An older person’s perceptions about their health – known as health-related quality of life (HRQoL) – may give an early signal about future health, an analysis of ASPREE data shows.
Four studies led by researchers at the Monash School of Public Health and Preventive Medicine found that self-perceptions of health and wellbeing were a valuable tool in helping to identify older adults at risk major adverse health events, and could assist doctors in patient care.
In the latest study, researchers found older adults who reported a decline in physical aspects of quality of life, such as reduced physical ability, over almost five years were 51 per cent more likely to develop cardiovascular disease compared to those who reported having high physical HRQoL.
Dr Phyo led several analyses of Health Related Quality of Life (HRQoL) data that was generously shared by ASPREE participants.
This study, published in American Heart Journal Plus: Cardiology Research and Practice, marks the first time researchers have established a link between declining physical HRQoL and the risk of cardiovascular disease over an extended period of time.
Researchers analysed self-reported quality of life data from 16, 871 ASPREE study participants and tracked their health for a further two years in the follow-up ASPREE-XT study.
ASPREE participants were mostly aged over 70 years, healthy and living independently in Australia and the USA at enrolment into the trial.
Participants self-reported HRQoL – a method to rate aspects of their physical, psychological and social (mental) wellbeing – at entry into the study and annually for an average of 4.7 years.
Sixty-seven per cent of participants consistently rated their physical HRQoL in the high category; 13 per cent as intermediate, 14 per cent as declining and 7 per cent as low.
Earlier, in separate analyses of ASPREE data that examined HRQoL at the beginning of the study only, researchers found:
- Better physical HRQoL at enrolment into ASPREE was linked with lower risks of cardiovascular disease (14 per cent), cognitive (thinking and memory) decline (6 per cent) and death (17 per cent) over an average of 4.7 years.
- Higher mental HRQoL at study entry was linked to lower risks of cognitive decline (12 per cent) and dementia (15 per cent) over the same period.
Lead researcher, Dr Aung Zaw Zaw Phyo said: “The studies indicate that self-reported HRQoL could be used to supplement objective measures, such as weight, blood pressure and cholesterol in outpatient health assessments and care.
“Our research strengthens the importance of HRQoL as a predictive measure of cardiovascular disease, dementia, cognitive decline and deaths among older adults living independently in later life.”
The studies were reported in papers published in four separate journals:
- Trajectories of physical health-related quality of life and the risk of incident cardiovascular disease events and all-cause mortality in older people in American Heart Journal Plus: Cardiology Research and Practice
- Health-related quality of life and incident cardiovascular disease events in community-dwelling older people: A prospective cohort study in International Journal of Cardiology
- The utility of assessing health-related quality of life to predict cognitive decline and dementia in Journal of Alzheimer’s Disease
- Health‑related quality of life and all‑cause mortality among older healthy individuals in Australia and the United States: A prospective cohort study in Quality of Life Research
The studies were undertaken with Monash researchers Dr Rosanne Freak-Poli and Associate Professor Joanne Ryan, together with Associate Professor David Gonzalez-Chica and Professor Nigel Stocks from Adelaide Medical School (University of Adelaide), and co-investigators from the University of Tasmania and Curtin University (Australia), the University of Edinburgh (UK), and Rush University Medical Center and Hennepin HealthCare Research Institute (United States).
Dr Aung Zaw Zaw Phyo works in the Biological Neuropsychiatry and Dementia research unit at Monash University School of Public Health and Preventive Medicine, and was funded by a Monash Graduate Scholarship and Postgraduate Publications Award for his PhD study.