The purpose of the study was to examine the association between 3 lifestyle behaviors (smoking, physical activity, and fruit and vegetable consumption) and health-related quality of life (HRQOL) among older adults diagnosed with diabetes.
Methods
A sample of the US population 65 years and older who were diagnosed with diabetes from the 2015 Behavioral Risk factor Surveillance System (N = 11 503) was analyzed. The 4 HRQOL measures were self-rated health, physically unhealthy days, mentally unhealthy days, and impaired activity days in the past month. Multiple logistic regression analysis was conducted to predict HRQOL.
Results
The multiple logistic regression results showed that smoking and lack of physical activity were significant predictors for higher odds of fair or poor self-rated health, more physically unhealthy days, more mentally unhealthy days, and more impaired activity days during past 30 days. No significant relationship was found between fruit and vegetable consumption and any HRQOL measure.
Conclusions
Findings imply that diabetes education could continue and enhance efforts in smoking cessation and increase physical activity to promote the HRQOL among older adults diagnosed with diabetes. In addition, the measure of fruit and vegetable consumption should be further studied to reflect the needs of older adults with diabetes.
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References
1.
US Department of Health and Human Services. Healthy People 2020. Washington, DC: US Department of Health and Human Services; 2010.
2.
BakasTMcLennonSMCarpenterJSet al. Systematic review of health-related quality of life models. Health Qual Life Outcomes. 2012;10(1):134.
3.
MoriartyDGZackMMKobauR. The centers for disease control and prevention’s healthy days measures—population tracking of perceived physical and mental health over time. Health Qual Life Outcomes. 2003;1:37.
4.
TillJEOsobaDPaterJLYoungJR. Research on health-related quality of life: dissemination into practical applications. Qual Life Res. 1994;3(4):279-283.
5.
Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey Questionnaire. Atlanta, GA: CDC; 2015.
6.
BrownGCBrownMMSharmaSBrownHGozumMDentonP. Quality of life associated with diabetes mellitus in an adult population. J Diabetes Complications. 2000;14(1):18-24.
7.
JacobsonAMBraffettBHClearyPAGubitosi-KlugRLarkinME. The long-term effects of type 1 diabetes treatment and complications on health-related quality of life. Diabetes Care. 2013;36(10):3131.
8.
BrownDWBalluzLSGilesWHet al. Diabetes mellitus and health-related quality of life among older adults. Diabetes Res Clin Pract. 2004;65(2):105-115.
9.
WeinbergerMKirkmanMSSamsaGPet al. The relationship between glycemic control and health-related quality of life in patients with non-insulin-dependent diabetes mellitus. Med Care. 1994;32(12):1173-1181.
10.
WexlerDJGrantRWWittenbergEet al. Correlates of health-related quality of life in type 2 diabetes. Diabetologia. 2006;49(7): 1489-1497.
11.
WilliamsonDARejeskiJLangWet al. Impact of a weight management program on health-related quality of life in overweight adults with type 2 diabetes. Arch Intern Med. 2009;169(2):163-171.
12.
PaschalidesCWeardenAJDunkerleyRBundyCDaviesRDickensCM. The associations of anxiety, depression and personal illness representations with glycaemic control and health-related quality of life in patients with type 2 diabetes mellitus. J Psychosom Res. 2004;57(6):557-564.
13.
EyreHKahnRRobertsonRM. Preventing cancer, cardiovascular disease, and diabetes. Diabetes Care. 2004;27(7):1812.
14.
HuFBMansonJEStampferMJet al. Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. N Engl J Med. 2001;345(11):790-797.
15.
CamachoFAndersonRTBellRAet al. Investigating correlates of health related quality of life in a low-income sample of patients with diabetes. Qual Life Res. 2002;11(8):783-796.
16.
LiCFordES. Healthy lifestyle habits and health-related quality of life in diabetes. In: PreedyVRWatsonRR, eds. Handbook of Disease Burdens and Quality of Life Measures. New York, NY: Springer; 2010:2095-2114.
17.
LiCFordESMokdadAHJilesRGilesWH. Clustering of multiple healthy lifestyle habits and health-related quality of life among U.S. adults with diabetes. Diabetes Care. 2007;30(7):1770.
18.
KirkmanMSBriscoeVJClarkNet al. Diabetes in older adults. Diabetes Care. 2012;35(12):2650-2664.
19.
Centers for Disease Control and Prevention (CDC). National Diabetes Statistics Report. Atlanta, GA: CDC; 2017.
20.
American Diabetes Association. Economic costs of diabetes in the U.S. in 2012. Diabetes Care. 2013;36(4):1033-1046.
FowlerMJ. Diabetes: magnitude and mechanisms. Clin Diabetes. 2010;28(1):42-46.
23.
California Healthcare Foundation/American Geriatrics Society Panel in Improving Care for Elders with Diabetes. Guidelines for improving the care of the older person with diabetes mellitus. J Am Geriatr Soc. 2003;51(5):265-280.
24.
Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey Data. Atlanta, GA: CDC; 2015.
25.
IachanRPierannunziCHealeyKGreenlundKJTownM. National weighting of data from the behavioral risk factor surveillance system (BRFSS). BMC Med Res Methodol. 2016;16(1):1-12.
26.
Centers for Disease Control and Prevention (CDC). BRFSS 2015 Summary Data Quality Report. Atlanta, GA: CDC; 2015.
27.
HennessyCHMoriartyDGZackMMScherrPABrackbillR. Measuring health-related quality of life for public health surveillance. Public Health Rep. 1994;109(5):665-672.
28.
StrineTWOkoroCAChapmanDPet al. Health-related quality of life and health risk behaviors among smokers. Am J Prev Med. 2005;28(2):182-187.
29.
StrineTWChapmanDPKobauRBalluzLMokdadAH. Depression, anxiety, and physical impairments and quality of life in the U.S. noninstitutionalized population. Psychiatr Serv. 2004;55(12):1408-1413.
30.
US Department of Health and Human Services, US Department of Agriculture. 2015-2020 Dietary Guidelines for Americans. 8th ed.2015. Available at http://health.gov/dietaryguidelines/2015/guidelines/. Accessed October 15, 2018.
31.
National Heart, Lung, and Blood Institute; National Institute of Diabetes and Digestive and Kidney Diseases; National Institutes of Health. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report. NIH Publication 98-4083. June1998.
32.
CurranPWestSFinchJ. The robustness of test statistics to nonnormality and specification error in confirmatory factor analysis. Psychol Methods. 1996;1(1):16-29.
33.
LomaxRHahs-VaughnD. Logistic regression. In: An Introduction to Statistical Concepts. New York, NY: Routledge; 2012:737-738.
34.
American Diabetes Association. Introduction: standards of medical care in diabetes—2018. Diabetes Care. 2018;41(suppl 1):S2.
35.
WalkerSNVolkanKSechristKRPenderNJ. Health-promoting life styles of older adults: comparisons with young and middle-aged adults, correlates and patterns. Adv Nurs Sci. 1988;11(1):76-90.
36.
HopmanWMHarrisonMBCooHFriedbergEBuchananMVanDenKerkhofEG. Associations between chronic disease, age and physical and mental health status. Chronic Dis Can. 2009; 29(3):108-116.
37.
BlazerDBurchettBServiceCGeorgeLK. The association of age and depression among the elderly: an epidemiologic exploration. J Gerontol. 1991;46(6):M215.
38.
BabyakM. What you see may not be what you get: a brief, nontechnical introduction to overfitting in regression-type models. Psychosom Med. 2004;66:411-421.
