title: A population-based survey of quality of life in middle-aged Finnish women.
abstract: OBJECTIVE
  Factors that cause a decrease in quality of life (QoL) among middle-aged women are contradictory. Given that previous studies have been presumably performed in ethnically heterogeneous populations, we evaluated the impact of socioeconomic and lifestyle factors on QoL in Finnish women because the Finnish population is ethnically homogenous.
  
  
  METHODS
  A total of 6,408 women (aged 41-54 y) who were called for municipal screening mammography received a postal survey concerning their health-related issues. A total of 3,421 women returned the questionnaire. QoL was evaluated with the Women's Health Questionnaire, from which we included eight symptom clusters (somatic symptoms, depressive symptoms, cognitive difficulties, anxiety/fears, sexual functioning, vasomotor symptoms, sleep problems, and menstrual symptoms). The effects of variables on QoL were defined with multivariate analysis.
  
  
  RESULTS
  Older women had more symptoms. Lower educational level was associated with lower QoL. Retired women had more symptoms than working or unemployed women, and unemployed women had more symptoms than employed women. Increasing body mass index was associated with lower QoL. Women who consumed alcohol occasionally had fewer symptoms, and women who consumed alcohol weekly had more symptoms than abstainers. Women who smoked had more symptoms than nonsmokers. Current hormone therapy users had more symptoms than nonusers, and former hormone therapy users had more symptoms than nonusers or current hormone therapy users.
  
  
  CONCLUSIONS
  Higher socioeconomic status and healthier lifestyle are beneficial for good QoL in middle-aged women. Thus, women should be encouraged to continue employment and to avoid behavioral health risks.
authors.affiliation: From the 1Department of Obstetrics and Gynecology, Turku University Hospital and University of Turku, Turku, Finland; 2Department of Obstetrics and Gynecology, Heinola Regional Hospital, Heinola, Finland; and 3Department of Mathematics and Statistics, University of Turku, Turku, Finland.
authors.forename: Riina E
authors.initials: RE
authors.lastname: Katainen
authors.forename: Tiina J
authors.initials: TJ
authors.lastname: Siirtola
authors.forename: Janne R
authors.initials: JR
authors.lastname: Engblom
authors.forename: Risto U
authors.initials: RU
authors.lastname: Erkkola
authors.forename: Päivi
authors.initials: P
authors.lastname: Polo-Kantola
mesh_terms: D000328:Adult; D004967:Estrogens / Q000627:therapeutic use; D005260:Female; D005387:Finland; D006306:Health Surveys; D020249:Hormone Replacement Therapy; D006801:Humans; D008019:Life Style; D008593:Menopause / Q000523:psychology*; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D012923:Social Class; D011795:Surveys and Questionnaires; D016387:Women's Health
chemical_list: D004967:Estrogens