Advertisement

Quality of Life Research

, Volume 28, Issue 12, pp 3249–3257 | Cite as

Age-specific trends in health-related quality of life among US adults: findings from National Health and Nutrition Examination Survey, 2001–2016

  • Mary L. GreaneyEmail author
  • Steven A. Cohen
  • Bryan J. Blissmer
  • Jacob E. Earp
  • Furong Xu
Article

Abstract

Purpose

Health-related quality of life (HRQoL) is an important indicator of population health, yet no age-specific trend analyses in HRQoL have been conducted with a nationally representative sample since 2004. Therefore, to address this gap, an age-specific trend analysis of HRQoL was conducted using National Health and Nutrition Examination Surveys (NHANES) data.

Methods

NHANES 2001–2016 data (8 cycles) were examined to evaluate trends in HRQoL by age group (young adults: 21–39, middle-aged: 40–64, older adults: 65+). HRQoL was assessed by self-reported health (SRH) and number of physically unhealthy, mentally unhealthy, and inactive days to due to physical or mental health in the past 30 days. Multiple linear or logistic regression analyses explored trends in HRQoL by age group, adjusting for demographics over time.

Results

Analysis revealed increasing fair/poor SRH over time for the entire sample (β = 0.34, 95% CI 0.08, 0.60, p = 0.011). However, age-specific analysis identified a bi-annual increase in fair/poor SRH only among young adults (β = 0.49, 95% CI 0.22, 0.76, p < 0.001) and a decrease among older adults (β = − 0.60, 95% CI − 1.14, − 0.06, p = 0.03). Closer inspection revealed increasing fair/poor SRH increased among young women (β = 0.52, 95% CI 0.11, 0.93, p = 0.013) and young men (β = 0.46, 95% CI 0.04, 0.88, p = 0.03) but decreased among older women (β = − 0.81, 95% CI − 1.59, − 0.03, p = 0.042) over time. Analyses also determined that there was a trend for a decreasing number of physically unhealthy days among young adults (p < 0.001), although no trends were observed for the other HRQoL items.

Conclusions

Although there was a significant trend over time for increasing fair/poor SRH when considering the entire sample, this trend was not consistent between age groups or sexes. Given increasing fair/poor SRH among young adults, there is a need to understand and address factors relating to HRQoL among this age group.

