Chronic physical conditions, physical multimorbidity, and quality of life among adults aged ≥ 50 years from six low- and middle-income countries

Olawale Olanrewaju; Mike Trott; Lee Smith; Guillermo F. López Sánchez; Christina Carmichael; Hans Oh; Felipe Schuch; Louis Jacob; Nicola Veronese; Pinar Soysal; Jae Il Shin; Laurie Butler; Yvonne Barnett; Ai Koyanagi

doi:10.1007/s11136-022-03317-6

Chronic physical conditions, physical multimorbidity, and quality of life among adults aged ≥ 50 years from six low- and middle-income countries

Olawale Olanrewaju, Mike Trott, Lee Smith^*, Guillermo F. López Sánchez, Christina Carmichael, Hans Oh, Felipe Schuch, Louis Jacob, Nicola Veronese, Pinar Soysal, Jae Il Shin, Laurie Butler, Yvonne Barnett, Ai Koyanagi

^*Corresponding author for this work

School of Medicine, Dentistry and Biomedical Sciences

Research output: Contribution to journal › Article › peer-review

6 Citations (Scopus)

29 Downloads (Pure)

Abstract

Purpose: Multimorbidity (i.e., ≥ 2 chronic conditions) poses a challenge for health systems and governments, globally. Several studies have found inverse associations between multimorbidity and quality of life (QoL). However, there is a paucity of studies from low- and middle-income countries (LMICs), especially among the older population, as well as studies examining mediating factors in this association. Thus, the present study aimed to explore the associations, and mediating factors, between multimorbidity and QoL among older adults in LMICs.

Methods: Cross-sectional nationally representative data from the Study on Global Ageing and Adult Health were analyzed. A total of 11 chronic conditions were assessed. QoL was assessed with the 8-item WHO QoL instrument (range 0–100) with higher scores representing better QoL. Multivariable linear regression and mediation analyses were conducted to assess associations.

Results: The final sample consisted of 34,129 adults aged ≥ 50 years [mean (SD) age 62.4 (16.0) years; age range 50–114 years; 52.0% females]. Compared to no chronic conditions, 2 (b-coefficient − 5.89; 95% CI − 6.83, − 4.95), 3 (− 8.35; − 9.63, − 7.06), 4 (− 10.87; − 12.37, − 9.36), and ≥ 5 (− 13.48; − 15.91, − 11.06) chronic conditions were significantly associated with lower QoL, dose-dependently. The mediation analysis showed that mobility (47.9%) explained the largest proportion of the association between multimorbidity and QoL, followed by pain/discomfort (43.5%), sleep/energy (35.0%), negative affect (31.9%), cognition (20.2%), self-care (17.0%), and interpersonal activities (12.0%).

Conclusion: A greater number of chronic conditions was associated with lower QoL dose-dependently among older adults in LMICs. Public health and medical practitioners should aim to address the identified mediators to improve QoL in patients with multimorbidity.

Original language	English
Pages (from-to)	1031-1041
Number of pages	11
Journal	Quality of Life Research
Volume	32
Issue number	4
Early online date	26 Dec 2022
DOIs	https://doi.org/10.1007/s11136-022-03317-6
Publication status	Published - Apr 2023

Bibliographical note

Funding Information:
Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature. Dr. Guillermo F. López Sánchez is funded by the European Union—Next Generation EU.

Funding Information:
This paper uses data from WHO’s Study on Global Ageing and Adult Health (SAGE). SAGE is supported by the U.S. National Institute on Aging through Interagency Agreements OGHA 04034785, YA1323–08-CN-0020, Y1-AG-1005–01 and through research grants R01-AG034479 and R21-AG034263.

Publisher Copyright:
© 2022, The Author(s).

