Contribution of taking part in sport to the association between physical activity and quality of life

Purpose

The purpose of this study was to investigate the contribution of sport to the association between physical activity (PA) and quality of life (QoL).

Methods

Cross-sectional data were gathered on 4,909 subjects (age 15–69) from the French National Barometer 2005 survey. The International Physical Activity Questionnaire (IPAQ) and the abbreviated version of the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF) were administered. An additional question was used to assess sporting activity. All analyses used linear regression models and were adjusted on variables associated with QoL in a general population.

Results

The mean age of the participants (both men and women) decreased with increasing PA level. Sport was positively associated with QoL among men (β range from 4.2 [95 % CI 3.1–5.4] for physical health to 2.4 [95 % CI 1.1–3.8] for social relationship domains) and women (β range from 3.6 [95 % CI 2.6–4.5] for physical health to 1.6 [95 % CI 0.6–2.8] for social relationship domains). The association between sport and QoL was greater for low or high PA levels rather than moderate PA for men (physical and psychological health) and women (physical health only). For women, there was a dose–response association with psychological health and social relationships (contribution of sport to QoL increased with PA level).

Conclusions

These results showed that sport was nearly always associated with better QoL, even more so for people who had low or high PA levels (physical and psychological health for men and physical health for women). Prospective studies are necessary to confirm these findings.     

Anthropometric measures change and quality of life in elderly people: a longitudinal population-based study in Southern Brazil

Purpose

To analyze the effects of anthropometric measures change on quality of life (QoL) in elderly, using measured anthropometric data on body mass index (BMI) and waist circumference (WC).

Method

Population-based cohort study investigating a sample of elderly (≥60) assessed in 2009 (n = 1705) and followed up in 2013 (n = 1197). QoL was evaluated in 2013 using the CASP-19. Variables evaluated as exposure including BMI and WC in 2009 (both standardized), categories of anthropometric measures change from 2009 to 2013 (excess weight = BMI ≥ 25.0 kg/m²; large WC = top quartile), and the absolute BMI and WC change in same period. Multivariate linear regressions adjusted for possible confounding factors and mediators were used.

Results

Both BMI and WC at baseline were associated with lower QoL scores, even after adjustment for confounding variables (β _BMI = ?0.9; 95 % CI ?1.5; ?0.3 and β _WC = ?1.0; 95 % CI ?1.7; ?0.4). Additionally, QoL scores were lower among elderly with excess weight (β = ?1.4; 95 % CI ?2.9; 0.0) or large WC (β = ?3.3; 95 % CI ?5.2; ?1.4) in both waves than among those whose BMI and WC were always normal, but changes in anthropometric measures did not affect QoL. The presence of chronic diseases was a partial mediator of these associations, especially for effects of BMI change. Anthropometric measures change treated as a continuous variable was not associated with QoL.

Conclusions

Having excess weight and large WC in both waves was associated with lower QoL scores in elderly, but changing the anthropometric measures did not affect this outcome. Maintaining weight and WC within normal limits during aging can help to preserve QoL.

     

The longitudinal association between weight change and health-related quality of life: the KORA S4/F4 cohort study

Objectives

Despite the increasing importance of patient-centered perspectives, the impact of weight change on the health-related quality of life (HRQL) has remained unclear. This work aims to investigate this longitudinal relationship.

Methods

Data was collected from a population-based cohort study of 3,080 Germans. Anthropometrics and HRQL were assessed at baseline and after a 7-year follow-up period. Using linear regression the average change in HRQL scores was calculated among 5 mutually exclusive weight change groups. Multilevel growth modeling was conducted to differentiate between interpersonal (cross-sectional) and intrapersonal (longitudinal) associations between body mass index (BMI)/BMI change and HRQL.

Results

Heavy weight gain (≥10 % body weight) was associated with impairments in physical health among women (?2.82 points, CI: ?4.29, ?1.34) and obese men (?4.33 points, CI: ?7.62, ?1.04) and with improvements in mental health among women (+3.20 points, CI: +1.37, +5.02). Results from the multilevel models were consistent, showing negative associations between BMI change and physical health, positive associations between BMI change and mental health and a high degree of similarity between interpersonal and intrapersonal associations.

Conclusions

Weight gain leads to clinically relevant impairments in physical health. More research is needed to clarify the antipodal effects of weight change on physical and mental health components.     

Quality of life as a predictor of overall survival after breast cancer treatment

Purpose

To describe quality of life (QoL) in a cohort of surviving women 4 years after breast cancer treatment and to analyze its role as a predictor of mortality within 2 years.

