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Meta-Analysis
. 2020 Nov 6;20(1):1596.
doi: 10.1186/s12889-020-09639-9.

Quality of life and mortality in the general population: a systematic review and meta-analysis

Aung Zaw Zaw Phyo  1 , Rosanne Freak-Poli  1   2 , Heather Craig  1 , Danijela Gasevic  1   3 , Nigel P Stocks  4 , David A Gonzalez-Chica  4   5 , Joanne Ryan  6   7
Affiliations
Meta-Analysis

Quality of life and mortality in the general population: a systematic review and meta-analysis

Aung Zaw Zaw Phyo et al. BMC Public Health. .

Abstract

Background: Quality of life (QoL) is multi-dimensional concept of an individual' general well-being status in relation to their value, environment, cultural and social context in which they live. This study aimed to quantitatively synthesise available evidence on the association between QoL and mortality in the general population.

Methods: An electronic search was conducted using three bibliographic databases, MEDLINE, EMBASE and PsycINFO. Inclusion criteria were studies that assessed QoL using standardized tools and examined mortality risk in a non-patient population. Qualitative data synthesis and meta-analyses using a random-effects model were performed.

Results: Of 4184 articles identified, 47 were eligible for inclusion, involving approximately 1,200,000 participants. Studies were highly heterogeneous in terms of QoL measures, population characteristics and data analysis. In total, 43 studies (91.5%) reported that better QoL was associated with lower mortality risk. The results of four meta-analyses indicated that higher health-related QoL (HRQoL) is associated with lower mortality risk, which was consistent for overall HRQoL (HR 0.633, 95% CI: 0.514 to 0.780), physical function (HR 0.987, 95% CI: 0.982 to 0.992), physical component score (OR 0.950, 95% CI: 0.935 to 0.965), and mental component score (OR 0.980, 95% CI: 0.969 to 0.992).

Conclusion: These findings provide evidence that better QoL/HRQoL was associated with lower mortality risk. The utility of these measures in predicting mortality risk indicates that they should be considered further as potential screening tools in general clinical practice, beyond the traditional objective measures such as body mass index and the results of laboratory tests.

Keywords: Health-related quality of life; Life quality; Meta-analysis; Mortality; Predictor; Quality of life; Review.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Fig. 1
Fig. 1
Flow Diagram of Review Process
Fig. 2
Fig. 2
Forest plot of all-cause mortality risk per one unit increase in a SF-36 PCS, b SF-36 Physical-Functioning, c SF-36 MCS. CI = confidence interval; FU (yrs) = follow-up in years; N = sample size; OR = odds ratio; RR = relative risk; HR = hazard ratio
Fig. 3
Fig. 3
Forest plot of all-cause mortality risk per one-SD (0.14) increase in 15D index. CI = confidence interval; FU (yrs) = follow-up in years; HR = hazard ratio; N = sample size
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