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<p>Health-related quality of life (HRQOL) is a key determinant of loss of independence (LOI) among older adults. However, the relationship between late-life HRQOL trajectory patterns and the risk of LOI remains unclear. This study utilized 5-year longitudinal data from the Sukagawa Study, and group-based trajectory modeling. HRQOL trajectories were analyzed using the mental component scale (MCS) and physical component scale (PCS) from the SF-8. Hazard ratios (HRs) and 95% confidence intervals (CIs) for LOI or death were calculated using Cox proportional hazards regression. Among 4043 participants (median age 78.8&#xa0;years, interquartile range [IQR] 75.8–82.5; 56% women), HRQOL change score trajectories were categorized as decline, stable, and increase for MCS (11.7%, 81.0%, 7.2%) and PCS (10.9%, 81.4%, 7.6%). Over a mean follow-up of 66.4&#xa0;months (IQR 48.0–73.0), LOI or death incidence was 42.5 per 1000 person-years (95% CI 39.8–45.2). Compared to the stable group, MCS decline was associated with higher LOI or death risk (HR 1.51, 95% CI 1.04–2.18), and an increase was associated with lower risk (HR 0.26, 95% CI 0.11–0.57). PCS decline was linked to higher LOI risk (HR 1.66, 95% CI 1.17–2.37), while an increase showed no significant association (HR 1.07, 95% CI 0.61–1.89). Longitudinal HRQOL trajectory is closely related to LOI risk among community-dwelling older adults. A declining trajectory in physical and mental components is strongly associated with higher LOI risk, while an increasing trajectory in the mental component is possibly associated with lower risk.</p> Graphical Abstract <p></p>

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Health-related quality of life trajectories and loss of independence among community-dwelling older adults

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月29日

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  • Atsushi Takayama,
  • Kenji Omae,
  • Takeshima Taro,
  • Takashi Yoshioka,
  • Hiroaki Nakagawa,
  • Ozaka Akihiro,
  • Shunichi Fukuhara,
  • Shunichi Fukuhara,
  • Sugihiro Hamaguchi,
  • Takao Tsuchiya,
  • Mitsuru Munakata

摘要

Health-related quality of life (HRQOL) is a key determinant of loss of independence (LOI) among older adults. However, the relationship between late-life HRQOL trajectory patterns and the risk of LOI remains unclear. This study utilized 5-year longitudinal data from the Sukagawa Study, and group-based trajectory modeling. HRQOL trajectories were analyzed using the mental component scale (MCS) and physical component scale (PCS) from the SF-8. Hazard ratios (HRs) and 95% confidence intervals (CIs) for LOI or death were calculated using Cox proportional hazards regression. Among 4043 participants (median age 78.8 years, interquartile range [IQR] 75.8–82.5; 56% women), HRQOL change score trajectories were categorized as decline, stable, and increase for MCS (11.7%, 81.0%, 7.2%) and PCS (10.9%, 81.4%, 7.6%). Over a mean follow-up of 66.4 months (IQR 48.0–73.0), LOI or death incidence was 42.5 per 1000 person-years (95% CI 39.8–45.2). Compared to the stable group, MCS decline was associated with higher LOI or death risk (HR 1.51, 95% CI 1.04–2.18), and an increase was associated with lower risk (HR 0.26, 95% CI 0.11–0.57). PCS decline was linked to higher LOI risk (HR 1.66, 95% CI 1.17–2.37), while an increase showed no significant association (HR 1.07, 95% CI 0.61–1.89). Longitudinal HRQOL trajectory is closely related to LOI risk among community-dwelling older adults. A declining trajectory in physical and mental components is strongly associated with higher LOI risk, while an increasing trajectory in the mental component is possibly associated with lower risk.

Graphical Abstract