The relationship between nutritional status, functional capacity, and health-related quality of life in older adults with type 2 diabetes: A pilot explanatory study

Alfonso-Rosa, Rosa M.; Pozo-Cruz, Borja del; Pozo-Cruz, Jesús del; Sañudo, Borja

doi:10.1007/s12603-013-0028-5

Cited by 37 publications

(23 citation statements)

References 39 publications

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“…The combination of physical activity and total protein intake was positively associated with overall quality of life in our adjusted model. Most studies that assessed the association between nutrition and quality of life, focus on nutritional status or malnutrition in frail or hospitalized populations [ 49 , 50 , 51 ]. While these studies do find a positive association between total protein intake and quality of life, no relationship was present in our study with total protein intake only.…”

Section: Discussionmentioning

confidence: 99%

Protein Intake and Distribution in Relation to Physical Functioning and Quality of Life in Community-Dwelling Elderly People: Acknowledging the Role of Physical Activity

et al. 2018

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Increasing total protein intake and a spread protein intake distribution are potential strategies to attenuate sarcopenia related loss of physical function and quality of life. The aim of this cross-sectional study was to investigate whether protein intake and protein intake distribution are associated with muscle strength, physical function and quality of life in community-dwelling elderly people with a wide range of physical activity. Dietary and physical activity data were obtained from two studies (N = 140, age 81 ± 6, 64% male), with the following outcome measures: physical functioning (Short Physical Performance Battery (SPPB), comprising balance, gait speed and chair rise tests), handgrip strength and quality of life (EQ-5D-5L). Protein intake distribution was calculated for each participant as a coefficient of variance (CV = SD of grams of protein intake per main meal divided by the average total amount of proteins (grams) of the main meals). Based on the CV, participants were divided into tertiles and classified as spread, intermediate or pulse. The average total protein intake was 1.08 ± 0.29 g/kg/day. Total protein intake was not associated with outcome measures using multivariate regression analyses. Individuals with a spread protein diet during the main meals (CV < 0.43) had higher gait speed compared to those with an intermediate diet (CV 0.43–0.62) (β = −0.42, p = 0.035), whereas a spread and pulse protein diet were not associated with SPPB total score, chair rise, grip strength and Quality-Adjusted Life Year (QALY). The interaction of higher physical activity and higher total protein intake was significantly associated with higher quality of life (β = 0.71, p = 0.049). While this interaction was not associated with SPPB or grip strength, the association with quality of life emphasizes the need for a higher total protein intake together with an active lifestyle in the elderly.

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Section: Discussionmentioning

confidence: 99%

Protein Intake and Distribution in Relation to Physical Functioning and Quality of Life in Community-Dwelling Elderly People: Acknowledging the Role of Physical Activity

et al. 2018

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“…However, few studies have empirically demonstrated the link between either specific neurological deficits or functional measures with HRQoL in individuals with DPN. To our knowledge, only one previous pilot study has reported on this relationship, finding significant associations between HRQoL (assessed by EQ-5D-3L) and functional mobility (assessed by chair sit–stand, timed up and go, and 6-m walk tests) in older patients with diabetes, though this was not the primary study aim [ 31 ]. While the role of functional status in HRQoL has been previously demonstrated in patient populations with known functional debility, like the elderly [ 32 ] and those with multiple sclerosis [ 33 ], ours is one of the first studies to formally investigate the role of functional status in patients with DPN on HRQoL and examine the inter-relationships between DPN, functional status, and HRQoL.…”

Section: Discussionmentioning

confidence: 99%

Functional status mediates the association between peripheral neuropathy and health-related quality of life in individuals with diabetes

