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BMC Geriatrics
Published in: BMC Geriatrics 1/2019

Open Access 01-12-2019 | Nutrition | Research article

Change in quality of life and potentially associated factors in patients receiving home-based primary care: a prospective cohort study

Authors: Chi-Hsien Huang, Hiroyuki Umegaki, Hiroko Kamitani, Atushi Asai, Shigeru Kanda, Keiko Maeda, Hideki Nomura, Masafumi Kuzuya

Published in: BMC Geriatrics | Issue 1/2019

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Abstract

Background

The trajectories for health-related quality of life of patients receiving home-based primary care are not well identified. Our objective was to investigate changes in the quality of life (QOL) and factors that affected the QOL of patients receiving home-based primary care.

Methods

Our prospective cohort study, the Observational study of Nagoya Elderly with HOme MEdical (ONE HOME) study, recruited 184 patients undergoing home-based primary care with a 5-year follow-up period. Patients’ demographic data, socioeconomic status, physical diseases, medication use, feeding intake status, nutritional status, and functional status were measured annually. The 4-item quality of life index (QOL-HC [home care]) including self-perceived and family-reported QOL ratings that had been developed and previously validated in home care settings was used. Linear regression models were used for cross-sectional and longitudinal analyses.

Results

The participants’ mean age was 78.8 ± 10.8 years, and 55.9% of the sample was male. Most patients were frail, disabled, and/or malnourished. Self-perceived and family-reported QOL scores dropped sequentially on annual follow-ups. In the multivariate longitudinal analysis, patients who were divorced (β = 1.74) had high baseline QOL scores (β = 0.75) and reported higher QOL ratings. In addition, high functional dependency was associated with a low self-perceived QOL rating, with a β-value of − 1.24 in the pre-bedridden group and − 1.39 in the bedridden group. Given the family-reported QOL rating, the baseline QOL scores (β = 0.50) and Mini-Nutritional Assessment–Short-Form scores (β = 0.37) were found to have positive associations with the QOL rating.

