Multiple chronic medical conditions and health-related quality of life in older adults, 2004-2006.
BACKGROUND
Understanding longitudinal relationships among multiple chronic conditions, limitations in activities of daily living, and health-related quality of life is important for identifying potential opportunities for health promotion and disease prevention among older adults.


METHODS
This study assessed longitudinal associations between multiple chronic conditions and limitations in activities of daily living on health-related quality of life among older adults (≥65 years) from 2004 through 2006, using data from the Medicare Health Outcomes Survey (N = 27,334).


RESULTS
Using a longitudinal path model, we found the numbers of chronic conditions at baseline and 2-year follow-up were independently associated with more limitations in activities of daily living at 2-year follow-up. In addition, more limitations in activities of daily living at 2-year follow-up were associated with worse health-related quality of life during the follow-up time period. The association between multiple chronic conditions and indices of health-related quality of life was mediated by changes in limitations in activities of daily living.


CONCLUSIONS
Both baseline and new multiple chronic conditions led to worse health in terms of activities of daily living and health-related quality of life and should be considered important outcomes to intervene on for improved long-term health. In addition, public health practitioners should consider addressing classes of multiple chronic conditions by using interventions designed to reduce the emergence of multiple chronic conditions, such as physical activity, reductions in smoking rates, and improved and coordinated access to health care services.
University of Hawai'i at Mānoa, 2530 Dole St, Honolulu, HI 96822, USA. Barile@Hawaii.edu
John P
JP
Barile
William W
WW
Thompson
Matthew M
MM
Zack
Gloria L
GL
Krahn
Willi
W
Horner-Johnson
Sonya E
SE
Bowen
D000203:Activities of Daily Living; D000368:Aged; D002908:Chronic Disease; D005260:Female; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D009519:New York City; D011203:Poverty; D011788:Quality of Life