The authors declare that they have no competing interests.
AN and HB performed the statistical analyses and interpretation of the data, and drafted the manuscript. IS, BW, MS and HvB conceived and designed the study. GS and BW prepared the data for analysis. AD, AF, JG, HHK, SRH, WM and SW participated in study design and implementation. All authors read and approved the final manuscript.
With increasing life expectancy the number of people affected by multimorbidity rises. Knowledge of factors associated with health-related quality of life in multimorbid people is scarce. We aimed to identify the factors that are associated with self-rated health (SRH) in aged multimorbid primary care patients.
Cross-sectional study with 3,189 multimorbid primary care patients aged from 65 to 85 years recruited in 158 general practices in 8 study centers in Germany. Information about morbidity, risk factors, resources, functional status and socio-economic data were collected in face-to-face interviews. Factors associated with SRH were identified by multivariable regression analyses.
Depression, somatization, pain, limitations of instrumental activities (iADL), age, distress and Body Mass Index (BMI) were inversely related with SRH. Higher levels of physical activity, income and self-efficacy expectation had a positive association with SRH. The only chronic diseases remaining in the final model were Parkinson’s disease and neuropathies. The final model accounted for 35% variance of SRH. Separate analyses for men and women detected some similarities; however, gender specific variation existed for several factors.
In multimorbid patients symptoms and consequences of diseases such as pain and activity limitations, as well as depression, seem to be far stronger associated with SRH than the diseases themselves. High income and self-efficacy expectation are independently associated with better SRH and high BMI and age with low SRH.
MultiCare Cohort study registration: ISRCTN89818205.
Idler EL, Russell LB, Davis D: Survival, functional limitations, and self-rated health in the NHANES I epidemiologic follow-up study, 1992. First National health and nutrition examination survey. Am J Epidemiol. 1992, 2000 (152): 874-883.
Jia H, Lubetkin EI: The impact of obesity on health-related quality-of-life in the general adult US population. J Public Health (Oxf). 2005, 27: 156-164. 10.1093/pubmed/fdi025. CrossRef
The EuroQol Group: EuroQol--a new facility for the measurement of health-related quality of life. Health Policy. 1990, 16: 199-208. CrossRef
Brauns H, Steinmann S: Educational reform in France, West-Germany and the United Kingdom: Updating the CASMIN educational classification. ZUMA-Nachrichten. 1999, 44: 7-44.
Burniaux J-M: Income distribution and poverty in selected OECD countries. OECD Econ Dep Working Papers. 1998, 6: 1-21.
Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA: The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory care quality improvement project (ACQUIP). Alcohol use disorders identification test. Arch Intern Med. 1998, 158: 1789-1795. 10.1001/archinte.158.16.1789. CrossRefPubMed
Fydrich T, Sommer G, Brähler E, F-Soz U: Fragebogen zur Sozialen Unterstützung. 2007, Göttingen: Hogrefe
Hinz A, Schumacher J, Albani C, Schmid G, Brähler E: Bevölkerungsrepräsentative Normierung der Skala zur allgemeinen Selbstwirksamkeitserwartung. Diagnostica. 2006, 52: 26-32. 10.1026/0012-19184.108.40.206. CrossRef
Sheikh J, Yesavage J: Geriatric Depression Scale (GDS): recent evidence and development of a shorter version. Clin Gerontol. 1986, 5: 165-173. 10.1300/J018v05n01_09. CrossRef
Terluin B, van Marwijk HW, Ader HJ, de Vet HC, Penninx BW, Hermens ML, et al: The Four-Dimensional Symptom Questionnaire (4DSQ): a validation study of a multidimensional self-report questionnaire to assess distress, depression, anxiety and somatization. BMC Psychiatry. 2006, 6: 34-10.1186/1471-244X-6-34. CrossRefPubMedPubMedCentral
Gower JC: A general coefficient of similarity and some of its properties. Biometrics. 1971, 27: 857-871. 10.2307/2528823. CrossRef
D’Orazio M: StatMatch: Statistical Matching. 2009, Ref Type: Computer Program
Schäfer I, Hansen H, Schön G, Höfels S, Altiner A, Dahlhaus A, et al: The influence of age, gender and socio-economic status on multimorbidity patterns in primary care. first results from the multicare cohort study. BMC Health Serv Res. 2012, 12: 89-10.1186/1472-6963-12-89. CrossRefPubMedPubMedCentral
Szende A, Williams A: Measuring self-reported population health: an international perspective based on EQ-5D. 2004, Budapest: SpringMed Publishing
Sach TH, Barton GR, Doherty M, Muir KR, Jenkinson C, Avery AJ: The relationship between body mass index and health-related quality of life: comparing the EQ-5D, EuroQol VAS and SF-6D. Int J Obes (Lond). 2007, 31: 189-196. 10.1038/sj.ijo.0803365. CrossRef
Imai K, Gregg EW, Chen YJ, Zhang P, de Rekeneire N, Williamson DF: The association of BMI with functional status and self-rated health in US adults. Obesity (Silver Spring). 2008, 16: 402-408. 10.1038/oby.2007.70. CrossRef
Violán C, Fouguet-Boreu Q, Hermosilla-Pérez E, Valderas JM, Bolíbar B, Fábregas-Escurriola M, Brugulat-Guiteras P, Muñoz-Pérez MÁ: Comparison of the information provided by electronic health records data and a population health survey to estimate prevalence of selected health conditions and multimorbidity. BMC Public Health. 2013, 21: 251-10.1007/s10389-012-0536-5. CrossRef
- Self-rated health in multimorbid older general practice patients: a cross-sectional study in Germany
Hendrik van den Bussche
- BioMed Central
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