Methods

This is a prospective cohort study of 544 women who have undergone surgical treatment, from 2001 to 2002 and who answered a questionnaire about QoL in 2006. After, we conducted a survival study to evaluate the association between QoL and mortality within 2 years with the same population. We conducted factor analysis between the variables of the scales of function and symptoms. Survival analysis was conducted by Kaplan–Meier, and differences in survival curves were assessed with the log-rank test, assuming significant statistical level of 5 %. The Cox proportional hazards regression model was used to explore the relationship between QoL variables (functional scales) and prognostic value for survival.

Results

The mean age of the women was 59.1 years (SD 11.66). The mean of overall QoL score was 75.16 (SD 20.93). Using factor analysis, we identified three conditions that made up the construct of QoL in this group of patients: social, psycho-emotional, and physical. Social condition was the most important factor. After assessment of QoL, the mean survival was 23 months (SD 3.90). Women who reported worse future perspective had higher chance of death compared with women better prospect of future (HR = 3.46; 95 % CI 1.36–8.79; p value = 0.009).

Conclusion

Future perspectives were predictors of mortality, which reinforce the relevance of social support and psychological aspects for these women.     

Health behaviors contribute to quality of life in patients with advanced heart failure independent of psychological and medical patient characteristics

Background

Little is known about the contribution of health behaviors to quality of life (QoL) in heart transplant candidates. We examined physical activity, dietary habits, psychological, and medical patient characteristics as correlates of QoL among patients enrolled in the multisite Waiting for a New Heart Study.

Method

QoL (Minnesota Living with Heart Failure Questionnaire), demographic variables, psychological variables (e.g., depression, coping styles), and health behaviors (physical activity, dietary habits) were assessed in 318 patients (82 % male, 53 ± 11 years) at the time of wait-listing and analyzed in 312 patients (excluding six underweight patients). Eurotransplant provided BMI and medical variables to compute the Heart Failure Survival Score (HFSS). Hierarchical multiple regression models were used to assess the independent contribution of health behaviors to QoL.

Results

The HFSS was unrelated to QoL. As expected, psychological characteristics (depression, anxiety, vigilant coping style) contributed to impaired QoL, accounting for 22.9, 35.9, and 12.9 % of the variance in total, emotional, and physical QoL, respectively. Physical inactivity further impaired QoL (total: 4.1 %, p < 0.001; physical: 7.4 %, p < 0.001). Dietary habits typically considered as unhealthy (i.e., infrequent consumption of fruits/vegetables/legumes; frequent intake of foods high in saturated fats) were related to enhanced physical QoL, but only among the overweight and obese patients.

Conclusion

Lifestyle interventions to modify negative emotions and to increase physical activity could help to improve QoL in heart transplant candidates, regardless of their disease severity. The role of eating habits in QoL among obese and overweight patients needs further exploration.     

Prognostic value of quality of life measured after treatment on subsequent survival in patients with nasopharyngeal carcinoma

Purpose

Pretreatment quality of life (QoL) has been used to predict survival in cancer patients. In this study, we examined the prognostic value of QoL measured after treatment on subsequent survival in patients with nasopharyngeal carcinoma (NPC).

Methods

We enrolled 273 patients with NPC who had been curatively treated for more than 1 year. The EORTC QLQ-C30 and H&N35 questionnaires were completed 1 year after radiotherapy. The predictability of QoL variables on disease-specific survival (DSS) and overall survival (OS) was analyzed using Cox’s proportional hazards models.

Results

Twenty-nine (10.6 %) patients developed locoregional relapse and 27 (9.9 %) had distant metastasis after the QoL survey with subsequent 5-year DSS and OS rates of 87.9 % and 84.0 %, respectively. Based on the QLQ-C30, scales of physical functioning, fatigue, and appetite loss significantly predicted DSS and OS (p < 0.05). In the H&N35, only sexuality was significantly correlated with DSS and OS (p < 0.05). An increment of 10 points in physical functioning (HR: 0.69; 95 % CI: 0.48–0.90; p = 0.004) or a decline of 10 points in fatigue problems (HR: 1.40; 95 % CI: 1.19–1.61; p = 0.0002), appetite loss (HR: 1.21; 95 % CI: 1.03–1.40; p = 0.02), and sexuality (HR: 1.14; 95 % CI: 1.02–1.25; p = 0.019) was associated with better OS.

Conclusion

Some QoL variables measured after the treatment provide prognostic value on subsequent survival in patients with NPC.     

