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Mild cognitive impairment in combination with comorbid diabetes mellitus and hypertension is negatively associated with health-related quality of life among older persons in Taiwan

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Abstract

Purpose

To fill the gap in knowledge about associations of health-related quality of life (HRQoL) with comorbid diabetes mellitus (DM), hypertension (HTN), and/or mild cognitive impairment (MCI) in the elderly, we explored associations of comorbid DM, HTN, and/or MCI with HRQoL.

Methods

Data for this study were from a population-based cross-sectional survey of elderly Taiwanese (≥ 65 years old). Participants (N = 4,634; 47.9% male) were categorized into eight chronic-illness groups: DM only (n = 224); HTN only (n = 1226); DM and HTN (n = 365); MCI only (n = 497); DM and MCI (n = 58); HTN and MCI (n = 303); DM, HTN, and MCI (n = 101); and none (healthy; n = 1860). Associations were examined between the eight chronic-illness groups and HRQoL (measured by EQ-5D scores) using binary logistic regression analyses and generalized linear models adjusted for covariates. Index scores were calculated from EQ-5D scores using Taiwan’s general population-preference weights.

Results

Compared to the healthy group, after adjusting covariates, MCI alone or with other comorbidities was significantly, negatively associated with HRQoL. Among all chronic-illness groups, comorbid DM, HTN, and MCI exhibited the lowest HRQoL. After adjusting covariates, between-group odds ratios for index scores were significant when comparing comorbid DM and MCI to DM only, comparing comorbid HTN and MCI to HTN only and comorbid DM, comparing HTN and MCI to comorbid DM and HTN, suggesting that MCI additively affects HRQoL.

Conclusions

HRQoL of older Taiwanese adults was negatively associated with having MCI. Thus, clinicians managing older persons with chronic illnesses should assess their cognitive function to identify high-risk groups needing HRQoL assistance.

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Acknowledgements

The authors would like to express their gratitude to the Taiwan Alzheimer’s Disease Association for generously allowing us to use an invaluable database that they partly developed and supporting us under the commission of the Ministry of Health and Welfare of Taiwan (DOH100-TD-M113-100001). The views expressed throughout this study are exclusively those of the authors and do not represent the views or opinions of the Ministry of Health and Welfare, Taiwan.

Funding

This work was supported by the Chang Gung Medical Foundation [grant numbers BMRP297, CMRPD1E0162] and Healthy Aging Research Center, Chang Gung University, Taiwan [grant number EMRPD1H0361, EMRPD1H0551].

Author information

Authors and Affiliations

  1. Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan

    Hsin-Yun Liu & Yea-Ing L. Shyu

  2. Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan

    Wen-Che Tsai

  3. Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan

    Ming-Jang Chiu

  4. College of Medicine, National Taiwan University, Taipei, Taiwan

    Ming-Jang Chiu

  5. Graduate Institute of Brain and Mind Sciences, National Taiwan University, Taipei, Taiwan

    Ming-Jang Chiu

  6. Graduate Institute of Psychology, National Taiwan University, Taipei, Taiwan

    Ming-Jang Chiu

  7. Graduate Institute of Biomedical Engineering and Bioinformatics, National Taiwan University, Taipei, Taiwan

    Ming-Jang Chiu

  8. Taiwan Alzheimer’s Disease Association, Taipei, Taiwan

    Li-Yu Tang & Huey-Jane Lee

  9. School of Nursing, College of Medicine, Chang Gung University, 259 Wenhua 1st Road, Guishan District, Taoyuan, 33302, Taiwan

    Yea-Ing L. Shyu

  10. Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan

    Yea-Ing L. Shyu

  11. Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan

    Yea-Ing L. Shyu

  12. Department of Gerontology and Health Care Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan

    Yea-Ing L. Shyu

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  1. Hsin-Yun Liu
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Correspondence to Yea-Ing L. Shyu.

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The data were approved by the National Taiwan University Hospital’s Institutional Review Board. Informed consent was obtained from the participants or their proxy.

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Liu, HY., Tsai, WC., Chiu, MJ. et al. Mild cognitive impairment in combination with comorbid diabetes mellitus and hypertension is negatively associated with health-related quality of life among older persons in Taiwan. Qual Life Res 28, 1281–1291 (2019). https://doi.org/10.1007/s11136-019-02101-3

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