TY - JOUR
T1 - A population-based perspective of changes in health-related quality of life after myocardial infarction in older men and women
AU - Mendes De Leon, Carlos F.
AU - Krumholz, Harlan M.
AU - Vaccarino, Viola
AU - Williams, Christianna S.
AU - Glass, Thomas A.
AU - Berkman, Lisa F.
AU - Kas, Stanislav V.
N1 - Funding Information:
We used data from the New Haven site of the Established Populations for the Epidemiologic Studies of the Elderly (E.P.E.S.E.) project, one of four sites funded by the National Institute on Aging. The cohort was assembled by obtaining a stratified probability sample of the non-institutionalized New Haven population 65 years and older living in three housing strata: public housing for the elderly (age- and income-restricted), private housing for the elderly (age-restricted), and general community housing. The sampling strategies varied by housing stratum and included an over-sampling of men [15] . The response rate for the combined strata was 82%. The baseline sample consisted of 1169 men and 1643 women, for a total of 2812 subjects. Baseline data collection took place during in-home face-to-face interviews in 1982. Follow-up face-to-face interviews were conducted at 3-year intervals, in 1985 and 1988, with annual telephone interviews in the intervening years. Since most of the data used in this analysis was collected during the face-to-face interviews only, we will not use any data from the telephone interviews.
PY - 1998/7
Y1 - 1998/7
N2 - This study analyzes changes in health-related quality-of-life (HQL) outcomes following myocardial infraction (MI) from a population-based perspective. Data came from a representative sample of 2812 men and women 65 years and older living in New Haven, CT. All subjects were interviewed at baseline in 1982, and again in 1985 and 1988. HQL outcomes included self-rated health, depressive symptoms, and physical and social functioning. Pooled logistic regression models were used to estimate the risk for decline in HQL outcomes due to MI. Of the 203 MIs during follow-up, 111 (55%) survived until the next interview to provide post-MI data on outcomes. In bivariate analysis, MI patients were more likely than subjects without MI to show a decline in physical functioning (26.4% vs. 11.9%, P = .001) and social functioning (31.4% vs. 20.8%, P = .06). There were no differences in self-rated health (26.3% vs. 26.9%), but MI patients were less likely to show an increase in depression (9.1% vs. 15.8%, P = .08). These associations remained mostly unchanged after adjustment for CHD risk factors. The effect of MI on physical and social functioning was much stronger among patients with a recent MI (< 1 year ago) than those whose MI had occurred more than a year before post-MI assessment. While a substantial proportion of MI patients experience a significant decline in quality of life-related outcomes, only some of these declines occur more frequently among MI patients than in the population at large. This effect may also be limited to the immediate post-MI period. Results from this analysis are discussed in terms of the 'burden of illness' within a defined population due to MI.
AB - This study analyzes changes in health-related quality-of-life (HQL) outcomes following myocardial infraction (MI) from a population-based perspective. Data came from a representative sample of 2812 men and women 65 years and older living in New Haven, CT. All subjects were interviewed at baseline in 1982, and again in 1985 and 1988. HQL outcomes included self-rated health, depressive symptoms, and physical and social functioning. Pooled logistic regression models were used to estimate the risk for decline in HQL outcomes due to MI. Of the 203 MIs during follow-up, 111 (55%) survived until the next interview to provide post-MI data on outcomes. In bivariate analysis, MI patients were more likely than subjects without MI to show a decline in physical functioning (26.4% vs. 11.9%, P = .001) and social functioning (31.4% vs. 20.8%, P = .06). There were no differences in self-rated health (26.3% vs. 26.9%), but MI patients were less likely to show an increase in depression (9.1% vs. 15.8%, P = .08). These associations remained mostly unchanged after adjustment for CHD risk factors. The effect of MI on physical and social functioning was much stronger among patients with a recent MI (< 1 year ago) than those whose MI had occurred more than a year before post-MI assessment. While a substantial proportion of MI patients experience a significant decline in quality of life-related outcomes, only some of these declines occur more frequently among MI patients than in the population at large. This effect may also be limited to the immediate post-MI period. Results from this analysis are discussed in terms of the 'burden of illness' within a defined population due to MI.
KW - Depression
KW - Epidemiologic studies
KW - Myocardial infarction
KW - Physical functioning
KW - Quality of life
KW - Social functioning
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U2 - 10.1016/S0895-4356(98)00037-7
DO - 10.1016/S0895-4356(98)00037-7
M3 - Article
C2 - 9674668
AN - SCOPUS:0032127517
VL - 51
SP - 609
EP - 616
JO - Journal of Chronic Diseases
JF - Journal of Chronic Diseases
SN - 0895-4356
IS - 7
ER -