Page 68 - IJPS-11-1

International Journal of
Population Studies Health-related quality of life and mortality

In Brazil, this age group currently represents 13% of the & Zafar, 2018), and femoral fractures (Campenfeldt
population (United Nations, 2017), with projections et al., 2020). A systematic review of 47 studies concluded
indicating that this percentage may increase to 29.3% by that higher HRQoL is associated with a reduced risk of
2050 (United Nations, 2015). all-cause mortality (Phyo et al., 2020). However, less than
two-thirds of the included studies (28 articles) focused
This increase in longevity is accompanied by a
significant rise in chronic non-communicable diseases exclusively on elders aged 65 years and older, and only
13 were published in the last 5 years. In addition, 14 studies
(CNCDs), which affect vulnerable populations (Marmot had sample sizes of fewer than 1,000 individuals, and only
& Bell, 2019). CNCDs are the leading cause of mortality seven provided a minimum follow-up of 10 years. Notably,
in Brazil, accounting for 72% of all deaths in this country 98% of the studies (46 articles) were conducted in high- or
(Inês Schmidt et al., 2011) and 63% globally (World Health upper-middle-income countries (Phyo et al., 2020).
Organization., 2011). By 2019, approximately 47.6% of the
elderly reported having one or more CNCDs (Malta et al., This retrospective cohort study utilizes a representative
2021). With the rise in life expectancy, the prevalence of sample of the elderly population, offering groundbreaking
multimorbidity is also expected to increase (De Melo & De findings for Brazil and Latin America regarding various
Lima, 2020), resulting in consequences such as functional facets of health and QoL. By employing a globally
decline, increased risk of premature death (Fortin et al., validated standardized instrument, the study assessed
2004; Jani et al., 2019), and adverse effects on quality of these dimensions as predictors of mortality in the elderly.
life (QoL) (Nunes et al., 2015). Health-related quality Global health organizations highlight the importance
of life (HRQoL) serves as a critical indicator of chronic of measuring QoL as a prospective screening tool in
disease management, capturing how these diseases affect routine clinical practice (Centers for Disease Control and
individuals’ lives. HRQoL encompasses a range of self- Prevention, 2019; World Health Organization, 2007). The
reported measures that address physical, psychological, adoption of self-assessed QoL metrics can assist healthcare
social, and functional aspects, thereby providing insights professionals in promptly identifying signs of impending
into the impact of health conditions on daily living (Ware, health decline and increased risk of mortality in the elderly.
2007; Karimi & Brazier, 2016). This contribution not only enhances our understanding
of the challenges faced by the elderly but also provides
According to Idler & Benyamini (1997), valuable information for clinical and policy interventions
self-assessments of health are dynamic and encompass aimed at supporting the health of this population.
not only an individual’s current health status but also their
health trajectory over time. Individuals integrate past With projections indicating that 80% of older
health changes into their current health evaluations, and individuals will reside in low- or middle-income countries
by 2050 (World Health Organization, 2021), the predictive
self-rated poor health serves as an indicator of perceived power of HRQoL concerning mortality outcomes among
decline or impending mortality. Thus, self-reported health non-institutionalized, healthy elders in these regions
measures can anticipate future health outcomes (Idler & remains largely unexplored. Therefore, this study aims to
Benyamini, 1997; Miller & Wolinsky, 2007). The authors assess the probability of survival among older adults with
found that responses to a simple question, “How do you varying HRQoL statuses and to investigate the association
assess your health?” were highly correlated with objective of the 36-item Short Form Health Survey (SF-36) domains
clinical measures of morbidity and could predict mortality and components with all-cause mortality over a 10-year
(Idler & Benyamini, 1997; Miller & Wolinsky, 2007). This follow-up period in Brazil, from 2008 to 2018.
raises the question of how this relationship might extend to
other self-reported dimensions of health, such as functional 2. Methods
capacity, emotional aspects, social aspects, and pain.
This retrospective longitudinal study utilized baseline
Few studies have evaluated this correlation between data from 1,520 elders aged 60 years and older who were
HRQoL and mortality in the general population, and to interviewed as part of the Health Care Survey of the
our knowledge, no study has been conducted in Brazil Municipality of Campinas (ISACamp) in 2008 – 2009.
or Latin America to evaluate HRQoL as a predictor of These participants were subsequently tracked over a 10-year
mortality in older individuals. On the other hand, existing period. The ISACamp 2008 – 2009 employed a complex
studies have demonstrated that poor HRQoL is associated sampling design based on cluster probability sampling
with a higher mortality rate among patients with serious conducted in two stages – territorial and household sectors.
conditions, including heart failure (Erceg et al., 2019), In the first stage, 50 territories were randomly selected with
pulmonary embolism (Chuang et al., 2019), cancer a probability proportional to the number of households. In
(DuMontier et al., 2018; Ediebah et al., 2014; Sitlinger the second stage, households within each selected sector

Volume 11 Issue 1 (2025) 62 https://doi.org/10.36922/ijps.1928