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The Journals of Gerontology Series B: Psychological Sciences and Social Sciences Advance Access originally published online on February 4, 2009
The Journals of Gerontology Series B: Psychological Sciences and Social Sciences 2009 64B(2):290-295; doi:10.1093/geronb/gbn014
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© The Author 2009. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Antecedents of Global Decline in Health-Related Quality of Life Among Middle-Aged African Americans

Fredric D. Wolinsky1,2, Theodore K. Malmstrom3, J. Philip Miller4, Elena M. Andresen5, Mario Schootman4 and Douglas K. Miller6,7

1 Iowa City Veterans Affairs Medical Center, Iowa
2 College of Public Health, University of Iowa, Iowa City
3 School of Medicine, Saint Louis University, St. Louis, Missouri
4 School of Medicine, Washington University, St. Louis, Missouri
5 College of Public Health, University of Florida, Gainesville
6 School of Medicine, Indiana University, Evanston
7 Regenstrief Institute for Health Care, Indianapolis, Indiana

Address correspondence to Fredric D. Wolinsky, PhD, Department of Health Management and Policy, College of Public Health, University of Iowa, 200 Hawkins Drive, E205 General Hospital, Iowa City, IA 52242. E-mail: fredric-wolinsky{at}uiowa.edu


  Abstract

Objective: We examined global declines in health-related quality of life (HRQoL) for a period of 3 years among the 998 participants in the African American Health (AAH) project.

Methods: The AAH is a population-based sample from two areas of metropolitan St. Louis. Global declines were defined as clinically important differences (CIDs) on four or more of the eight Short Form 36-Item scales. Individual CIDs were defined as drops of 0.5 SD or more from the baseline score. Multivariable logistic regression was used to identify antecedents of global decline.

Results: Fourteen percent (n = 117) of the 846 AAH subjects in the analysis demonstrated global declines in HRQoL. Five statistically significant risk factors were identified, including sampling strata (inner-city vs. suburban residence; adjusted odds ratio [AOR] = 2.06), cancer (AOR = 3.56), chronic obstructive pulmonary disease (AOR = 2.19), clinically relevant levels of depressive symptoms (AOR = 1.96), and incident (postbaseline) health conditions (1 [AOR = 1.71] and ≥2 [AOR = 3.09] vs. none).

Conclusion: Although these risk factors are for the most part nonmalleable, they can serve as markers of impending global HRQoL declines among late-middle-aged African Americans.

Key Words: African Americans • Epidemiology • Health-related quality of life • Prospective cohort study

Received July 7, 2008; Accepted October 10, 2008

Decision Editor: Kenneth F. Ferraro, PhD


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