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Associations between illness duration and health-related quality of life in specified mental and physical chronic health conditions: results from a population-based survey

Quality of Life Research volume 26, pages 2671–2681 (2017)Cite this article

Abstract

Purpose

We compared health-related quality of life (HRQOL) in incident (≤1 year since diagnosis), mid-term (>1–5 years since diagnosis), and long-term (>5 years since diagnosis) cases of mental and physical chronic illness with the general population and assessed the modifying effects of age and gender on the association between HRQOL and illness duration.

Methods

Data from the 2007 Australian National Health and Mental Wellbeing Survey were used. HRQOL was captured by the Assessment of Quality of Life Scale 4D. Multivariable linear regression analyses compared HRQOL of individuals with different duration of illnesses with those who did not have the condition of interest.

Results

The 8841 survey respondents were aged 16–85 years (median 43 years, 50.3% female). For the overall sample, worse HRQOL was associated with incident (P = 0.049) and mid-term (P = 0.036) stroke and long-term depression (P < 0.001) and anxiety (P = 0.001). Age had moderating effect on the associations between HRQOL and duration of asthma (P < 0.001), arthritis (P = 0.001), diabetes (P = 0.004), stroke (P = 0.009), depression (P < 0.001), bipolar disorder (P < 0.001), and anxiety (P < 0.001), but not heart disease (P = 0.102). In older ages, the greatest loss in HRQOL was associated with incident asthma, depression, and bipolar disorder. In younger ages, the greatest loss in HRQOL was associated with arthritis (any duration) and incident diabetes and anxiety. Additionally, gender moderated the association between HRQOL and arthritis, with worse HRQOL among men with incident arthritis (P = 0.047).

Conclusions

Loss of HRQOL associated with longer duration of chronic illness is most apparent in stroke and mental illness and differs between age groups.

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References

  1. Vos, T., Flaxman, A. D., Naghavi, M., Lozano, R., Michaud, C., Ezzati, M., et al. (2012). Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet, 380(9859), 2163–2196.

    Article  PubMed  Google Scholar 

  2. Global Burden of Disease Study, C. (2015). Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet, 386(9995), 743–800.

    Article  Google Scholar 

  3. Megari, K. (2013). Quality of life in chronic disease patients. Health Psychology Research, 1(3), e27.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Wilmot, E., & Idris, I. (2014). Early onset type 2 diabetes: Risk factors, clinical impact and management. Therapy Advanced Chronic Disease, 5(6), 234–244.

    Article  Google Scholar 

  5. Alonso, J., Ferrer, M., Gandek, B., Ware, J. E., Jr., Aaronson, N. K., Mosconi, P., et al. (2004). Health-related quality of life associated with chronic conditions in eight countries: Results from the International Quality of Life Assessment (IQOLA) Project. Quality of Life Research, 13(2), 283–298.

    Article  PubMed  Google Scholar 

  6. Ko, Y., & Coons, S. J. (2006). Self-reported chronic conditions and EQ-5D index scores in the US adult population. Current Medical Research and Opinion, 22(10), 2065–2071.

    Article  PubMed  Google Scholar 

  7. Lam, C. L., & Lauder, I. J. (2000). The impact of chronic diseases on the health-related quality of life (HRQOL) of Chinese patients in primary care. Family Practice, 17(2), 159–166.

    CAS  Article  PubMed  Google Scholar 

  8. Schlenk, E. A., Erlen, J. A., Dunbar-Jacob, J., McDowell, J., Engberg, S., Sereika, S. M., et al. (1998). Health-related quality of life in chronic disorders: A comparison across studies using the MOS SF-36. Quality of Life Research, 7(1), 57–65.

    CAS  Article  PubMed  Google Scholar 

  9. Fischer, M., Scharloo, M., Abbink, J., van ‘t Hul, A., van Ranst, D., Rudolphus, A., et al. (2010). The dynamics of illness perceptions: Testing assumptions of Leventhal’s common-sense model in a pulmonary rehabilitation setting. British Journal of Health Psychology, 15(Pt 4), 887–903.

    Article  PubMed  Google Scholar 

  10. Livneh, H. (2001). Psychosocial adaptation to chronic illness and disability: A conceptual framework. Rehabilitation Counselling Bulletin, 44(3), 151–160.

    Article  Google Scholar 

  11. Stewart, D. E., & Yuen, T. (2011). A systematic review of resilience in the physically ill. Psychosomatics, 52(3), 199–209.