Conclusions

For the disabled receiving home-based primary care, independent functional status and divorce were positively associated with better self-perceived QOL, whereas nutritional status was correlated with better family-reported QOL.
Literature
1.
Parker E, Zimmerman S, Rodriguez S, Lee T. Exploring Best practices in home health care. Home Health Care Manag Pract. 2013;26(1):17–33.CrossRef
2.
Rowles GD. Evolving images of place in aging and ‘aging in place. Generations. 1993;17(2):65–70.
3.
Olsen C, Pedersen I, Bergland A, Enders-Slegers MJ, Joranson N, Calogiuri G, Ihlebaek C. Differences in quality of life in home-dwelling persons and nursing home residents with dementia - a cross-sectional study. BMC Geriatr. 2016;16:137.PubMedPubMedCentralCrossRef
4.
Keehan SP, Cuckler GA, Sisko AM, Madison AJ, Smith SD, Lizonitz JM, Poisal JA, Wolfe CJ. National health expenditure projections: modest annual growth until coverage expands and economic growth accelerates. Health Aff. 2012;31(7):1600–12.CrossRef
5.
6.
Burwell SM. Setting value-based payment goals—HHS efforts to improve US health care. N Engl J Med. 2015;372(10):897–9.PubMedCrossRef
7.
Persson MD, Brismar KE, Katzarski KS, Nordenström J, Cederholm TE. Nutritional status using mini nutritional assessment and subjective global assessment predict mortality in geriatric patients. J Am Geriatr Soc. 2002;50(12):1996–2002.PubMedCrossRef
8.
9.
Hoeksema AR, Peters LL, Raghoebar GM, Meijer HJA, Vissink A, Visser A. Health and quality of life differ between community living older people with and without remaining teeth who recently received formal home care: a cross sectional study. Clin Oral Investig. 2018.
10.
Herdman M, Gudex C, Lloyd A, Janssen M, Kind P, Parkin D, Bonsel G, Badia X. Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res. 2011;20(10):1727–36.PubMedPubMedCentralCrossRef
11.
Shiroiwa T, Fukuda T, Ikeda S, Igarashi A, Noto S, Saito S, Shimozuma K. Japanese population norms for preference-based measures: EQ-5D-3L, EQ-5D-5L, and SF-6D. Qual Life Res. 2016;25(3):707–19.PubMedCrossRef
12.
Fukuhara S, Bito S, Green J, Hsiao A, Kurokawa K. Translation, adaptation, and validation of the SF-36 health survey for use in Japan. J Clin Epidemiol. 1998;51(11):1037–44.PubMedCrossRef
13.
Vagetti GC, Barbosa Filho VC, Moreira NB, Oliveira V, Mazzardo O, Campos W. Association between physical activity and quality of life in the elderly: a systematic review, 2000-2012. Rev Bras Psiquiatr. 2014;36(1):76–88.PubMedCrossRef
14.
Tourani S, Behzadifar M, Martini M, Aryankhesal A, Taheri Mirghaed M, Salemi M, Behzadifar M, Bragazzi NL. Health-related quality of life among healthy elderly Iranians: a systematic review and meta-analysis of the literature. Health Qual Life Outcomes. 2018;16(1):18.PubMedPubMedCentralCrossRef
15.
Le J, Dorstyn DS, Mpfou E, Prior E, Tully PJ. Health-related quality of life in coronary heart disease: a systematic review and meta-analysis mapped against the international classification of functioning, disability and health. Qual Life Res. 2018;27(10):2491–503.PubMedCrossRef
16.
Treanor C, Donnelly M. A methodological review of the short form health survey 36 (SF-36) and its derivatives among breast cancer survivors. Qual Life Res. 2015;24(2):339–62.PubMedCrossRef
17.
Naveiro-Rilo JC, Diez-Juarez D, Flores-Zurutuza ML, Javierre Perez P, Alberte Perez C, Molina Mazo R. Quality of life in the elderly on polymedication and with multiple morbidities. Rev Esp Geriatr Gerontol. 2014;49(4):158–64.PubMedCrossRef
18.
Ghiasi B, Sarokhani D, Dehkordi AH, Sayehmiri K, Heidari MH. Quality of life of patients with chronic kidney disease in Iran: systematic review and meta-analysis. Indian J Palliative Care. 2018;24(1):104–11.
19.
Zhang S, Moyes S, McLean C, Searchfield G, Welch D, Jacobs R, Kerse N. Self-reported hearing, vision and quality of life: older people in New Zealand. Australas J Ageing. 2016;35(2):98–105.PubMedCrossRef
20.
Read S, Grundy E, Foverskov E. Socio-economic position and subjective health and well-being among older people in Europe: a systematic narrative review. Aging Ment Health. 2016;20(5):529–42.PubMedCrossRef
