Mental component of health-related quality of life is an independent predictor of incident functional disability among community-dwelling older people: a prospective cohort study

Abstract

Purpose

Previous studies have reported a positive association between poor health-related quality of life (HRQOL) and disability mainly in relation to the physical component of HRQOL. Given the mental component’s responsivity to interventions, this study aimed to investigate whether the mental component of HRQOL independently predicted functional disability.

Methods

We targeted all residents aged ≥ 65 years in one municipality and analyzed 3858 men and 4475 women without disability at baseline (November 2016). HRQOL was measured using the physical component summary (PCS) and mental component summary (MCS) of the SF-8 Health Survey. At 3-year follow-up (October 2019), incident functional disability was measured, defined as a new certification according to the Japanese long-term care insurance system. Multivariable Poisson regression models stratified by gender were used to estimate adjusted cumulative incidence ratio (CIR) and 95% confidence interval (CI) for functional disability.

Results

Among both genders, there was a significant dose-response relationship between better MCS and lower risk of functional disability, independent of potential confounders including the PCS (P for trend = 0.026 in men and 0.003 in women). Compared with the worst MCS group, the CIRs (95% CIs) for functional disability in the second worst, the middle, the second best, and the best MCS quintile groups were 1.09 (0.80–1.48), 0.58 (0.40–0.85), 0.90 (0.59–1.37), and 0.70 (0.48–1.02) for men, and 0.76 (0.58–1.00), 0.62 (0.46–0.84), 0.73 (0.53–0.99), and 0.63 (0.48–0.85) for women, respectively.

Conclusion

The MCS is an independent predictor of functional disability among high-functioning older adults. This suggests that strategies focused on mental HRQOL are important for realizing a healthy, long-lived society.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

This work was supported by JSPS KAKENHI Grant Number JP17K09209 and the Center Administrative Expense from Nara Medical University. We wish to thank the participants of this study and support staff who make the study possible. We also thank Dr. Heather Hill for her English language editing.

Funding

This work was supported by JSPS KAKENHI Grant Number JP17K09209 and the Center Administrative Expense from Nara Medical University.

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Contributions

Study concept and design: KT and MS. Acquisition of subjects and data and preparation of manuscript: All authors. Analysis and interpretation of data: KT and KS.

Corresponding author

Correspondence to Kimiko Tomioka.

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Conflict of interest

KS received research grants from YKK AP Inc.; Ushio Inc.; Tokyo Electric Power Company; EnviroLife Research Institute Co., Ltd.; Sekisui Chemical Co., Ltd.; LIXIL Corp.; and KYOCERA Corp. This does not alter our adherence to the Quality of Life Research’s policies on sharing data and materials. For the remaining authors, none were declared.

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Submission of self-completed questionnaires was considered agreement to participate in the research.

Ethical approval

This study was approved by the Nara Medical University Ethics Committee (Approval No. 939).

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Tomioka, K., Shima, M. & Saeki, K. Mental component of health-related quality of life is an independent predictor of incident functional disability among community-dwelling older people: a prospective cohort study. Qual Life Res (2021). https://doi.org/10.1007/s11136-021-02780-x

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Keywords

  • Health-related quality of life
  • Functional disability
  • Prospective study
  • Community-dwelling older people
  • SF-8