Prospective Change in Health-Related Quality of Life and Subsequent Mortality Among Middle-Aged and Older Women

The objective of this study was to determine prospective changes in health-related quality of life (HRQoL) measures and subsequent mortality in middle-aged and older women.

Data were obtained from 40,337 healthy women from the Nurses’ Health Study aged 46 to 71 years in 1992. The authors used Cox proportional hazards regression to evaluate associations of changes in self-assessed physical and mental component summary (PCS and MSC) scores from the Short Form 36 Health Survey between 1992 and 1996 and between 1996 and 2000, with all-cause mortality through 2004.

Women with low health-related quality of life (PCS and MCS scores) and the greatest ©health-related quality of life declines had higher mortality than did women with stable scores. Change in PCS score predicted mortality across the range of four-year change: severe decline (relative risk [RR] = 3.32; 95% confidence interval [CI] = 2.45, 4.50), moderate decline (RR = 1.44; 95% CI = 1.16, 1.79), slight decline (RR = 1.35; 95% CI = 1.12, 1.63), no change (reference category), improvement (RR = 0.72; 95% CI = 0.56, 0.91; continuous P < .001). MCS score results were similar. Score increases were associated with lifestyle improvements, especially increased physical activity.

The study concluded that observed associations demonstrate the predictive validity of changes in self-assessed health-related quality of life for subsequent mortality in healthy populations. Future research should examine determinants of patterns of change.