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Health-related quality of life and all-cause mortality among older healthy individuals in Australia and the United States: a prospective cohort study


Phyo, AZZ and Ryan, J and Gonzalez-Chica, DA and Woods, RL and Reid, CM and Nelson, MR and Murray, AM and Gasevic, D and Stocks, NP and Freak-Poli, R, ASPREE Investigator Group, Health-related quality of life and all-cause mortality among older healthy individuals in Australia and the United States: a prospective cohort study, Quality of Life Research, 30, (4) pp. 1037-1048. ISSN 0962-9343 (2021) [Refereed Article]

Copyright Statement

2021 Springer Nature Switzerland AG

DOI: doi:10.1007/s11136-020-02723-y


Purpose: Previous research has demonstrated that lower health-related quality of life (HRQoL) is associated with higher morbidity and mortality, especially in-patient groups. The association of HRQoL with all-cause mortality in community samples requires further investigation. This study aimed to examine whether HRQoL predicts all-cause mortality in older healthy community-dwelling people from Australia and the United States (U.S.) enrolled in the Aspirin in Reducing Events in the Elderly (ASPREE) trial. We also explored whether this association varies by gender or country.

Method: A prospective cohort of 19,106 individuals aged 65-98 years, who were without a dementia diagnosis or a known major life-limiting disease, and completed the 12-item short-form-HRQoL at recruitment (2010-2014). They were followed until June 2017. Cox proportional-hazard models were used to determine the association between the physical (PCS) and mental component scores (MCS) of HRQoL and all-cause mortality, adjusting for sociodemographic factors, health-related behaviours and clinical measures. Hazards ratios were estimated for every 10-unit increase in PCS or MCS.

Results: There were 1052 deaths over a median 4.7-years (interquartile range 3.6-5.7) of follow-up, with 11.9 events per 1000 person-years. Higher PCS was associated with lower all-cause mortality (HR 0.83, 95% CI 0.77, 0.89) in the entire sample, while higher MCS was associated with lower mortality among U.S. participants only (HR 0.78, 95% CI 0.63, 0.95). Gender differences in the association of either PCS or MCS with mortality were not observed.

Conclusion: Our large study provides evidence that HRQoL is inversely associated with all-cause mortality among initially healthy older people.

Item Details

Item Type:Refereed Article
Keywords:12-item short form SF-12; Australia; Health-related quality of life; Mortality; Older people; Predictor; Prospective cohort; United States
Research Division:Health Sciences
Research Group:Health services and systems
Research Field:Aged health care
Objective Division:Health
Objective Group:Evaluation of health and support services
Objective Field:Determinants of health
UTAS Author:Nelson, MR (Professor Mark Nelson)
ID Code:152518
Year Published:2021
Web of Science® Times Cited:9
Deposited By:Menzies Institute for Medical Research
Deposited On:2022-08-19
Last Modified:2022-09-07

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