriately address patients' unique healthcare needs.

Sex differences in health-related quality of life and poverty risk among older people living with HIV in Spain: A cross-sectional study.

Current antiretroviral therapies have increased the life expectancy of people living with HIV (PLHIV). There is, however, limited evidence regarding the health-related quality of life (HRQoL) and living conditions of older people living with HIV (OPLHIV) in Spain. We implemented a self-administered online questionnaire to identify sex differences in HRQoL and poverty risk among Spanish OPLHIV (PLHIV ≥50 years). Participants were contacted through non-governmental organisations. We used the standardised WHOQoL-HIV BREF questionnaire and the Europe 2020 guidelines to estimate HRQoL and poverty risk respectively. The statistical analysis included multivariable generalised linear models with potential confounding variables and robust estimates. The study included 247 OPLHIV (192 men and 55 women). On the WHOQoL-HIV BREF questionnaire, men scored higher on 84% of items and in all six domains. Women had significantly lower HRQoL in five domains: physical health (β: -1.5; 95% CI: -2.5, -0.5; p: 0.002), psychological health (β: -1.0; 95% CI: -1.9, -0.1; p: 0.036), level of independence (β: -1.1; 95% CI: -1.9, -0.2; p: 0.019), environmental health (β: -1.1; 95% CI: -1.8, -0.3; p: 0.008), and spirituality/personal beliefs (β: -1.4; 95% CI: -2.5, -0.3; p: 0.012). No statistical differences were found in the domain of social relations. Poverty risk was considerable for both men (30%) and women (53%), but women were significantly more likely to experience it (OR: 2.9; 95% CI: 1.3, 6.5; p: 0.009). The aging of PLHIV is a public health concern. Our findings indicate that HRQoL and poverty risk among Spanish OPLHIV differ significantly by sex. Spain should, therefore, implement specific policies and interventions to address OPLHIV needs. The strategies must place a high priority on the reduction of sex inequalities in HRQoL and the enhancement of the structural conditions in which OPLHIV live.

Gender and Sex Differences in Health-related Quality of Life, Clinical Outcomes and Survival after Treatment of Metastatic Spine Disease.

Retrospective review of prospective, multicenter and international cohort study. To describe the effect of gender on HRQoL, clinical outcomes and survival for patients with spinal metastases treated with either surgery and/or radiation. Gender differences in health-related outcomes are demonstrated in numerous studies, with women experiencing worse outcomes and receiving lower standards of care than men, however, the influence that gender has on low health-related quality of life (HRQoL) and clinical outcomes after spine surgery remains unclear. Patient demographic data, overall survival, treatment details, perioperative complications, and HRQoL measures including EQ-5D, pain NRS, the short form 36 version 2 (SF-36v2) and the Spine Oncology Study Group Outcomes Questionnaire (SOSGOQ2.0) were reviewed. Patients were stratified by sex, and a separate sensitivity analysis that excluded gender-specific cancers (i.e., breast, prostate, etc.) was performed. The study cohort included 207 female and 183 male patients, with age, smoking status, and site of primary cancer being significantly different between the two cohorts (P<0.001). Both males and females experienced significantly improved SOSGOQ2.0, EQ-5D, and pain NRS scores at all study time points from baseline (P<0.001). Upon sensitivity analysis, (gender-specific cancers removed from analysis), the significant improvement in SOSGOQ physical, mental, and social subdomains and on SF-36 domains disappeared for females. Males experienced higher rates of postoperative complications. Kaplan-Meier survival analysis of both the overall and sensitivity analysis cohorts showed females lived longer than males after treatment (P=0.001 and 0.043, respectively). Both males and females experienced significantly improved HRQoL scores after treatment, but females demonstrated longer survival and a lower complication rate. This study suggests that gender may be a prognostic factor in survival and clinical outcomes for patients undergoing treatment for spine metastases and should be taken into consideration when counseling patients accordingly.

Sex differences in health-related quality of life trajectories following myocardial infarction: national longitudinal cohort study

ObjectivesTo investigate sex-based differences in baseline values and longitudinal trajectories of health-related quality of life (HRQoL) in a large cohort of myocardial infarction (MI) survivors after adjusting for other important...

Weight Loss in Advanced Cancer: Sex Differences in Health-Related Quality of Life and Body Image.

Weight maintenance is a priority in cancer care, but weight loss is common and a serious concern. This study explores if there are sex differences in the perception of weight loss and its association to health-related quality of life (HRQoL) and body image. Cancer patients admitted to Advanced Medical Home Care were recruited to answer a questionnaire, including characteristics, the HRQoL-questionnaire RAND-36, and a short form of the Body Image Scale. Linear regression analyses stratified by sex and adjusted for age were performed to examine associations between percent weight loss and separate domains of HRQoL and body image score in men and women separately. In total, 99 participants were enrolled, of which 80 had lost weight since diagnosis. In men, an inverse association between weight loss and the HRQoL-domain physical functioning, β = −1.34 (95%CI: −2.44, −0.24), and a positive association with body image distress, β = 0.22 (95%CI: 0.07, 0.37), were found. In women, weight loss was associated with improvement in the HRQoL-domain role limitations due to physical health, β = 2.02 (95%CI: 0.63, 3.41). Following a cancer diagnosis, men appear to experience weight loss more negatively than women do. Recognizing different perceptions of weight loss may be of importance in clinical practice.

