title: The burden of common chronic disease on health-related quality of life in an elderly community-dwelling population in the UK.
abstract: BACKGROUND
  Given the high prevalence of chronic conditions and multimorbidity in the elderly, there is a need to determine which chronic conditions have the greatest impact on health-related quality of life (HRQL) and identify where additional intervention may be required.
  
  
  OBJECTIVE
  To explore the impact of a range of common chronic conditions on HRQL in a community-based population aged 65 years or more in the UK.
  
  
  METHODS
  Secondary analysis of data derived from a large (n = 5849) cross-sectional study. HRQL was assessed using the EuroQoL EQ-5D. Multivariable models were used to estimate the relative effect of 15 individual common chronic conditions and combinations of these conditions on HRQL.
  
  
  RESULTS
  Mean age of participants was 74.6 years, 49.2% were male. The mean EQ-5D index score was 0.78 (standard deviation 0.2), range -0.43 to 1.00. Overall, 53% (n = 3078) of the cohort reported problems with pain, 39% (n = 2273) with mobility and 9% (n = 529) with self-care. Multivariate modelling demonstrated that impaired HRQL was significantly associated with 13 of the 15 common chronic conditions studied. Clinically meaningful reductions in EQ-5D index scores were observed for osteoarthritis (-0.081, P = 0.0006), neurological disease (-0.172, P < 0.0001) and depression (-0.269, P < 0.001).
  
  
  CONCLUSIONS
  This study quantifies the relative impact of 13 common chronic conditions on HRQL in a UK-based community-dwelling ageing population. Findings indicate that osteoarthritis, depression and neurological disease have a strong clinically important negative effect on HRQL. These findings may help clinical decision making and priority setting for management of individuals with multimorbidity.
authors.affiliation: University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Walsgrave, Coventry CV2 2DX and.
authors.forename: Laura
authors.initials: L
authors.lastname: Parker
authors.affiliation: Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
authors.forename: Grace M
authors.initials: GM
authors.lastname: Moran
authors.affiliation: Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
authors.forename: Lesley M
authors.initials: LM
authors.lastname: Roberts
authors.affiliation: Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
authors.forename: Melanie
authors.initials: M
authors.lastname: Calvert
authors.affiliation: Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. d.mccahon@bham.ac.uk.
authors.forename: Deborah
authors.initials: D
authors.lastname: McCahon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000453:epidemiology* / Q000523:psychology; D059350:Chronic Pain / Q000453:epidemiology; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D057187:Independent Living; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D009422:Nervous System Diseases / Q000453:epidemiology / Q000523:psychology; D010003:Osteoarthritis / Q000453:epidemiology / Q000523:psychology; D011788:Quality of Life; D012648:Self Care; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology
keywords: Ageing; health-related quality of life; multimorbidity; primary care.