et al. 2017

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AimsTo examine differences in health-related quality of life (HRQoL) between patients with and without diabetic peripheral neuropathy (DPN), and whether these differences can be explained by functional deficits.MethodsThis was a cross-sectional study of 160 patients with type 2 diabetes mellitus, 80 with DPN and 80 without. Assessments included HRQoL (health utility score derived from EQ-5D-5L), functional status measurements [muscle strength, timed up and go (TUG), five times sit-to-stand (FTSTS), functional reach, body sway velocity] and self-reported balance confidence [Activities-specific Balance Confidence (ABC) scale].ResultsMean utility scores were 0.67 ± 0.14 and 0.77 ± 0.16 in patients with and without DPN, respectively (p < 0.001). Patients with DPN had lower great toe extensor strength (6.4 ± 1.8 vs 7.6 ± 2.8 lbs, p = 0.001), greater body sway velocity (2.40 ± 1.31 vs 1.90 ± 0.52 mm/s, p = 0.002), slower TUG (12.1 ± 4.6 vs 10.1 ± 2.3 s, p < 0.001) and FTSTS (15.8 ± 5.8 vs 13.9 ± 5.4 s, p = 0.03) scores, and lower ABC score (73.4 ± 21.3 vs 82.6 ± 16.9, p = 0.003), compared to those without DPN. On stepwise multiple regression, DPN status, FTSTS, body sway velocity, BMI, diabetes duration, pain, and gender explained 38% of HRQoL variance. Addition of ABC score into the model explained 45% of variance. Results from structural equation modelling showed that DPN had direct effects on HRQoL and indirect effects through FTSTS, body sway velocity, and ABC score, with χ 2 = 8.075 (p = 0.044), root mean square error of approximation = 0.103 (lower bound 0.015, upper bound 0.191), Comparative Fit Index = 0.966, Tucker–Lewis Index = 0.887, and Standardized Root Mean Square Residual = 0.053.ConclusionsPatients with DPN have worse HRQoL compared to patients without DPN, partly mediated by functional status parameters. Effective interventions targeting functional status may be beneficial in improving HRQoL in these patients. Electronic supplementary materialThe online version of this article (10.1007/s00592-017-1077-8) contains supplementary material, which is available to authorized users.

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“…In addition to patient demographic variables, patient lifestyle risk factors have been found to be associated with HRQoL. Other than low HL [ 7 , 10 ], several studies found that smoking [ 22 ], poor diet [ 23 , 24 ], alcohol risk [ 25 ], insufficient physical activity [ 26 – 28 ] and overweight [ 29 – 31 ] were negatively associated with HRQoL.…”

Section: Introductionmentioning

confidence: 99%

The impact of health literacy and life style risk factors on health-related quality of life of Australian patients

Jayasinghe

Harris

Parker

et al. 2016

Health Qual Life Outcomes

128

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BackgroundLimited evidence exists regarding the relationship between health literacy and health-related quality of life (HRQoL) in Australian patients from primary care. The objective of this study was to investigate the impact of health literacy on HRQoL in a large sample of patients without known vascular disease or diabetes and to examine whether the difference in HRQoL between low and high health literacy groups was clinically significant.MethodsThis was a cross-sectional study of baseline data from a cluster randomised trial. The study included 739 patients from 30 general practices across four Australian states conducted in 2012 and 2013 using the standard Short Form Health Survey (SF-12) version 2. SF-12 physical component score (PCS-12) and mental component score (MCS-12) are derived using the standard US algorithm. Health literacy was measured using the Health Literacy Management Scale (HeLMS). Multilevel regression analysis (patients at level 1 and general practices at level 2) was applied to relate PCS-12 and MCS-12 to patient reported life style risk behaviours including health literacy and demographic factors.ResultsLow health literacy patients were more likely to be smokers (12 % vs 6 %, P = 0.005), do insufficient physical activity (63 % vs 47 %, P < 0.001), be overweight (68 % vs 52 %, P < 0.001), and have lower physical health and lower mental health with large clinically significant effect sizes of 0.56 (B (regression coefficient) = −5.4, P < 0.001) and 0.78(B = -6.4, P < 0.001) respectively after adjustment for confounding factors. Patients with insufficient physical activity were likely to have a lower physical health score (effect size = 0.42, B = −3.1, P < 0.001) and lower mental health (effect size = 0.37, B = −2.6, P < 0.001). Being overweight tended to be related to a lower PCS-12 (effect size = 0.41, B = −1.8, P < 0.05). Less well-educated, unemployed and smoking patients with low health literacy reported worse physical health. Health literacy accounted for 45 and 70 % of the total between patient variance explained in PCS-12 and MCS-12 respectively.ConclusionsAddressing health literacy related barriers to preventive care may help reduce some of the disparities in HRQoL. Recognising and tailoring health related communication to those with low health literacy may improve health outcomes including HRQoL in general practice.

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The relationship between nutritional status, functional capacity, and health-related quality of life in older adults with type 2 diabetes: A pilot explanatory study

Cited by 37 publications

References 39 publications

Protein Intake and Distribution in Relation to Physical Functioning and Quality of Life in Community-Dwelling Elderly People: Acknowledging the Role of Physical Activity

Protein Intake and Distribution in Relation to Physical Functioning and Quality of Life in Community-Dwelling Elderly People: Acknowledging the Role of Physical Activity

Functional status mediates the association between peripheral neuropathy and health-related quality of life in individuals with diabetes

The impact of health literacy and life style risk factors on health-related quality of life of Australian patients

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