Sex Differences in Health-related Quality of Life in Patients with Keratinocyte Carcinomas.

The difference between men and women in the impact of keratinocyte carcinomas on quality of life has not been widely studied. This study of 364 patients with keratinocyte carcinoma, measured quality of life using the self-administered 12-item Short Form Health Survey (SF-12) and Skindex-29. Results for both the physical and the mental components of SF-12 were worse in women than in men. For the mental component, women had significantly lower scores compared with men in almost all subgroups, based on demographic and clinical variables. The Skindex-29 emotions mean score was worse in women than in men. Women reported significantly higher level of worry that the disease could get worse and of developing scars, and more depression. On the other hand, men reported lower quality of sleep. The impact of keratinocyte carcinomas on quality of life is generally higher in women than in men. Such data may be important for tailored management of the disease in different categories of patients.

Sex differences in health-related quality of life among acute myocardial infarction survivors: an inverse weighted propensity score analysis

Abstract Background Over 800,000 women in the UK are living with coronary heart disease, which is the main cause of acute myocardial infarction (AMI). Marked improvements have been noted in clinical outcomes following AMI due to improved use of evidence-based treatments. However, sex differences in outcomes following AMI persist, with limited evidence in the literature concerning patient reported outcomes such as health related quality of life (HRQoL). Purpose To investigate sex differences in HRQoL following AMI. Methods Data on HRQoL among 9,566 survivors of AMI were collected from 77 National Health Service hospitals in England between 1 November 2011 and 24 June 2015. HRQoL at time of hospitalisation with an AMI as well as at 1, 6 and 12 months post discharge were collected using the self-reported EuroQol five dimension questionnaire which contains a descriptive system (EQ-5D ranging from −0.5 “worse than death” to 1 “full health”) and a visual analogue scale (EQ-VAS ranging from 0 “worst imaginable health state” to 100 “best imaginable health state”). Multilevel regression modelling coupled with inverse probability weighting propensity score analysis was used to investigate longitudinal trajectories of sex differences in perceived HRQoL following AMI. Results Overall, there were 2,397 (25%) women in the study. HRQoL improved over time, however, women had a lower baseline HRQoL compared with men (EQ-VAS mean (SD) 59.8 (20.4) vs. 64.5 (20.9), and EQ-5D median (IQR) 0.73 (0.52 to 0.88) vs. 0.81 (0.62 to 1.00). Sex differences in HRQoL over time persisted, with women having a reduced HRQoL (EQ-VAS coefficient: −4.41, 95% CI: −5.16 to −3.66 and EQ-5D coefficient: −0.07, −0.08 to −0.06) and across the individual EQ-5D dimensions women were more likely to report problems with anxiety (odds ratio 2.03, 95% CI: 1.80 to 2.29), mobility (1.82, 1.58 to 2.09), self-care (1.75, 1.47 to 2.08), usual activities (1.70, 1.52 to 1.89) and pain (1.59, 1.45 to 1.75). Conclusion Although quality of life improves for AMI survivors, women have a lower baseline and worse recovery compared with men. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): British Heart Foundation, Wellcome Trust, Sir Henry Wellcome Postdoctoral Fellowship

Sex differences in relation patterns between health-related quality of life of older adults and its correlates: a population-based cross-sectional study in Madeira, Portugal.

A population-based cross-sectional study aimed to examine sex differences in health-related quality of life (HRQoL) of older adults, and investigate whether the relation patterns between HRQoL and its correlates differed between sexes. A stratified proportional and representative sample included 802 volunteers, aged 60-79. HRQoL (36-item Short Form Health Survey), functional fitness (Senior Fitness Test), physical activity (PA) (Baecke questionnaire), demographic information and health features (questionnaires) were assessed. Men showed significantly higher HRQoL (P<0.001). Body mass index, body strength, aerobic endurance, PA, depressive symptoms, falls, and living alone were significantly related to HRQoL. With sex as moderator, these relations were not significant, except for PA (β=0.12, P=0.004). A significant interaction of sex with PA on HRQoL (β=0.08, P=0.037) was found, indicating that this relation was higher in men. A similar relation pattern was found for HRQoL physical component. HRQoL and its correlates differed between sexes, demanding a sex specific approach to promote HRQoL.

Evaluation of sex differences in health-related quality of life outcomes associated with child abuse: Results from the Ontario Child Health Study.