    Article  PubMed  Google Scholar 

  12. Xu, W., Collet, J.-P., Shapiro, S., Lin, Y., Yang, T., Wang, C., et al. (2010). Negative impacts of unreported COPD exacerbations on health-related quality of life at 1 year. European Respiratory Journal, 35(5), 1022–1030.

    CAS  Article  PubMed  Google Scholar 

  13. Silverman, S. L., Piziak, V. K., Chen, P., Misurski, D. A., & Wagman, R. B. (2005). Relationship of health related quality of life to prevalent and new or worsening back pain in postmenopausal women with osteoporosis. Journal of Rheumatology, 32(12), 2405–2409.

    PubMed  Google Scholar 

  14. Karlsen, K. H., Tandberg, E., Arsland, D., & Larsen, J. P. (2000). Health related quality of life in Parkinson’s disease: A prospective longitudinal study. Journal of Neurology, Neurosurgery and Psychiatry, 69(5), 584–589.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  15. Dadgostar, H., Firouzinezhad, S., Ansari, M., Younespour, S., Mahmoudpour, A., & Khamseh, M. E. (2016). Supervised group-exercise therapy versus home-based exercise therapy: Their effects on quality of life and cardiovascular risk factors in women with type 2 diabetes. Diabetes Syndrome, 10(2, Supplement 1), S30–S36.

    Article  Google Scholar 

  16. Kosinski, M., Kujawski, S. C., Martin, R., Wanke, L. A., Buatti, M. C., Ware, J. E., Jr., et al. (2002). Health-related quality of life in early rheumatoid arthritis: Impact of disease and treatment response. American Journal Management Care, 8(3), 231–240.

    Google Scholar 

  17. Dayapoglu, N., & Tan, M. (2010). Quality of life in stroke patients. Neurology India, 58(5), 697–701.

    Article  PubMed  Google Scholar 

  18. Mokrowiecka, A., Pinkowski, D., Malecka-Panas, E., & Johnson, C. D. (2010). Clinical, emotional and social factors associated with quality of life in chronic pancreatitis. Pancreatology, 10(1), 39–46.

    CAS  Article  PubMed  Google Scholar 

  19. Scire, C. A., Manara, M., Cimmino, M. A., Govoni, M., Salaffi, F., Punzi, L., et al. (2013). Gout impacts on function and health-related quality of life beyond associated risk factors and medical conditions: Results from the KING observational study of the Italian Society for Rheumatology (SIR). Arthritis Research Therapy, 15(5), R101.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Ariza-Ariza, R., Hernandez-Cruz, B., Lopez-Antequera, G., & Navarro-Sarabia, F. (2009). Variables related to utility in patients with ankylosing spondylitis. Clinical Rheumatology, 28(2), 207–211.

    Article  PubMed  Google Scholar 

  21. Sparring, V., Nystrom, L., Wahlstrom, R., Jonsson, P. M., Ostman, J., & Burstrom, K. (2013). Diabetes duration and health-related quality of life in individuals with onset of diabetes in the age group 15–34 years—A Swedish population-based study using EQ-5D. BMC Public Health, 13, 377.

    Article  PubMed  PubMed Central  Google Scholar 

  22. van Rhijn, B. D., Smout, A. J., & Bredenoord, A. J. (2014). Disease duration determines health-related quality of life in adult eosinophilic esophagitis patients. Neurogastroenterology and Motility, 26(6), 772–778.

    Article  PubMed  Google Scholar 

  23. Arat, S., Verschueren, P., De Langhe, E., Smith, V., Vanthuyne, M., Diya, L., et al. (2012). The association of illness perceptions with physical and mental health in systemic sclerosis patients: An exploratory study. Musculoskeletal Care, 10(1), 18–28.

    Article  PubMed  Google Scholar 

  24. Rini, C., Jandorf, L., Valdimarsdottir, H., Brown, K., & Itzkowitz, S. H. (2008). Distress among inflammatory bowel disease patients at high risk for colorectal cancer: A preliminary investigation of the effects of family history of cancer, disease duration, and perceived social support. Psychooncology, 17(4), 354–362.

    Article  PubMed  Google Scholar 

  25. Kuriyama, M., Kato, J., Kuwaki, K., Morimoto, N., Nawa, T., Fujimoto, T., et al. (2008). Clinical factors that impair health-related quality of life in ulcerative colitis patients vary with the disease duration. European Journal of Gastroenterology and Hepatology, 20(7), 634–641.

    Article  PubMed  Google Scholar 

  26. Yildiz, N., Topuz, O., Gungen, G. O., Deniz, S., Alkan, H., & Ardic, F. (2010). Health-related quality of life (Nottingham Health Profile) in knee osteoarthritis: Correlation with clinical variables and self-reported disability. Rheumatology International, 30(12), 1595–1600.