Keywords

Low- and middle-income countries
Multimorbidity
Older adults
Quality of life

ASJC Scopus subject areas

Public Health, Environmental and Occupational Health

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Chronic physical conditions, physical multimorbidity, and quality of life among adults aged ≥ 50 years from six low- and middle-income countries
Copyright 2022 the authors. This is an open access article published under a Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium, provided the author and source are cited.
Final published version, 630 KBLicence: CC BY

Cite this

Olanrewaju, O., Trott, M., Smith, L., López Sánchez, G. F., Carmichael, C., Oh, H., Schuch, F., Jacob, L., Veronese, N., Soysal, P., Shin, J. I., Butler, L., Barnett, Y., & Koyanagi, A. (2023). Chronic physical conditions, physical multimorbidity, and quality of life among adults aged ≥ 50 years from six low- and middle-income countries. Quality of Life Research, 32(4), 1031-1041. https://doi.org/10.1007/s11136-022-03317-6

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abstract = "Purpose: Multimorbidity (i.e., ≥ 2 chronic conditions) poses a challenge for health systems and governments, globally. Several studies have found inverse associations between multimorbidity and quality of life (QoL). However, there is a paucity of studies from low- and middle-income countries (LMICs), especially among the older population, as well as studies examining mediating factors in this association. Thus, the present study aimed to explore the associations, and mediating factors, between multimorbidity and QoL among older adults in LMICs. Methods: Cross-sectional nationally representative data from the Study on Global Ageing and Adult Health were analyzed. A total of 11 chronic conditions were assessed. QoL was assessed with the 8-item WHO QoL instrument (range 0–100) with higher scores representing better QoL. Multivariable linear regression and mediation analyses were conducted to assess associations. Results: The final sample consisted of 34,129 adults aged ≥ 50 years [mean (SD) age 62.4 (16.0) years; age range 50–114 years; 52.0% females]. Compared to no chronic conditions, 2 (b-coefficient − 5.89; 95% CI − 6.83, − 4.95), 3 (− 8.35; − 9.63, − 7.06), 4 (− 10.87; − 12.37, − 9.36), and ≥ 5 (− 13.48; − 15.91, − 11.06) chronic conditions were significantly associated with lower QoL, dose-dependently. The mediation analysis showed that mobility (47.9%) explained the largest proportion of the association between multimorbidity and QoL, followed by pain/discomfort (43.5%), sleep/energy (35.0%), negative affect (31.9%), cognition (20.2%), self-care (17.0%), and interpersonal activities (12.0%). Conclusion: A greater number of chronic conditions was associated with lower QoL dose-dependently among older adults in LMICs. Public health and medical practitioners should aim to address the identified mediators to improve QoL in patients with multimorbidity.",

keywords = "Low- and middle-income countries, Multimorbidity, Older adults, Quality of life",

author = "Olawale Olanrewaju and Mike Trott and Lee Smith and {L{\'o}pez S{\'a}nchez}, {Guillermo F.} and Christina Carmichael and Hans Oh and Felipe Schuch and Louis Jacob and Nicola Veronese and Pinar Soysal and Shin, {Jae Il} and Laurie Butler and Yvonne Barnett and Ai Koyanagi",

note = "Funding Information: Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature. Dr. Guillermo F. L{\'o}pez S{\'a}nchez is funded by the European Union—Next Generation EU. Funding Information: This paper uses data from WHO{\textquoteright}s Study on Global Ageing and Adult Health (SAGE). SAGE is supported by the U.S. National Institute on Aging through Interagency Agreements OGHA 04034785, YA1323–08-CN-0020, Y1-AG-1005–01 and through research grants R01-AG034479 and R21-AG034263. Publisher Copyright: {\textcopyright} 2022, The Author(s).",

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Olanrewaju, O, Trott, M, Smith, L, López Sánchez, GF, Carmichael, C, Oh, H, Schuch, F, Jacob, L, Veronese, N, Soysal, P, Shin, JI, Butler, L, Barnett, Y & Koyanagi, A 2023, 'Chronic physical conditions, physical multimorbidity, and quality of life among adults aged ≥ 50 years from six low- and middle-income countries', Quality of Life Research, vol. 32, no. 4, pp. 1031-1041. https://doi.org/10.1007/s11136-022-03317-6

TY - JOUR

T1 - Chronic physical conditions, physical multimorbidity, and quality of life among adults aged ≥ 50 years from six low- and middle-income countries

AU - Olanrewaju, Olawale

AU - Trott, Mike

AU - Smith, Lee

AU - López Sánchez, Guillermo F.

