title: Antecedents of global decline in health-related quality of life among middle-aged African Americans.
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 > or =2 [AOR = 3.09] vs. none).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Iowa City Veterans Affairs Medical Center, Iowa, USA. fredric-wolinsky@uiowa.edu
authors.forename: Fredric D
authors.initials: FD
authors.lastname: Wolinsky
authors.forename: Theodore K
authors.initials: TK
authors.lastname: Malmstrom
authors.forename: J Philip
authors.initials: JP
authors.lastname: Miller
authors.forename: Elena M
authors.initials: EM
authors.lastname: Andresen
authors.forename: Mario
authors.initials: M
authors.lastname: Schootman
authors.forename: Douglas K
authors.initials: DK
authors.lastname: Miller
mesh_terms: D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D000368:Aged; D002908:Chronic Disease / Q000453:epidemiology / Q000208:ethnology* / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D008297:Male; D008609:Mental Status Schedule / Q000706:statistics & numerical data; D008875:Middle Aged; D008923:Missouri; D016017:Odds Ratio; D011594:Psychometrics / Q000706:statistics & numerical data; D011788:Quality of Life / Q000523:psychology*; D015203:Reproducibility of Results; D012307:Risk Factors; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data; D044465:White People / Q000523:psychology* / Q000706:statistics & numerical data