Despite the advances in child maltreatment research, there is still the need for comprehensive information about how abuse affects a broad range of categories of young adult functioning, and the extent to which these vary by sex. We examined the associations between child physical abuse (PA) and sexual abuse (SA) and six areas of functioning (mental health, physical health, life satisfaction, illegal substance use, alcohol problems and daily smoking). Data were obtained from the 1983 Ontario Child Health Study and follow-up in 2000/2001 (n=1893). Multilevel regression estimated the adjusted associations for PA (with severity) and SA with each of the outcomes. Estimates with an entire sample were presented with sex-by-abuse interactions to examine sex differences and then presented separately by sex. In the adjusted model, severe PA and SA were associated with impairment in mental health, and both forms of PA (severe and non-severe) and SA were associated with low life satisfaction. In addition, severe PA was associated with illegal substance use. Child abuse variables were not associated with poor physical health, alcohol problems or smoking. Although sex-stratified analyses revealed different patterns, there was no significant sex difference in the integrated sample. This is among the first community-based studies to show a strong association between child PA and SA and low life satisfaction in young adults. The abuse effects were similar for both sexes.

Sex differences in health-related quality of life among adult stroke patients in Northeastern China

Inconsistent results have been reported for the impact of sex on stroke outcomes. We investigated the differences in health-related quality of life between adult male and female stroke survivors in Northeastern China. Information on background variables was collected during hospital stay. Follow-up data were obtained through a phone interview 6months after discharge, which included the Barthel Index and a 36-Item Short-Form Health Survey (SF-36) reflecting overall health status. The independent effects of sex on activities of daily living independence (Barthel Index ⩾95) were analyzed. Our results showed that female stroke patients were older than male stroke patients and were more likely to have transient ischemic attack and hypertension. Male stroke patients were more likely to have a history of smoking, heart disease and dyslipidemia, while female patients were less likely to achieve daily living independence. The mean scores of physical functioning, bodily pain, vitality, social functioning, emotional role, and mental health in the SF-36 survey were significantly higher in men than woman. Regression analyses confirmed that female sex was adversely associated with overall health status at discharge. In conclusion, our data demonstrated that there were sex differences in stroke recovery and quality of life among Chinese stroke survivors at 6months post-discharge, with an overall worse stroke outcome for female stroke survivors.

Sex differences in health‐related quality of life impairment associated with eating disorder features: A general population study

To determine sex differences in the prevalence and impact of specific eating disorder features on health-related quality of life (HRQoL). A general population sample of men (n = 1,479) and women (n = 1,555) completed interviews that assessed HRQoL (Medical Outcomes Study Short Form, SF-36), and current regular occurrence of binge eating, extreme dietary restriction, purging, and overevaluation of weight or shape. Men constituted a substantial minority (23-41%) of participants reporting eating disorder features. Objective binge eating had a greater impact on mental health impairment in men versus women, whereas the overevaluation of weight or shape had a greater impact on general and mental health impairment in women compared with men. Eating disorder features that impact on HRQoL are now common in men; however, the impact of specific features may differ between sexes.

Understanding sex differences in health-related quality of life following myocardial infarction

Background The role of sex differences in health-related quality of life (HRQoL) after myocardial infarction (MI) remains controversial. Methods In total 408 Norwegian patients completed the Short Form 36 (SF-36) questionnaire 2.5 years after MI. We compared HRQoL between sexes and with national norms. Multiple linear regression analysis was used to explore the association of scores on the Physical (PCS) and Mental (MCS) component summary scales with clinical and sociodemographic variables. Results Women scored lower than norms on the Physical functioning, Role functioning-physical, General health, and Role functioning-emotional scales. Men scored higher on Bodily pain, and lower on the other 7 scales compared to norms. Women < 70 years scored lower than men on 3 out of 8 scales and on PCS. Women ≥ 70 scored lower than men on 5 out of 8 scales and on PCS. Relative to sex- and age-specific norms, there were no sex-differences in SF-36 scores. Age, time since the index MI, chronic obstructive pulmonary disease (COPD), previous MI, and stroke predicted PCS scores in women. Education, COPD, infarct localization, number of indications for cardiovascular medication at discharge, medication for heart failure, and subsequent MI predicted PCS scores in men. Smoking status, education, and Q-wave MI were determinants for MCS scores in men. Conclusion Patients had impaired HRQoL compared to sex- and age-specific norms 2.5 years after MI. Women had lower HRQoL scores than men, but relative to norms HRQoL was equally affected in both sexes. Men and women had different determinants of HRQoL.

Are There Sex Differences in Health-Related Quality of Life After Lung Transplantation for Chronic Obstructive Pulmonary Disease?

The primary study aim was to examine sex differences in health-related quality of life (HRQoL) in a sample of 37 patients (20 men, 17 women) with chronic obstructive pulmonary disease (COPD) who were evaluated both before and after lung transplantation. Main outcome measures were change in HRQoL from pre- to post-transplantation assessment as measured by the Short Form-36 Health Survey, Transplant Symptom Frequency Questionnaire, forced expiratory volume in 1 second percent predicted, and 6-minute walk test. Study findings showed (1) substantial gains in HRQoL, lung function, and physical endurance for most patients, (2) significant sex differences, with women reporting more frequent and problematic symptoms and a lower percentage gain in HRQoL than men, and (3) a higher percentage gain on spirometry findings after transplantation for women than for men. We conclude that there may be a need to examine the post-transplantation symptom profile of women and men separately.