No abstract

The objective of the present study is to compare the QL of a wide range of chronic disease patients. Secondary analysis of eight existing data sets, including over 15,000 patients, was performed. The studies were conducted between 1993 and 1996 and included population-based samples, referred samples, consecutive samples, and/or consecutive samples. The SF-36 or SF-24 were employed as generic QL instruments. Patients who were older, female, had a low level of education, were not living with a partner, and had at least one comorbid condition, in general, reported the poorest level of QL. On the basis of rank ordering across the QL dimensions, three broad categories could be distinguished. Urogenital conditions, hearing impairments, psychiatric disorders, and dermatologic conditions were found to result in relatively favorable functioning. A group of disease clusters assuming an intermediate position encompassed cardiovascular conditions, cancer, endocrinologic conditions, visual impairments, and chronic respiratory diseases. Gastrointestinal conditions, cerebrovascular/neurologic conditions, renal diseases, and musculoskeletal conditions led to the most adverse sequelae. This categorization reflects the combined result of the diseases and comorbid conditions. If these results are replicated and validated in future studies, they can be considered in addition to information on the prevalence of the diseases, potential benefits of care, and current disease-specific expenditures. This combined information will help to better plan and allocate resources for research, training, and health care.

Migraineurs report more asthma and chronic musculoskeletal pain. Compared with nonmigraineurs and to others with chronic conditions, migraineurs report compromised physical, mental, and social functioning, particularly those with a high frequency of attack.

No abstract

In Western countries, 10% to 20% of men and women have a body mass index above 30 kg/M2, and these prevalences have been increasing.1-3 Since overweight and central fat distribution are associated with increased risks of chronic diseases such as diabetes,4 cardiovascular diseases,5'6 cancer,7 8 and premature death,9"0 it is surprising that the quality of life in overweight subjects is less well documented than these diseases.An early study indicated that overweight subjects are more likely to have poorer physical functioning status," a measure of quality of life, but detailed quantification in the present-day population is unavailable. With advancing age, overweight persons are more likely to develop serious limitations in performing basic daily activities.'2 These persons impose an enormous burden on health care resources. 13"4 Poor physical function and quality of life attributable to overweight are important in terms of public health, and they should be addressed by preventive measures and promotion of healthy living. To our knowledge, the quality of life for subjects with adverse fat distribution (i.e., large waists and high waist-to-hip ratios) has not been reported in the literature. The present study quantified the impairment of the quality of life in overweight subjects and in those with large waist circumferences.of subjects in the present study represent those who attended their local health centers for measurements, which included anthropometry. Those who did not attend the health centers or were of non-Dutch nationality were excluded from the analyses. AnthropometryAll anthropometric measurements were made by trained paramedic personnel in accordance with World Health Organization16 recommendations. Subjects wore light clothes during measurements; body weight was measured to the nearest 100 g with calibrated scales, height in bare feet to the nearest millimeter, waist circumference at the level between the lowest rib margin and iliac crest, and hip circumference at the widest trochanters to the nearest millimeter. Circumferences were measured twice and average values were used in analysis. The waist-to-hip circumferential ratio was computed, and body mass index was calculated as weight (in kilograms) divided by height (in meters) squared. Quality ofLife

Studies that relate change in physical activity to change in health-related quality of life in the general population are needed to confirm associations suggested by cross-sectional studies. In the present study, cross-sectional as well as longitudinal associations between leisure time physical activity and health-related quality of life were studied in an apparently healthy population. The present study showed cross-sectional associations between at least moderately intense leisure time physical activity and general health perceptions, vitality, physical functioning and role limitations due to physical health problems. No associations were present for total leisure time physical activity. Change in leisure time physical activity was associated with change in social functioning in men as well as in women, irrespective of the intensity of physical activity. Only in men, change in total leisure time physical activity was associated with change in vitality and general mental health. In our study, cross-sectional associations were not confirmed by longitudinal analyses. Cross-sectional associations were mainly found for physical components of health-related quality of life, whereas longitudinal associations were predominantly observed for mental components of health-related quality of life. Confirmation of our results by those of other studies is needed in order to quantify health promotion messages.

Even in old age, participation in activities with at least a medium-low intensity may postpone cognitive decline. Moreover, a decrease in duration or intensity of physical activity results in a stronger cognitive decline than maintaining duration or intensity.

A moderate intake of EPA+DHA may postpone cognitive decline in elderly men. Results from other studies are needed before definite conclusions about this association can be drawn.