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. 2020 Oct 20;15(10):e0240024.
doi: 10.1371/journal.pone.0240024. eCollection 2020.

Role of clinical, functional and social factors in the association between multimorbidity and quality of life: Findings from the Survey of Health, Ageing and Retirement in Europe (SHARE)

Tatjana T Makovski  1   2   3 , Gwenaëlle Le Coroller  4 , Polina Putrik  5 , Yun Hee Choi  6 , Maurice P Zeegers  3 , Saverio Stranges  1   6   7 , Maria Ruiz Castell  1 , Laetitia Huiart  1 , Marjan van den Akker  2   8   9
Affiliations

Role of clinical, functional and social factors in the association between multimorbidity and quality of life: Findings from the Survey of Health, Ageing and Retirement in Europe (SHARE)

Tatjana T Makovski et al. PLoS One. .

Abstract

Objective: An increasing number of diseases is linked to deterioration of quality of life (QoL). Part of this association can be explained by socio-economic factors, which are most commonly accounted for. Our aim was to explore the potential contribution of other factors related to clinical burden, social interaction and functioning.

Methods: A cross-sectional analysis was conducted on wave 6 of the population-based Survey of Health, Ageing and Retirement in Europe (SHARE), among participants aged 50+ (n = 67 179). The Control, Autonomy, Self-Realization and Pleasure (CASP-12v1) questionnaire measured QoL. The association between number of diseases and QoL was tested in a mixed-effects linear regression model. The base model controlled for socio-economic characteristics. Factors of interest (symptoms, polypharmacy, unmet care needs, utilisation of care, social network, personal and financial help, loneliness and activities of daily living (ADL) with instrumental activities (IADL)) were added to the base model one at a time and tested for relevance (i.e. change in the β-coefficient of the number of conditions of 15% or more).

Results: Symptoms, polypharmacy, loneliness and ADL/IADL appeared relevant and were retained in the final model. The association between number of conditions and QoL in the base model was -2.44 [95% CI: -2.72; -2.16], while this association was -0.76 [95%CI: -0.97; -0.54] after all relevant factors were included.

Conclusion: Factors beyond the socio-economic circumstances play an important role in explaining the association between number of conditions and QoL. These factors should be considered to better estimate the impact of chronic diseases on QoL, and for improving patient care.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Conceptual framework describing clinical, functional and social factors to test for relevance in the association between number of diseases and quality of life adjusted for confounders.
Fig 2
Fig 2. Countries’ intercepts and slopes.
See this image and copyright information in PMC

References

    1. United Nations. Department of Economic and Social Affairs, Population Division (2020), World Population Ageing 2019(ST/ESA/SER.A/444).
    1. Fortin M, Bravo G, Hudon C, Vanasse A, Lapointe L. Prevalence of multimorbidity among adults seen in family practice. Ann Fam Med. 2005;3(3):223–8. Epub 2005/06/02. 10.1370/afm.272 - DOI - PMC - PubMed
    1. van den Akker M, Buntinx F, Knottnerus JA. Comorbidity or multimorbidity: what's in a name? A review of literature. Eur J Gen Pract. 1996;2(2):65–70. 10.3109/13814789609162146 - DOI
    1. Marengoni A, Angleman S, Melis R, Mangialasche F, Karp A, Garmen A, et al. Aging with multimorbidity: a systematic review of the literature. Ageing Res Rev. 2011;10(4):430–9. Epub 2011/03/16. 10.1016/j.arr.2011.03.003 . - DOI - PubMed
    1. Makovski TT, Schmitz S, Zeegers MP, Stranges S, van den Akker M. Multimorbidity and quality of life: Systematic literature review and meta-analysis. Ageing Res Rev. 2019;53:100903 Epub 2019/05/03. 10.1016/j.arr.2019.04.005 . - DOI - PubMed