Multiple chronic conditions affect people’s health-related quality of life (QoL) and the distributions of the conditions may differ between genders. Our goal was to examine gender differences in chronic conditions and QoL among community-living elderly in Taiwan and to examine whether differences in QoL between genders, if present, were attributable to the distribution of chronic conditions.
We used data from the Nutrition and Health Survey in Taiwan (NAHSIT, 2005–2008), which interviewed a representative sample of the Taiwanese population. The survey questions included the SF-36 questionnaire to assess participants’ QoL and items for participants’ medical history. We used multiple linear regressions to examine the difference in QoL between genders.
We included 1179 elders for our analysis; men accounted for 52% (612/1179). The mean age was 73; women were slightly younger. The mean (standard deviation) of SF-36 physical and mental health component score (PCS and MCS) was 44.5 (11.1) and 55.6 (9.0), respectively, and women reported a significantly lower PCS than men (difference − 4.85, p < 0.001). Urinary incontinence, arthritis, stroke, and kidney disease were associated with a clinically meaningful decrease in PCS (≤ − 6.5 points). The difference in PCS between genders was not attenuated after we accounted for chronic conditions in regression analysis.
Our findings suggest that women tend to report that their physical health-related QoL is poorer than that of men, and such a difference does not seem to be attributable to the distribution of chronic conditions. Elderly men and women may perceive health-related QoL differently.
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Mental health component score
Nutrition and health survey in Taiwan
Physical health component score
Quality of life
Short form 36
Global Health Observatory (GHO) data. World Health Organization. http://www.who.int/gho/mortality_burden_disease/life_tables/situation_trends_text/en/. Accessed 1 July 2018
Department of Statistics, Ministry of the Interior, Taiwan. https://www.moi.gov.tw/stat/. Accessed 1 July 2018
Orfila F et al (2006) Gender differences in health-related quality of life among the elderly: the role of objective functional capacity and chronic conditions. Soc Sci Med 63:2367–2380
Case A, Paxson C (2005) Sex differences in morbidity and mortality. Demography 42:189–214
Bowling A et al (1999) Short form 36 (SF-36) health survey questionnaire: which normative data should be used? Comparisons between the norms provided by the Omnibus Survey in Britain, the Health Survey for England and the Oxford Healthy Life Survey. J Public Health Med 21:255–270
Cherepanov D et al (2011) Gender differences in multiple underlying dimensions of health-related quality of life are associated with sociodemographic and socioeconomic status. Med Care 49:1021–1030
Wilson IB, Cleary PD (1995) Linking clinical variables with health-related quality of life. A conceptual model of patient outcomes. Jama 273:59–65
Lin YY, Huang CS (2016) Aging in Taiwan: building a society for active aging and aging in place. Gerontologist 56:176–183
Fortin M et al (2004) Multimorbidity and quality of life in primary care: a systematic review. Health Qual Life Outcomes 2:51
Tu SH et al (2011) Design and sample characteristics of the 2005–2008 nutrition and health survey in Taiwan. Asia Pac J Clin Nutr 20:225–237
Chiang PH et al (2013) Leisure time physical activities and dietary quality of the general and indigenous Taiwanese populations are associated with fat distribution and sarcopenia. Asia Pac J Clin Nutr 22:599–613
Tseng HM, Lu JF, Gandek B (2003) Cultural issues in using the SF-36 health survey in Asia: results from Taiwan. Health Qual Life Outcomes 1:72
Hays RD,Sherbourne CD Mazel RM,1995 User’s manual for the Medical Outcomes Study (MOS) core measures of health-related quality of life Rand Corporation, Santa Monica
StataCorp,2011 Stata survey data reference manual: release 13, Stata Press Publication: College Station
Ware JE Jr et al (1996) Differences in 4-year health outcomes for elderly and poor, chronically ill patients treated in HMO and fee-for-service systems. Results from the Medical Outcomes Study. Jama 276:1039–1047
Heidelbaugh J, Lipid disorders: a multidisciplinary approach, 1e (clinics collections), Vol. Volume 5C, 1st Elsevier Amsterdam. 2015
Derby CA et al (2009) Lipid changes during the menopause transition in relation to age and weight: the Study of Women’s Health Across the Nation. Am J Epidemiol 169:1352–1361
Ko Y, Coons SJ (2005) An examination of self-reported chronic conditions and health status in the 2001 Medicare Health Outcomes Survey. Curr Med Res Opin 21:1801–1808
Bartoli S, Aguzzi G, Tarricone R (2010) Impact on quality of life of urinary incontinence and overactive bladder: a systematic literature review. Urology 75:491–500
Matcham F et al (2014) The impact of rheumatoid arthritis on quality-of-life assessed using the SF-36: a systematic review and meta-analysis. Semin Arthritis Rheum 44:123–130
Hanmer J, Kaplan RM (2016) Update to the report of nationally representative values for the noninstitutionalized US adult population for five health-related quality-of-life scores. Value Health 19:1059–1062
Greenspan JD et al (2007) Studying sex and gender differences in pain and analgesia: a consensus report. Pain 132:S26–S45
Bowling A et al (2002) A multidimensional model of the quality of life in older age. Aging Ment Health 6:355–371
Mondor L et al (2016) The relative impact of chronic conditions and multimorbidity on health-related quality of life in Ontario long-stay home care clients. Qual Life Res 25:2619–2632
Parker L et al (2014) The burden of common chronic disease on health-related quality of life in an elderly community-dwelling population in the UK. Fam Pract 31:557–563
Data analyzed in this paper were collected by the research project “Nutrition and Health Survey in Taiwan (NAHSIT 2005–2008)” sponsored by the Department of Health in Taiwan (DOH94-fs-6-4). This research project was carried out by the Center for Survey Research of the Research Center for Humanities and Social Sciences of Academia Sinica, directed by Professor Wen-Harn Pan. The Office of Nutrition Survey, the Institute of Biomedical Sciences, Academia Sinica is responsible for data distribution. The assistance provided by the institutes and efforts made by all contributed to the survey are greatly appreciated. The views expressed herein are solely those of the authors.
TY was partly funded by the Ministry of Science and Technology in Taiwan. HY was funded by Mackay Medical College (1071B07 & 1061B05). NEA and GZ were partly funded by the Department of Public Health, China Medical University, Taiwan.
Conflict of interest
The authors declare that they have no competing interests.
The survey implementation and instruments were approved by the Institutional Review Board of Academia Sinica, Taiwan.
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Yu, T., Enkh-Amgalan, N., Zorigt, G. et al. Gender differences and burden of chronic conditions: impact on quality of life among the elderly in Taiwan. Aging Clin Exp Res 31, 1625–1633 (2019). https://doi.org/10.1007/s40520-018-1099-2
- Health-related quality of life
- Gender differences
- Chronic conditions
- Health survey