Keywords

Health-related quality of life Aging Trend analysis NHANES 

Abbreviations

HRQOL

Health-related quality of life

SRH

Self-reported health

NHANES

National Health and Nutrition Examination Survey

BRFSS

Behavioral Risk Factors Surveillance System

CI

Confidence interval

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

References

  1. 1.
    Moriarty, D. G., Zack, M. M., & Kobau, R. (2003). The centers for disease control and prevention’s healthy days measures: Population tracking of perceived physical and mental health over time. Health and Quality of Life Outcomes,1, 37.  https://doi.org/10.1186/1477-7525-1-37.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    DeSalvo, K. B., Fan, V. S., McDonell, M. B., & Fihn, S. D. (2005). Predicting mortality and healthcare utilization with a single question. Health Services Research,40, 1234–1246.CrossRefGoogle Scholar
  3. 3.
    Miilunpalo, S., Vuori, I., Oja, P., Pasanen, M., & Urponen, H. (1997). Self-rated health status as a health measure: The predictive value of self-reported health status on the use of physician services and on mortality in the working-age population. Journal of Clinical Epidemiology,50, 517–528.CrossRefGoogle Scholar
  4. 4.
    Wang, L., Palmer, A. J., Cocker, F., & Sanderson, K. (2017). Multimorbidity and health-related quality of life (HRQOL) in a nationally representative population sample: Implications of count versus cluster method for defining multimorbidity on HRQOL. Health and Quality of Life Outcomes,15(1), 7.  https://doi.org/10.1186/s12955-016-0580-x.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Jia, H., Muennig, P., Lubetkin, E., & Gold, M. (2004). Predicting geographical variations in behavioural risk factors: An analysis of physical and mental healthy days. Journal of Epidemiology and Community Health,58(2), 150–155.CrossRefGoogle Scholar
  6. 6.
    Idler, E. L., & Benyamini, Y. (1997). Self-rated health and mortality: A review of twenty-seven community studies. Journal of Health and Social Behavior,28(1), 21–37.CrossRefGoogle Scholar
  7. 7.
    Zahran, H. S., Kobau, R., Moriarty, D. G., Zack, M. M., Holt, J., & Donehoo, R. (2005). Health-related quality of life surveillance–United States, 1993–2002. MMWR Surveillance Summary,54(4), 1–35.Google Scholar
  8. 8.
    Zack, M. M., Moriarty, D. G., Stroup, D. F., Ford, E. S., & Mokdad, A. H. (2004). Worsening trends in adult health-related quality of life and self-related health—United States, 1993–2001. Public Health Reports,119, 493–505.CrossRefGoogle Scholar
  9. 9.
    Centers for Disease Control and Prevention. (2004). Self-reported frequent mental distress among adults: United States, 1993–2001. MMWR. Morbidity and Mortality Weekly Report,53, 963–966.Google Scholar
  10. 10.
    Dwyer-Lindgren, L., Mackenbach, J. P., van Lenthe, F. J., & Mokdad, A. H. (2017). Self-reported general health, physical distress, mental distress, and activity limitation by US county, 1995–2012. Population Health Metrics,15, 16.  https://doi.org/10.1186/s12963-017-0133-5.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Zack, M. M. (2013). Health-related quality of life—United States, 2006 and 2010. MMWR Surveillance Summary,62(3), 105–111.Google Scholar
  12. 12.
    Olfson, M., Wall, M., Liu, S. M., Schoenbaum, M., & Blanco, C. (2017). Declining health-related quality of life in the U.S. American Journal of Preventive Medicine,54(3), 325–333.  https://doi.org/10.1016/j.amepre.2017.11.012.CrossRefGoogle Scholar
  13. 13.
    Sharma, R. (2013). The family and family structure classification redefined for the current times. Journal of Family Medicine and Primary Care,2(4), 306–310.  https://doi.org/10.4103/2249-4863.123774.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Antonucci, T. C., Ajrouch, K. J., & Manalel, J. A. (2017). Social relations and technology: Continuity, context, and change. Innovation in Aging,1(3), igx029.  https://doi.org/10.1093/geroni/igx029.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Centers for Disease Control and Prevention. (2017). National health and nutrition examination survey. Retrieved July 12, 2017 from https://wwwn.cdc.gov/nchs/nhanes.
  16. 16.
    Centers for Disease Control and Prevention. (2019). NHANES survey methods and analytic guidelines. Retrieved May 8, 2019 from https://wwwn.cdc.gov/nchs/nhanes/analyticguidelines.aspx.
  17. 17.
    U.S. Census Bureau, Population Division, Fertility & Family Statistics Branch. (2004). Current population survey: Definitions and explanations. Retrieved December 15, 2017 from http://www.census.gov.
  18. 18.
    CDC National Center for Health Statistics. (2013). Specifying weighting parameters. Retrieved August 11, 2017 from https://www.cdc.gov/nchs/tutorials/nhanes/surveydesign/weighting/intro.htm.
  19. 19.
    Waidmann, T., Bound, J., & Schoenbaum, M. (1995). The illusion of failure: Trends in the self-reported health of the U.S. elderly. Milbank Quarterly,73, 253–287.CrossRefGoogle Scholar
  20. 20.
    Juniper, E. F., Guyatt, G. H., Willam, A., & Griffith, L. E. (1994). Determining a minimal important change in a disease-specific Quality of Life Questionnaire. Journal of Clinical Epidemiology,47, 81–87.CrossRefGoogle Scholar
  21. 21.
    Sloan, J., Symonds, T., Vargas-Chanes, D., & Fridley, B. (2003). Practical guidelines for assessing the clinical significance of health-related quality of life changes within clinical trials. Drug Information Journal,37, 23–31.CrossRefGoogle Scholar
  22. 22.
    Smith, D. W. (2004). The population perspective in quality of life among Americans with diabetes. Quality of Life Research,13(8), 1391–1400.CrossRefGoogle Scholar
  23. 23.
    Ford, E., & Li, c. (2004). Metabolic syndrome and health-related quality of life among U.S. adults. Annals of Epidemiology,18(3), 165–171.CrossRefGoogle Scholar
  24. 24.
    Bown, D. W., Pleasants, R., Ohar, J. A., et al. (2010). Health-related quality of life and chronic obstructive pulmonary disease in North Carolina. North American Journal of Medical Sciences,2, 60–65.Google Scholar
  25. 25.
    Hart, P. D. (2016). Meeting recommended levels of physical activity and health-related quality of life in rural adults. Journal of Lifestyle Medicine,6, 1–6.CrossRefGoogle Scholar
  26. 26.
    Dankel, S. J., Loenneke, J. P., & Loprinzi, P. D. (2016). The WATCH (weight activity and time contributes to health) paradigm and quality of life: The impact of overweight/obesity duration on the association between physical activity and health-related quality of life. International Journal of Clinical Practice,70(5), 409–415.CrossRefGoogle Scholar
  27. 27.
    Ogden, C. L., Carroll, M. D., Lawman, H. G., Fryar, C. D., Kruszon-Moran, D., Kit, B. K., et al. (2016). Trends in obesity prevalence among children and adolescents in the United States, 1988–1994 through 2013–2014. JAMA,315(21), 2292–2299.  https://doi.org/10.1001/jama.2016.6361.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Cislaghi, B., & Cislaghi, C. (2019). Self-rated health as a valid indicator for health-equity analyses: Evidence from the Italian health interview survey. BMC Public Health,19(1), 533.CrossRefGoogle Scholar
  29. 29.
    Office of Disease Prevention and Health Promotion. (2019). Healthy people 2020 foundation health measure report: Health-related quality of life and well-being. Retrieved April 15, 2019 from https://www.healthypeople.gov/sites/default/files/HRQoLWBFullReport.pdf.

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Mary L. Greaney
    • 1
    Email author
  • Steven A. Cohen
    • 1
  • Bryan J. Blissmer
    • 2
  • Jacob E. Earp
    • 2
  • Furong Xu
    • 2
  1. 1.Department of Health Studies, University of Rhode IslandKingstonUSA
  2. 2.Department of KinesiologyUniversity of Rhode IslandKingstonUSA

Personalised recommendations