title: Predictors of patterns of change in health-related quality of life in older women over 7 years: evidence from a prospective cohort study.
abstract: BACKGROUND
  the evaluation of the determinants of change over time in health-related quality of life (HR-QoL) in older people is limited. This study aims to identify patterns of change in HR-QoL over 7 years and their determinants using data from the British Women's Heart and Health Study, a representative sample of older women (n = 4286).
  
  
  METHODS
  longitudinal latent class analysis was used to identify subpopulations of women with similar HR-QoL trajectories from 1999-2000 to 2007. HR-QoL was measured using the EQ-5D. Multivariate multinomial logistic regression was used to model the association of identified trajectories with baseline predictors after multiple imputation of missing data.
  
  
  RESULTS
  four distinct EQ-5D trajectories were suggested: high (19% of women), high decline (22%), intermediate (42%) and low decline (16%). Prevalent arthritis (OR = 13.4; 95% CI: 8.8, 20.5), diabetes (OR = 4.6; 95% CI: 1.5, 14.2) and obesity (OR = 3.9; 95% CI: 2.5, 6.0) were the strongest predicting health conditions of adverse changes in HR-QoL and physical activity the strongest predicting lifestyle factor (OR = 2.8; 95% CI: 2.0, 3.9).
  
  
  CONCLUSIONS
  findings suggest that older women without obesity or pre-existing health conditions who undertake more physical activity are more likely to experience high HR-QoL, reinforcing the importance of these factors for healthy ageing.
authors.affiliation: Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK. caroline.dale@lshtm.ac.uk
authors.forename: Caroline E
authors.initials: CE
authors.lastname: Dale
authors.forename: Ann
authors.initials: A
authors.lastname: Bowling
authors.forename: Joy
authors.initials: J
authors.lastname: Adamson
authors.forename: Hannah
authors.initials: H
authors.lastname: Kuper
authors.forename: Antoinette
authors.initials: A
authors.lastname: Amuzu
authors.forename: Shah
authors.initials: S
authors.lastname: Ebrahim
authors.forename: Juan P
authors.initials: JP
authors.lastname: Casas
authors.forename: Eveline
authors.initials: E
authors.lastname: Nüesch
mesh_terms: D000367:Age Factors; D000368:Aged; D000375:Aging; D001168:Arthritis / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D015444:Exercise; D005260:Female; D006304:Health Status; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008137:Longitudinal Studies; D008875:Middle Aged; D009043:Motor Activity; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology; D016017:Odds Ratio; D015995:Prevalence; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology