title: Quality of life across medical conditions and psychological factors: implications for population health management.
abstract: To identify the contributions of medical conditions and psychological distress to well-being within a non-clinical sample, stratified by age. It was predicted that medical conditions and psychological distress would be negatively associated with well-being. It was also predicted that psychological distress and medical conditions would account for significant variance in well-being. It was further predicted that psychological distress would mediate the relationship between medical conditions and well-being across the life span.
  
  
  
  1,424,307 employees/health plan members that completed an HRA. SEM was used to characterize relationships among medical conditions and psychological distress in predicting well-being (QoL, HRQoL, and impairments in ADLs) in five adult age groups.
  
  
  
  Medical conditions and psychological distress were negatively associated with well-being. As age increased, psychological distress was less associated with well-being. However, in those >75 years old, psychological distress had the largest association with well-being. All medical conditions, except cancer, were negatively associated with well-being. There were decreasing effects of medical conditions across the life span, with the exception of pulmonary disease which increased. Psychological distress mediated the relationship between medical conditions and well-being, with chronic pain having the greatest mediation across the life span.
  
  
  
  The analysis revealed differences in the contribution of psychological distress and medical conditions to well-being by age group. Additionally, the contribution of psychological distress was equitable to that of medical conditions, thus highlighting the importance of addressing psychological distress in medical populations for well-being. Findings suggest the relevance of age in well-being and the need for further longitudinal investigation.
authors.affiliation: Henry Ford Health System, 2799 W Grand Blvd, Detroit, MI, USA. awilli50@hfhs.org.
authors.forename: Amy M
authors.initials: AM
authors.lastname: Williams
authors.affiliation: Department of Psychology, Wayne State University, Detroit, MI, USA.
authors.forename: Pamela E
authors.initials: PE
authors.lastname: May
authors.affiliation: Johnson & Johnson Health and Wellness Solutions, Inc., Ann Arbor, MI, USA.
authors.forename: Shawn T
authors.initials: ST
authors.lastname: Mason
authors.affiliation: Johnson & Johnson Health and Wellness Solutions, Inc., Ann Arbor, MI, USA.
authors.forename: Chun
authors.initials: C
authors.lastname: Wang
authors.affiliation: Johnson & Johnson Health and Wellness Solutions, Inc., Ann Arbor, MI, USA.
authors.forename: Lidia
authors.initials: L
authors.lastname: Pomana
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000523:psychology; D019468:Disease Management; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Age; Health-related quality of life; Medical conditions; Psychological distress; Quality of life