title: Relationship between obesity, hypertension and diabetes, and health-related quality of life among the elderly.
abstract: BACKGROUND
  The purpose of this study was to study the cumulative effects of cardiovascular risk factors on all the health-related quality of life dimensions among the elderly in this era of epidemic obesity and diabetes.
  
  
  METHODS
  The population-based study covered 3567 participants, representative of the Spanish non-institutionalized population aged 60 years and above. Data were gathered from home-based interviews and from the measurements of blood pressure and other anthropometric variables. Multiple linear regression was used to examine the relationships between health-related quality of life, on each scale of the SF-36 questionnaire, and obesity (waist circumference >102 cm in men and >88 cm in women), hypertension (blood pressure >/=140/90 mmHg), and known diabetes, after adjusting for sociodemographic and lifestyle factors.
  
  
  RESULTS
  Patients with obesity, hypertension, and diabetes, or a combination of these factors were, in general, associated with a worse health-related quality of life, on both the physical and the mental scales, than those without these factors, though statistical significance (P<0.05) was only attained for some relationships. Obesity in women (-2.9 to -6.7 points, according to the scale) and diabetes in men (-6.1 to -16.4 points, according to the scale) were the factors most closely and significantly associated with diminished health-related quality of life. Women who had all three factors showed the maximum decline in health-related quality of life (-10.2 to -17.7 points, according to the scale).
  
  
  CONCLUSIONS
  Obesity in old women and diabetes in old men are the most decisive factors adversely affecting the health-related quality of life. The association with worse health-related quality of life is especially marked (greater than additive) in women with all three factors, thereby rendering them a group that calls for special study and attention.
authors.affiliation: Department of Preventive Medicine and Public Health, Universidad Autónomous Universidad of Madrid, Barcelona, Spain. joseramon.banegas@uam.es
authors.forename: José R
authors.initials: JR
authors.lastname: Banegas
authors.forename: Esther
authors.initials: E
authors.lastname: López-García
authors.forename: Auxiliadora
authors.initials: A
authors.lastname: Graciani
authors.forename: Pilar
authors.initials: P
authors.lastname: Guallar-Castillón
authors.forename: Juan L
authors.initials: JL
authors.lastname: Gutierrez-Fisac
authors.forename: Jordi
authors.initials: J
authors.lastname: Alonso
authors.forename: Fernando
authors.initials: F
authors.lastname: Rodríguez-Artalejo
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology* / Q000523:psychology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology* / Q000523:psychology; D011159:Population Surveillance; D011788:Quality of Life; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires