title: Baseline health-related quality of life and 10-year all-cause mortality among 1739 Chinese adults.
abstract: OBJECTIVE
  Health-related quality of life (HRQOL) may be associated with the longevity of patients; yet it is not clear whether this association holds in a general population, especially in low- and middle-income countries. The objective of this study was to determine whether baseline HRQOL was associated with 10-year all-cause mortality in a Chinese general population.
  
  
  METHODS
  A prospective cohort study was conducted from 2002 to 2012 on 1739 participants in 11 villages of Beijing. Baseline data on six domains of HRQOL, chronic diseases and cardiovascular risk factors were collected in either 2002 (n = 1290) or 2005 (n = 449). Subjects were followed through the end of the study period, or until they were censored due to death or loss to follow-up, whichever came first.
  
  
  RESULTS
  A multivariable Cox model estimated that Total HRQOL score (bottom 50% versus top 50%) was associated with a 44% increase in all-cause mortality (Hazard Ratio [HR] = 1.44; 95% confidence interval [CI]: 1.00-2.06), after adjusting for sex, age, education levels, occupation, marital status, smoking status, fruit intake, vegetable intake, physical exercise, hypertension, history of a stroke, myocardial infarction, chronic respiratory disease, and kidney disease. Among the six HRQOL domains, the Independence domain had the largest fully adjusted HR (HR = 1.66; 95% CI: 1.13-2.42), followed by Psychological (HR = 1.47; 95% CI: 1.03-2.09), Environmental (HR = 1.43, 95% CI: 1.003-2.03), Physical (HR = 1.38; 95% CI: 0.97-1.95), General (HR = 1.37; 95% CI: 0.97-1.94), and the Social domain (HR = 1.15; 95% CI: 0.81-1.65).
  
  
  CONCLUSIONS
  Lower HRQOL, especially the inability to live independently, was associated with a significantly increased risk of 10-year all-cause mortality. The inclusion of HRQOL measures in clinical assessment may improve diagnostic accuracy to improve clinical outcomes and better target public health promotions.
authors.affiliation: Peking University Clinical Research Institute, Beijing, People's Republic of China.
authors.forename: Gaoqiang
authors.initials: G
authors.lastname: Xie
authors.affiliation: Department of Neurology, Duke University Medicine Center, Durham, North Carolina, United States of America.
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Laskowitz
authors.affiliation: Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, United States of America; Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America.
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Turner
authors.affiliation: Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America.
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Egger
authors.affiliation: Shijingshan Center for Disease Control and Prevention, Beijing, People's Republic of China.
authors.forename: Ping
authors.initials: P
authors.lastname: Shi
authors.affiliation: Shijingshan Center for Disease Control and Prevention, Beijing, People's Republic of China.
authors.forename: Fuxiu
authors.initials: F
authors.lastname: Ren
authors.affiliation: Department of Cardiology, Peking University Third Hospital, Beijing, People's Republic of China; Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, People's Republic of China.
authors.forename: Wei
authors.initials: W
authors.lastname: Gao
authors.affiliation: Peking University Clinical Research Institute, Beijing, People's Republic of China; Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, China; The George Institute for Global Health at Peking University Health Science Center, Beijing, China.
authors.forename: Yangfeng
authors.initials: Y
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D011159:Population Surveillance; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors