Page 73 - IJPS-11-1

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

Table 2. Hazard ratios and 95% confidence intervals for that interventions aimed at improving HRQoL could
10‑year mortality based on the eight domains and two yield substantial public health benefits on a global scale.
components of the 36‑item Short Form Health Survey in Furthermore, the observed discrepancies between the
older adults with better and worse Health‑Related Quality of physical and mental dimensions of HRQoL underscore
Life in Campinas, São Paulo (2008 – 2018) the complexity of these relationships, warranting further
HRQoL Model 1 a Model 2 b Model 3 c investigation to elucidate the underlying mechanisms and
(SF‑36) inform targeted interventions.
Physical functioning A study in the United States with 2,166 participants
Best status 1 1 1 aged 65 and older, monitored over 28 months, found
Worst status 2.35 (1.79 – 3.09) 1.80 (1.34 – 2.40) 1.74 (1.30 – 2.34) that individuals in the lowest quartile of PC scores
Role-physical faced a significantly higher risk of death from all causes
Best status 1 1 1 compared to those in the highest quartile (HR = 5.99;
95% CI 1.90 – 18.95) (Dorr et al., 2006). A similar trend
Worst status 1.92 (1.50 – 2.45) 1.47 (1.12 – 1.92) 1.42 (1.09 – 1.85) was observed for MC (HR = 2.30; 95% CI 1.64 – 3.22).
Bodily pain A longitudinal study in Taiwan with 4,424 participants aged
Best status 1 1 1 65 and older followed for 3 years reported that a 10-point
Worst status 1.16 (0.92 – 1.44) 1.03 (0.80 – 1.32) 0.98 (0.76 – 1.26) reduction in PC and MC scores was associated with
General health increased risk of mortality (HR = 1.60; 95% CI 1.39 – 1.83
Best status 1 1 1 and HR = 1.16; 95% CI 1.01 – 1.34, respectively) (Tsai
Worst status 1.51 (1.18 – 1.93) 1.41 (1.10 – 1.79) 1.36 (1.06 – 1.74) et al., 2007).
Vitality In Germany, a study with 4,259 participants aged
Best status 1 1 1 20 – 79, monitored over a mean follow-up of 9.7 years,
Worst status 1.29 (1.02 – 1.63) 1.18 (0.92 – 1.51) 1.13 (0.88 – 1.45) identified the lowest quartile of PC as an independent
predictor of mortality (HR = 1.64; 95% CI 1.19 – 2.27),
Role-emotional while MC did not significantly predict premature
Best status 1 1 1 mortality (HR = 0.97; 95% CI 0.74 – 1.28) (Haring et al.,
Worst status 1.69 (1.35 – 2.11) 1.38 (1.12 – 1.70) 1.35 (1.10 – 1.65) 2011). Similarly, a study in Spain with 2,343 older adults
Social functioning (6-year follow-up) found no association between MC and
Best status 1 1 1 mortality (Otero-Rodríguez et al., 2010).
Worst status 1.66 (1.31 – 2.10) 1.32 (1.04 – 1.68) 1.28 (1.01 – 1.63) Previous research has indicated that the PC score is a
Mental health more critical measure than the MC score for predicting
Best status 1 1 1 mortality (Der-Martirosian et al., 2010; Liang et al.,
Worst status 1.35 (1.09 – 1.66) 1.40 (1.09 – 1.82) 1.36 (1.06 – 1.75) 2017). Variability in the association between MC and all-
Physical component cause mortality may reflect specific sociodemographic or
cultural factors, underscoring the need for context-specific
Best status 1 1 1 analysis (Phyo et al., 2021).
Worst status 2.04 (1.62 – 2.55) 1.53 (1.20 – 1.95) 1.47 (1.16 – 1.88) A systematic review conducted in 2020 (Phyo et al.,
Mental component 2020) noted that only five studies employing the SF-36 or
Best status 1 1 1 SF-20 assessed all domains of the instrument, rather than
Worst status 1.22 (0.98 – 1.50) 1.20 (0.96 – 1.50) 1.17 (0.94 – 1.45) focusing solely the summary components. These studies
a Crude hazard ratios and 95% confidence intervals. identified associations of mortality with general health,
b Adjusted by gender, age, income, education, and physical activity. bodily pain, vitality, and social functioning. In contrast,
c Adjusted by sex, age, income, education, physical activity, and the our study found no associations with bodily pain or vitality
number of chronic diseases.
Abbreviations: HRQoL: Health-related quality of life; SF-36: 36-item but identified significant relationships with physical
short-form health survey. functioning, role-physical, role-emotional, mental health,
general health, and social functioning. The discrepancies
conducted in France (Singh-Manoux et al., 2006), Italy may arise from the predominance of studies (98% of the
(Cavrini et al., 2012), and North America (Brown et al., total) in high- or upper-middle-income countries included
2015; Hart, 2019) consistently demonstrates a correlation in the review. By analyzing the individual domains of SF-36,
between higher levels of HRQoL and reduced mortality we have gained insights into which aspects of QoL are most
risk. This consistency across diverse regions suggests adversely affected by comorbidities in the older population,

Volume 11 Issue 1 (2025) 67 https://doi.org/10.36922/ijps.1928