The impact of being the intermediate caring generation and intergenerational transfers on self-reported health of women in Ireland

Objectives

To investigate the associations with being the “sandwich generation” in older women in Ireland and its impact on self-reported health.

Methods

Analysis of 3,196 women from wave 1 of the Irish Longitudinal Study on Ageing (TILDA) was undertaken. Poisson regression was used to determine whether intergenerational transfers, were associated with self-rated physical health and depression, when controlling for other socio-demographic variables.

Results

Multivariate analysis found that women in the sandwich generation who financially supported their children had better self-rated physical health (poor/fair health relative to excellent; RR 0.84, 95 % CI 0.72–0.97). Conversely, the women who provided other care for their children showed evidence of poorer mental health (case-level depression, RR 1.35, 95 %CI 1.05–1.73). Providing financial support for parents was associated with case-level depression (RR 2.21, 95 %CI 1.26–3.86).

Conclusions

Supporting two generations was associated with both better self-rated health and poorer mental health, depending on the type and direction of the transfers. This generation of women have substantial caring responsibilities. Strategies to address the stresses associated with bi-directional intergenerational transfers are needed.     

Sex-stratified socio-economic gradients in physical inactivity, obesity, and diabetes: evidence of short-term changes in Argentina

Objectives

To evaluate how socio-economic gradients in NCDs and NCD-related risk factors change over time.

Methods

Secondary analysis of cross-sectional data from the 2005 and 2009 Argentine National Risk Factor Surveys (N = 41,392 and N = 34,732) was conducted. We analyzed inequalities in three risk factors (low physical activity, obesity, and diabetes) according to income and educational attainment. The analysis was based on sex-stratified and age-adjusted logistic regression.

Results

The overall prevalence of low physical activity, obesity, and diabetes increased from 2005 to 2009. Increases occurred in most of the income and education groups, but females with the lowest socio-economic status generally showed the highest increases. In 2005, differences in physical inactivity among women with different levels of education were not statistically significant. By 2009, women with low education (OR = 1.57, 95 % CI = 1.34–1.84) and medium education (OR = 1.18, 95 % CI = 1.06–1.32) were more likely than women with high education to be physically inactive.

Conclusion

Inequalities in physical inactivity, obesity, and diabetes have grown in Argentina over a short period of time.     

Musculoskeletal symptoms and psychosocial work environment,among Swedish commercial pilots

Purpose

The associations between psychosocial work conditions and health in pilots are understudied, and therefore, the associations between the psychosocial work conditions and musculoskeletal problems among Swedish commercial pilots were investigated.

Methods

In 2010, a self-administered questionnaire study was performed among pilots in one Swedish commercial airline: 354 pilots participated (61 %). Musculoskeletal symptoms and the psychosocial work conditions measured by the demand control social support model were investigated. Odds ratios (OR) with 95 % confidence interval (95 % CI) were expressed per change of one unit on the interquartile score scale.

Results

Pilots on long-haul flights had less elbow symptoms (OR 0.34, 95 % CI 0.14–0.85), and women had more hand symptoms (OR 2.90, 95 % CI 1.11–7.52). There were associations between high work demands and symptoms from the neck (OR 2.04, 95 % CI 1.45–2.88), shoulders (OR 1.46, 95 % 1.05–2.03), elbows (OR 1.79, 95 % CI 1.10–2.90) and low back (OR 1.42, 95 % CI 1.02–1.96) in pilots. Low social support was associated with symptoms from the neck (OR 1.87, 95 % 1.35–2.58), shoulders (OR 1.56, 95 % CI 1.14–2.14) and low back (OR 1.63, 95 % CI 1.18–2.24). Low supervisor support was associated with neck (OR 1.67, 95 % CI 1.22–2.27), shoulders (OR 1.38, 95 % CI 1.02–1.87) and low back symptoms (OR 1.48, 95 % CI 1.09–2.01). The associations were mainly found among first officers.

Conclusions

Musculoskeletal symptoms in pilots can be affected by poor psychosocial work conditions such as high demands and low social support, especially for first officers. The psychosocial aspects of organisational changes in commercial airlines should be taken into consideration.     

Physical activity in relation to quality of life in newly diagnosed colon cancer patients: a 24-month follow-up

Purpose

Self-reported health status in cancer patients is an independent predictor of medical outcomes. This study investigated the association between changes in recreational physical activity in colon cancer survivors and quality of life (QoL) across a 24-month follow-up beginning at diagnosis.