21.
Kamitani H, Umegaki H, Okamoto K, Kanda S, Asai A, Maeda K, Nomura H, Shimojima T, Suzuki Y, Ohshima H, et al. Development and validation of a new quality of life scale for patients receiving home-based medical care: the observational study of Nagoya elderly with home medical care. Geriatr Gerontol Int. 2017;17(3):440–8.PubMedCrossRef
22.
Chrusciel P, Szczekala KM, Derewiecki T, Jakubowska K, Nalepa D, Czekirda ME, Mianowana V, Czarkowska M. Differences in the quality of life dependent on family status of the elderly living in rural areas - a cross-sectional survey. Ann Agric Environ Med. 2018;25(3):532–8.PubMedCrossRef
23.
Kwon HJ, Kim JS, Kim YJ, Kwon SJ, Yu JN. Sensory impairment and health-related quality of life. Iran J Public Health. 2015;44(6):772–82.PubMedPubMedCentral
24.
de Luis DA, Izaola O, de Mateo ML, Cuellar L, Terroba MC, Aller R. Quality of life and dietary intake in elderly patients with dysphagia. Nutrition. 2006;22(5):584.PubMedCrossRef
25.
Lee IC, Yang YH, Ho PS, Lee IC. Chewing ability, nutritional status and quality of life. J Oral Rehabil. 2014;41(2):79–86.PubMedCrossRef
26.
Miura H, Hara S, Morisaki N, Yamasaki K. Relationship between comprehensive quality of life and factors related to chewing and swallowing function among community-dwelling elderly individuals. Nihon Ronen Igakkai zasshi Japanese journal of geriatrics. 2013;50(1):110–5.PubMedCrossRef
27.
Umegaki H, Asai A, Kanda S, Maeda K, Shimojima T, Nomura H, Kuzuya M. Risk factors for the discontinuation of home medical care among low-functioning older patients. J Nutr Health Aging. 2016;20(4):453–7.PubMedCrossRef
28.
Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373–83.PubMedCrossRef
29.
Boeckxstaens P, Vaes B, Legrand D, Dalleur O, De Sutter A, Degryse JM. The relationship of multimorbidity with disability and frailty in the oldest patients: a cross-sectional analysis of three measures of multimorbidity in the BELFRAIL cohort. Eur J Gen Pract. 2015;21(1):39–44.PubMedCrossRef
30.
Formiga F, Ferrer A, Padros G, Montero A, Gimenez-Argente C, Corbella X. Evidence of functional declining and global comorbidity measured at baseline proved to be the strongest predictors for long-term death in elderly community residents aged 85 years: a 5-year follow-up evaluation, the OCTABAIX study. Clin Interv Aging. 2016;11:437–44.PubMedPubMedCentralCrossRef
31.
Komiya H, Umegaki H, Asai A, Kanda S, Maeda K, Shimojima T, Nomura H, Kuzuya M. Factors associated with polypharmacy in elderly home-care patients. Geriatr Gerontol Int. 2018;18(1):33–41.PubMedCrossRef
32.
Umegaki H, Asai A, Kanda S, Maeda K, Shimojima T, Nomura H, Kuzuya M. Factors associated with unexpected admissions and mortality among low-functioning older patients receiving home medical care. Geriatr Gerontol Int. 2017;17(10):1623–7.PubMed
33.
Filiatrault J, Arsenault AB, Dutil E, Bourbonnais D. Motor function and activities of daily living assessments: a study of three tests for persons with hemiplegia. Am J Occup Ther. 1991;45(9):806–10.PubMedCrossRef
34.
Tsutsui T, Muramatsu N. Care-needs certification in the long-term care insurance system of Japan. J Am Geriatr Soc. 2005;53(3):522–7.PubMedCrossRef
35.
Nishimura K, Kagaya H, Shibata S, Onogi K, Inamoto Y, Ota K, Miki T, Tamura S, Saitoh E. Accuracy of dysphagia severity scale rating without using videoendoscopic evaluation of swallowing. Japanese Journal of Comprehensive Rehabilitation Science. 2015;6:124–8.
36.
Rubenstein LZ, Harker JO, Salva A, Guigoz Y, Vellas B. Screening for undernutrition in geriatric practice: developing the short-form mini-nutritional assessment (MNA-SF). J Gerontol A Biol Sci Med Sci. 2001;56(6):M366–72.PubMedCrossRef
37.
Soini H, Routasalo P, Lagstrom H. Characteristics of the mini-nutritional assessment in elderly home-care patients. Eur J Clin Nutr. 2004;58(1):64–70.PubMedCrossRef
38.
Kuzuya M, Kanda S, Koike T, Suzuki Y, Satake S, Iguchi A. Evaluation of mini-nutritional assessment for Japanese frail elderly. Nutrition. 2005;21(4):498–503.PubMedCrossRef
39.