    Article  PubMed  Google Scholar 

  27. Szaflarski, M., Meckler, J. M., Privitera, M. D., & Szaflarski, J. P. (2006). Quality of life in medication-resistant epilepsy: The effects of patient’s age, age at seizure onset, and disease duration. Epilepsy & Behavior, 8(3), 547–551.

    Article  Google Scholar 

  28. Schilling, O. K., & Wahl, H. W. (2006). Modeling late-life adaptation in affective well-being under a severe chronic health condition: The case of age-related macular degeneration. Psychology and Aging, 21(4), 703–714.

    Article  PubMed  Google Scholar 

  29. Urowitz, M., Gladman, D. D., Ibanez, D., Sanchez-Guerrero, J., Bae, S. C., Gordon, C., et al. (2014). Changes in quality of life in the first 5 years of disease in a multicenter cohort of patients with systemic lupus erythematosus. Arthritis Care Res, 66(9), 1374–1379.

    CAS  Article  Google Scholar 

  30. Marcos, J., Waimann, C., Dal Pra, F., Hogrefe, J., Retamozo, S., Caeiro, F., et al. (2011). General characteristics of an early arthritis cohort in Argentina. Rheumatology (Oxford), 50(1), 110–116.

    Article  Google Scholar 

  31. Chiu, Y. M., Lai, M. S., Lin, H. Y., Lang, H. C., Lee, L. J., & Wang, J. D. (2014). Disease activity affects all domains of quality of life in patients with rheumatoid arthritis and is modified by disease duration. Clinical and Experimental Rheumatology, 32(6), 898–903.

    PubMed  Google Scholar 

  32. Rupp, I., Boshuizen, H. C., Roorda, L. D., Dinant, H. J., Jacobi, C. E., & van den Bos, G. (2006). Course of patient-reported health outcomes in rheumatoid arthritis: Comparison of longitudinal and cross-sectional approaches. Journal of Rheumatology, 33(2), 228–233.

    PubMed  Google Scholar 

  33. Matcham, F., Scott, I. C., Rayner, L., Hotopf, M., Kingsley, G. H., Norton, S., et al. (2014). The impact of rheumatoid arthritis on quality-of-life assessed using the SF-36: A systematic review and meta-analysis. Seminars in Arthritis and Rheumatism, 44(2), 123–130.

    Article  PubMed  Google Scholar 

  34. Urowitz, M. B., Gladman, D. D., Ibanez, D., Fortin, P. R., Bae, S. C., Gordon, C., et al. (2012). Evolution of disease burden over 5 years in a multicenter inception systemic lupus erythematosus cohort. Arthritis Care Res, 64(1), 132–137.

    CAS  Article  Google Scholar 

  35. Sparring, V., Nyström, L., Wahlström, R., Jonsson, P. M., Östman, J., & Burström, K. (2013). Diabetes duration and health-related quality of life in individuals with onset of diabetes in the age group 15–34 years—A Swedish population-based study using EQ-5D. BMC Public Health, 13(1), 377.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Hassan, K., Loar, R., Anderson, B. J., & Heptulla, R. A. (2006). The role of socioeconomic status, depression, quality of life, and glycemic control in type 1 diabetes mellitus. Journal of Pediatrics, 149(4), 526–531.

    Article  PubMed  Google Scholar 

  37. Australian Bureau of Statistics (2007). 4327.0—National Survey of Mental Health and Wellbeing: Users’ Guide. Canberra: ABS.

  38. Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189–198.

    CAS  Article  PubMed  Google Scholar 

  39. Australian Bureau of Statistics (2006). 1220.0—ANZSCO—Australian and New Zealand standard classification of occupations (1st ed ). Canberra: ABS.

  40. Üstün, T. B., & World Health Organisation (2010). Measuring health and disability: Manual for WHO Disability Assessment Schedule WHODAS 2.0. Geneva: World Health Organization.

  41. World Health Organisation. (1990). Composite international diagnostic interview. Geneva: World Health Organization.

    Google Scholar 

  42. Hawthorne, G., Richardson, J., & Osborne, R. (1999). The Assessment of Quality of Life (AQoL) instrument: A psychometric measure of health-related quality of life. Quality of Life Research, 8(3), 209–224. doi:10.1023/A:1008815005736.

