Alcohol consumption and physical health-related quality of life in older women using the transformation of SF-36 to account for death.
Moderate alcohol consumption has been associated with health benefits in several studies, but few studies investigating such association for elders have been done. So, we explored the relationship between alcohol intake and changes in physical health-related quality of life (HRQoL). As analyses of longitudinal HRQoL data excluding diseased participants produced overestimated results, we compared the methods with and without incorporating death and estimated valid physical HRQoL and its decline over time. Study subjects were women from the Australian Longitudinal Study on Women's Health, ages 70-75 years at Survey 1 in 1996 (n = 12,432), and were followed-up at 3 yearly intervals for 6 years. Alcohol consumption was divided into seven categories to identify harmful alcohol levels for older women. We measured Physical Component Score (PCS) of Medical Outcomes Study Short-Form (SF-36), and applied the transformed PCS incorporating death as a valid score to estimate HRQoL changes for each alcohol group with adjustment for potential confounders. Significant declines of values were observed and the values of 'non-drinker' and 'rare drinker' were lower than the other groups during 6 years in both PCS and the transformed PCS. Analysis of the PCS showed significant Alcohol x Time interaction effects for non-drinker and rare drinker groups, as the scores were overestimated towards higher values at Survey 2 due to loss to follow-up of women who died. In the transformed PCS, these interaction effects diminished, and a clearer dose-response relationship between alcohol and physical HRQoL was observed at the third survey. We examined the influence of deaths on the study conclusions with using PCS and its transformed value which included deaths. Being a nondrinker of alcohol was associated with greater risk of mortality and poorer physical HRQoL. Moderate alcohol consumption was not harmful, and may carry some health benefits for older women.
Basic Clinical Science and Public Health, Tokai University School of Medicine, Isehara-shi, Kanagawa 259-1193, Japan.
Hiroyuki
H
Furuya
Anne F
AF
Young
Jennifer R
JR
Powers
Julie E
JE
Byles
D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking / Q000401:mortality; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D011594:Psychometrics; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016387:Women's Health