Kitamura K, Nakamura K, Nishiwaki T, Ueno K, Hasegawa M. Low body mass index and low serum albumin are predictive factors for short-term mortality in elderly Japanese requiring home care. Tohoku J Exp Med. 2010;221(1):29–34.PubMedCrossRef
40.
Zeger SL, Liang KY, Albert PS. Models for longitudinal data: a generalized estimating equation approach. Biometrics. 1988;44(4):1049–60.PubMedCrossRef
41.
Paik MC. The generalized estimating equation approach when data are not missing completely at random. J Am Stat Assoc. 1997;92(440):1320–9.CrossRef
42.
Davis JC, Best JR, Dian L, Khan KM, Hsu CL, Chan W, Cheung W, Liu-Ambrose T. Are the EQ-5D-3L and the ICECAP-O responsive among older adults with impaired mobility? Evidence from the Vancouver falls prevention cohort study. Qual Life Res. 2017;26(3):737–47.PubMedCrossRef
43.
Bidinotto AB, Santos CM, Torres LH, de Sousa MD, Hugo FN, Hilgert JB. Change in quality of life and its association with Oral health and other factors in community-dwelling elderly adults-a prospective cohort study. J Am Geriatr Soc. 2016;64(12):2533–8.PubMedCrossRef
44.
Feng L, Zin Nyunt MS, Gao Q, Feng L, Yap KB, Ng TP. Cognitive frailty and adverse health outcomes: findings from the Singapore longitudinal ageing studies (SLAS). J Am Med Dir Assoc. 2017;18(3):252–8.PubMedCrossRef
45.
Jacob L, Han JW, Kim TH, Park JH, Lee SB, Lee JJ, Ryu SH, Kim SK, Yoon JC, Jhoo JH, et al. How different are quality of life ratings for people with dementia reported by their family caregivers from those reported by the patients themselves? J Alzheimers Dis. 2017;55(1):259–67.PubMedCrossRef
46.
Conde-Sala JL, Rene-Ramirez R, Turro-Garriga O, Gascon-Bayarri J, Campdelacreu-Fumado J, Juncadella-Puig M, Rico-Pons I, Garre-Olmo J. Severity of dementia, anosognosia, and depression in relation to the quality of life of patients with Alzheimer disease: discrepancies between patients and caregivers. Am J Geriatr Psychiatry. 2014;22(2):138–47.PubMedCrossRef
47.
Dourado MC, Sousa MF, Santos RL, Simoes JPN, Nogueira ML, Belfort TT, Torres B, Dias R, Laks J. Quality of life in mild dementia: patterns of change in self and caregiver ratings over time. Rev Bras Psiquiatr. 2016;38(4):294–300.PubMedCrossRef
48.
Olfson M, Wall M, Liu SM, Schoenbaum M, Blanco C. Declining health-related quality of life in the U.S. Am J Prev Med. 2018;54(3):325–33.PubMedCrossRef
49.
Bulanda JR, Brown JS, Yamashita T. Marital quality, marital dissolution, and mortality risk during the later life course. Soc Sci Med. 2016;165:119–27.PubMedCrossRef
50.
Huang LJ, Wen YF, Liu YC, Guo LN, Du WT, Qin MM, Zhang JJ, Liu K. Locomotive function and quality of life among older people in Liaoning, China: falls efficacy as mediator or moderator? Arch Gerontol Geriatr. 2018;76:73–9.PubMedCrossRef
51.
Damiao R, Meneguci J, da Silva Santos A, Matijasevich A, Rossi Menezes P. Nutritional risk and quality of life in community-dwelling elderly: a cross-sectional study. J Nutr Health Aging. 2018;22(1):111–6.PubMedCrossRef
52.
Beck AM. Nutritional interventions among old people receiving support at home. Proc Nutr Soc. 2018:1–5.
53.
Gustavson K, von Soest T, Karevold E, Roysamb E. Attrition and generalizability in longitudinal studies: findings from a 15-year population-based study and a Monte Carlo simulation study. BMC Public Health. 2012;12:918.PubMedPubMedCentralCrossRef
54.
Anjos KF, Boery RN, Pereira R, Pedreira LC, Vilela AB, Santos VC, Rosa Dde O. Association between social support and quality of life of relative caregivers of elderly dependents. Cien Saude Coletiva. 2015;20(5):1321–30.CrossRef
55.
Jeong YG, Myong JP, Koo JW. The modifying role of caregiver burden on predictors of quality of life of caregivers of hospitalized chronic stroke patients. Disabil Health J. 2015;8(4):619–25.PubMedCrossRef
Metadata
Title
Change in quality of life and potentially associated factors in patients receiving home-based primary care: a prospective cohort study
Authors
Chi-Hsien Huang
Hiroyuki Umegaki
Hiroko Kamitani
Atushi Asai
Shigeru Kanda
Keiko Maeda
Hideki Nomura
Masafumi Kuzuya
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2019
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-019-1040-3

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