AU - Carmichael, Christina

AU - Oh, Hans

AU - Schuch, Felipe

AU - Jacob, Louis

AU - Veronese, Nicola

AU - Soysal, Pinar

AU - Shin, Jae Il

AU - Butler, Laurie

AU - Barnett, Yvonne

AU - Koyanagi, Ai

N1 - Funding Information: Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature. Dr. Guillermo F. López Sánchez is funded by the European Union—Next Generation EU. Funding Information: This paper uses data from WHO’s Study on Global Ageing and Adult Health (SAGE). SAGE is supported by the U.S. National Institute on Aging through Interagency Agreements OGHA 04034785, YA1323–08-CN-0020, Y1-AG-1005–01 and through research grants R01-AG034479 and R21-AG034263. Publisher Copyright: © 2022, The Author(s).

PY - 2023/4

Y1 - 2023/4

N2 - Purpose: Multimorbidity (i.e., ≥ 2 chronic conditions) poses a challenge for health systems and governments, globally. Several studies have found inverse associations between multimorbidity and quality of life (QoL). However, there is a paucity of studies from low- and middle-income countries (LMICs), especially among the older population, as well as studies examining mediating factors in this association. Thus, the present study aimed to explore the associations, and mediating factors, between multimorbidity and QoL among older adults in LMICs. Methods: Cross-sectional nationally representative data from the Study on Global Ageing and Adult Health were analyzed. A total of 11 chronic conditions were assessed. QoL was assessed with the 8-item WHO QoL instrument (range 0–100) with higher scores representing better QoL. Multivariable linear regression and mediation analyses were conducted to assess associations. Results: The final sample consisted of 34,129 adults aged ≥ 50 years [mean (SD) age 62.4 (16.0) years; age range 50–114 years; 52.0% females]. Compared to no chronic conditions, 2 (b-coefficient − 5.89; 95% CI − 6.83, − 4.95), 3 (− 8.35; − 9.63, − 7.06), 4 (− 10.87; − 12.37, − 9.36), and ≥ 5 (− 13.48; − 15.91, − 11.06) chronic conditions were significantly associated with lower QoL, dose-dependently. The mediation analysis showed that mobility (47.9%) explained the largest proportion of the association between multimorbidity and QoL, followed by pain/discomfort (43.5%), sleep/energy (35.0%), negative affect (31.9%), cognition (20.2%), self-care (17.0%), and interpersonal activities (12.0%). Conclusion: A greater number of chronic conditions was associated with lower QoL dose-dependently among older adults in LMICs. Public health and medical practitioners should aim to address the identified mediators to improve QoL in patients with multimorbidity.

AB - Purpose: Multimorbidity (i.e., ≥ 2 chronic conditions) poses a challenge for health systems and governments, globally. Several studies have found inverse associations between multimorbidity and quality of life (QoL). However, there is a paucity of studies from low- and middle-income countries (LMICs), especially among the older population, as well as studies examining mediating factors in this association. Thus, the present study aimed to explore the associations, and mediating factors, between multimorbidity and QoL among older adults in LMICs. Methods: Cross-sectional nationally representative data from the Study on Global Ageing and Adult Health were analyzed. A total of 11 chronic conditions were assessed. QoL was assessed with the 8-item WHO QoL instrument (range 0–100) with higher scores representing better QoL. Multivariable linear regression and mediation analyses were conducted to assess associations. Results: The final sample consisted of 34,129 adults aged ≥ 50 years [mean (SD) age 62.4 (16.0) years; age range 50–114 years; 52.0% females]. Compared to no chronic conditions, 2 (b-coefficient − 5.89; 95% CI − 6.83, − 4.95), 3 (− 8.35; − 9.63, − 7.06), 4 (− 10.87; − 12.37, − 9.36), and ≥ 5 (− 13.48; − 15.91, − 11.06) chronic conditions were significantly associated with lower QoL, dose-dependently. The mediation analysis showed that mobility (47.9%) explained the largest proportion of the association between multimorbidity and QoL, followed by pain/discomfort (43.5%), sleep/energy (35.0%), negative affect (31.9%), cognition (20.2%), self-care (17.0%), and interpersonal activities (12.0%). Conclusion: A greater number of chronic conditions was associated with lower QoL dose-dependently among older adults in LMICs. Public health and medical practitioners should aim to address the identified mediators to improve QoL in patients with multimorbidity.

KW - Low- and middle-income countries

KW - Multimorbidity

KW - Older adults

KW - Quality of life

U2 - 10.1007/s11136-022-03317-6

DO - 10.1007/s11136-022-03317-6

M3 - Article

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SN - 0962-9343

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JO - Quality of Life Research

JF - Quality of Life Research

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ER -