The Impact of Multimorbidity on Quality of Life Among Midlife Women: Findings from a U.S. Nationally Representative Survey

Abstract

Background: Little is known about the prevalence and cumulative burden of coexisting health conditions including chronic joint and muscular pain, urinary incontinence (UI), depression, osteoporosis risk, moderate/ severe vasomotor symptoms, and vulvar/vaginal atrophy (VVA). We surveyed a nationally representative U.S. sample of midlife (age 40-64 years) women to ascertain the prevalence, general health-related quality of life (HRQoL), and health-seeking behaviors associated with these six conditions. Methods: This cross-sectional, telephone survey collected data from a sample of English-and Spanish-speaking U.S. women. The survey contained demographic and menopausal status questions, and also five conditionspecific symptom/disease risk-screening instruments. The EuroQol 5 dimensions (EQ-5D) questionnaire was used to measure HRQoL. Health-seeking behavior was measured based on clinician discussion of and recent treatment for each condition. Results: Three thousand fifty eight women (mean age 53.4 years) completed the survey. The majority were white (75.6%), married (60.5%), employed full-or part-time (59.0%), and postmenopausal (69.8%; based on self-report). The prevalence [95% confidence interval] of 0, 1, 2, and ‡ 3 conditions was 35.2% [33.5-36.9], 34.2% [32.5-35.9], 17.9% [16.6-19.3], and 12.7% [11.5-13.9], respectively. Osteoporosis risk (30.6%) was most prevalent, followed by VVA (27.8%) and UI (26.6%). UI and VVA coexisted most frequently (11.3%), followed by osteoporosis risk and VVA (9.8%). EQ-5D scores decreased with increasing number of illnesses (0, 1, 2, and ‡ 3 conditions, means: 0.92, 0.87, 0.77, 0.61, respectively; p < 0.01). Health-seeking behavior varied by condition. Conclusion: Over 25% of women surveyed had multiple coexisting conditions. Lower HRQoL was associated with multiple conditions and with each added condition.

Cardiopulmonary Resuscitation Training Disparities in the United States

“…Participants were queried as part of an ongoing omnibus survey, through both landline and mobile telephone modalities. Results from the omnibus survey have been used in previous peer‐reviewed biomedical investigations …”

Assessment of lower urinary tract symptoms in different stages of menopause

“…Age-related urinary changes, such as urinary incontinence, often lead to severe psychosocial problems that have a negative effect on the quality of life of women8, 9, 16 ) . This study found that the perimenopausal period exerted a greater impact on quality of life in relation to urinary losses.…”

“…This study found that the perimenopausal period exerted a greater impact on quality of life in relation to urinary losses. Several studies have demonstrated that UI has a negative influence on the quality of life of women aged between 40 and 65 years, as determined by the ICIQ-SF8, 9, 24 ) . In other words, regardless of the type of urinary loss, quality of life is compromised to some extent.…”

“…The high prevalence of LUTS over the course of a woman’s life, as well as the high cost for the public health system9 ) , have prompted studies that had investigated the natural history of urinary disorders, in order to lessen the impact of these symptoms on the quality of life of millions of women. In addiction this fact, the lack of information on these symptoms in the different stages of menopause motivates the development of studies seeking to determine the observe emergence or aggravation in a particular stage.…”

Is Australian primary care practice equipped to provide multimorbidity care?

“…Multiple long term conditions are associated with a wide range of adverse outcomes for individuals and the health system. These included: increased health service use (14,56,79,(89)(90)(91)(92), polypharmacy (56,90,(93)(94)(95)(96), hospital admissions (14,79,89,90,97,98), out-of-pocket expenses (99-103), and psychological distress (79,93,(104)(105)(106), along with reductions in physical functioning (79,(107)(108)(109)(110)(111)(112), quality-of-life (14,79,(113)(114)(115)(116)(117), employability (118)(119)(120),and continuity of care (56,93,121,122).…”