    CAS  Article  PubMed  Google Scholar 

  43. Osborne, R. H., Hawthorne, G., Lew, E. A., & Gray, L. C. (2003). Quality of life assessment in the community-dwelling elderly: Validation of the Assessment of Quality of Life (AQoL) Instrument and comparison with the SF-36. Journal of Clinical Epidemiology, 56(2), 138–147.

    Article  PubMed  Google Scholar 

  44. Ackerman, I. N., Busija, L., Tacey, M. A., Bohensky, M. A., Ademi, Z., Brand, C. A., et al. (2014). Performance of the assessment of quality of life measure in people with hip and knee joint disease and implications for research and clinical use. Arthritis Care Research, 66(3), 481–488.

    Article  PubMed  Google Scholar 

  45. Alexopoulos, G. S. (2005). Depression in the elderly. Lancet, 365(9475), 1961–1970.

    Article  PubMed  Google Scholar 

  46. Wylie, M. E., Mulsant, B. H., Pollock, B. G., Sweet, R. A., Zubenko, G. S., Begley, A. E., et al. (1999). Age at onset in geriatric bipolar disorder—Effects on clinical presentation and treatment outcomes in an inpatient sample. American Journal of Geriatric Psychiatry, 7(1), 77–83.

    CAS  PubMed  Google Scholar 

  47. Lenze, E. J., & Wetherell, J. L. (2011). A lifespan view of anxiety disorders. Dialogues Clinic Neuroscience, 13(4), 381–399.

    Google Scholar 

  48. Hart, H. E., Redekop, W. K., Bilo, H. J., Berg, M., & Jong, B. M. (2005). Change in perceived health and functioning over time in patients with type I diabetes mellitus. Quality of Life Research, 14(1), 1–10.

    Article  PubMed  Google Scholar 

  49. Paschalides, C., Wearden, A. J., Dunkerley, R., Bundy, C., Davies, R., & Dickens, C. M. (2004). The associations of anxiety, depression and personal illness representations with glycaemic control and health-related quality of life in patients with type 2 diabetes mellitus. Journal of Psychosomatic Research, 57(6), 557–564.

    CAS  Article  PubMed  Google Scholar 

  50. Cuijpers, P., Karyotaki, E., Pot, A. M., Park, M., & Reynolds, C. F., 3rd. (2014). Managing depression in older age: Psychological interventions. Maturitas, 79(2), 160–169.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Altamura, A. C., Dell’Osso, B., D’Urso, N., Russo, M., Fumagalli, S., & Mundo, E. (2008). Duration of untreated illness as a predictor of treatment response and clinical course in generalized anxiety disorder. CNS Spectrums, 13(5), 415–422.

    CAS  Article  PubMed  Google Scholar 

  52. Moylan, S., Maes, M., Wray, N. R., & Berk, M. (2013). The neuroprogressive nature of major depressive disorder: Pathways to disease evolution and resistance, and therapeutic implications. Molecular Psychiatry, 18(5), 595–606.

    CAS  Article  PubMed  Google Scholar 

  53. Hartog, C., Landman, G. W. D., Cimzar-Sweelssen, M., Knipscheer, A., Groenier, K. H., Kleefstra, N., et al. (2016). Health-related quality of life, rehabilitation and mortality in a nursing home population. Netherlands Journal of Medicine, 74(6), 247–256.

    CAS  PubMed  Google Scholar 

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Funding

This research did not receive any specific Grant from funding agencies in the public, commercial, or not-for-profit sectors.

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  1. Institute for Health & Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC, 3000, Australia

    Lucy Busija, Jeretine Tan & Kerrie M. Sanders

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  1. Lucy Busija
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  2. Jeretine Tan
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Contributions

LB and KS conceptualised the study and designed the analytic strategy. LB carried out data analysis and led the drafting of the manuscript. JT assisted with data analysis, helped to conduct literature review, and assisted with drafting the manuscript. KS assisted with drafting the manuscript and critically reviewed the manuscript for important intellectual content. All authors approved the manuscript and this submission.

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Correspondence to Lucy Busija.

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Conflict of interest

Lucy Busija declares that she has no conflict of interest. Jeretine Tan declares that she has no conflict of interest. Kerrie Sanders declares that she has no conflict of interest.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Busija, L., Tan, J. & Sanders, K.M. Associations between illness duration and health-related quality of life in specified mental and physical chronic health conditions: results from a population-based survey. Qual Life Res 26, 2671–2681 (2017). https://doi.org/10.1007/s11136-017-1592-7

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  • DOI: https://doi.org/10.1007/s11136-017-1592-7

Keywords

  • Duration of illness
  • Health-related quality of life
  • Physical health
  • Mental health
  • Population-based study