title: National study of chronic disease self-management: age comparison of outcome findings.
abstract: BACKGROUND
  The adult population is increasingly experiencing one or more chronic illnesses and living with such conditions longer. The Chronic Disease Self-Management Program (CDSMP) helps participants cope with chronic disease-related symptomatology and improve their health-related quality of life. Nevertheless, the long-term effectiveness of this evidence-based program on older adults as compared to the middle-aged populations has not been examined in a large-scale, national rollout.
  
  
  METHODS
  We identified baseline characteristics of CDSMP participants aged 65 years or older (n = 687, M = 74.8 years) in the National Study of CDSMP from 2010 to 2012. Comparisons were made to middle-aged participants aged 50 to 64 (n = 325, M = 58.3 years). Assessments were conducted at baseline and 12-month follow-up. Linear and generalized linear mixed models were performed to assess changes in primary and secondary outcomes, controlling the key sociodemographics and number of chronic conditions.
  
  
  RESULTS
  All primary outcomes (i.e., social/role activities limitation, depression, communication with doctors) significantly improved in both the older and middle-aged cohorts. Although improvements in illness symptomatology (e.g., fatigue, pain, shortness of breath, and sleep problems) were similar across both cohorts, only the middle-aged cohort benefitted significantly in terms of overall quality of life and unhealthy mental health days. Effect sizes were larger among the middle-aged population who were also more likely to enter the program in poorer health and be from minority backgrounds.
  
  
  CONCLUSIONS
  The current study documented improved health outcomes but more so among the middle-aged population. Findings suggest the importance of examining how age and interacting life circumstances may affect chronic disease self-management.
authors.affiliation: Texas A&M University Health Science Center, College Station, TX, USA mory@tamu.edu.
authors.forename: Marcia G
authors.initials: MG
authors.lastname: Ory
authors.affiliation: University of Memphis School of Public Health, Memphis, TN, USA.
authors.forename: Matthew Lee
authors.initials: ML
authors.lastname: Smith
authors.affiliation: The University of Georgia, College of Public Health, Athens, GA, USA.
authors.forename: SangNam
authors.initials: S
authors.lastname: Ahn
authors.affiliation: Texas A&M University Health Science Center, College Station, TX, USA.
authors.forename: Luohua
authors.initials: L
authors.lastname: Jiang
authors.affiliation: Stanford University, Palo Alto, CA, USA.
authors.forename: Kate
authors.initials: K
authors.lastname: Lorig
authors.affiliation: National Council on Aging, Washington, DC, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Whitelaw
mesh_terms: D000367:Age Factors; D000368:Aged; D002908:Chronic Disease / Q000523:psychology / Q000628:therapy*; D015331:Cohort Studies; D003863:Depression / Q000150:complications; D005260:Female; D006293:Health Promotion; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D012648:Self Care; D011795:Surveys and Questionnaires
keywords: aging and health; chronic disease management; community health; evaluation; health promotion