Methods

Patients (n = 453) diagnosed with stage II colon cancer were recruited from the North Carolina Central Cancer Registry from 2009 to 2011. Patients were interviewed annually about health behaviors (e.g., dietary intake, physical activity, alcohol and tobacco use), socioeconomic variables, and treatment. To index QoL, the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) and Short Form-12 (SF-12) were utilized.

Results

Baseline vigorous exercise showed a positive correlation with the Functional Assessment of Cancer Therapy-General (FACT-G) Colorectal Cancer Scale (CCS) (β = 0.15, 95 % CI 0.07–0.23), FACT-C (β = 0.39, 95 % CI 0.06–0.72), and Trial Outcome Index (TOI) (β = 0.28, 95 % CI 0.01–0.55). Race modified the association between vigorous activity and the FACT-G (P _interaction = 0.010), FACT-C (P _interaction = 0.020), TOI (P _interaction < 0.010), and the PCS (P _interaction < 0.010). As compared to no change, increasing physical activity over a 24-month period following diagnosis significantly improved scores from the FACT-G (β = 3.13, 95 % CI 0.48–5.77, P _trend = 0.054), FACT-C (β = 3.51, 95 % CI 0.35–6.68, P _trend = 0.08) TOI (β = 2.46, 95 % CI 0.16–4.75, P _trend = 0.04), and PCS of the SF-12 (β = 3.28, 95 % CI 0.93–5.63, P _trend < 0.01).

Conclusion

Vigorous exercise is a significant predictor of higher QoL in stage II colon cancer patients. Patients with increased recreational physical activity have significantly improved QoL over 24 months following diagnosis.     

Perceived physical exertion during healthcare work and risk of chronic pain in different body regions: prospective cohort study

Purpose

To estimate the risk of developing chronic musculoskeletal pain in different body regions from varying degrees of perceived physical exertion during healthcare work.

Methods

Prospective cohort study among 4,977 Danish female healthcare workers responding to a baseline and follow-up questionnaire in 2005 and 2006, respectively. Using multi-adjusted logistic regression analysis, the risk of developing chronic pain (>30 days last year) at follow-up in the low back, neck/shoulder, and knees—among those without pain (0 days last year) in these respective body regions at baseline—from moderate and strenuous (reference: light) perceived physical exertion during healthcare work was modeled.

Results

Adjusted for age, BMI, tenure, smoking status, and leisure physical activity, strenuous perceived physical exertion during healthcare work increased the risk of chronic low back pain (OR 3.16, 95 % CI 1.79–5.57) and chronic knee pain (OR 1.87, 95 % CI 1.19–2.94) at follow-up among those without pain in these respective body regions at baseline. With additional adjustment for psychosocial work conditions, only the risk of developing chronic low back pain from strenuous physical exertion remained significant (OR 1.99, 95 % CI 1.02–3.88). Strenuous physical exertion was not a risk factor for chronic neck pain, and moderate physical exertion was not a risk factor for chronic pain in any of the body regions.

Conclusion

Strenuous perceived physical exertion during healthcare work is a risk factor especially for developing chronic pain in the low back. The possible preventive effect of reducing strenuous physical exertion should be tested in randomized controlled trials.     

Experience and attitude of rural women to IPV in Nigeria

Aim

In Nigeria, few studies that have addressed intimate partner violence (IPV) to women have been carried out in urban settings. The purpose of the study was to determine the prevalence, types and factors associated with experience of IPV among rural women in Oyo State, Nigeria. Attitude to wife beating was also assessed.

Subject and methods

300 rural women aged between 15 and 49 years selected by multistage sampling method were interviewed using semi-structured interviewer administered questionnaire.

Results

Lifetime prevalence of IPV was 64.0 %, controlling behavior was 42.0 %, psychological violence ?34.7 %, physical violence ?28.0 % and sexual violence ?11.6 %. Predictors of controlling behavior were monthly income?>?$67(OR?=?2.2; 95% CI: 1.2–4.1) and age of partner ≤34 years (OR?=?2.8; 95 % CI: 1.3–6.2). Respondents in relationship for more than 10 years were more likely to experience psychological violence (OR?=?5.7; 95 % CI 2.1–15.2). Predictors of physical violence were being in relationship for ≥3 years (OR?=?3.8; 95 % CI: 1.1–13.3) and partner consuming alcohol (OR?=?2.1; 95 % CI: 1.1–4.1). Partner’s educational level (at least secondary) (OR?=?5.7; 95 % CI: 1.2–24.6) and alcohol consumption (OR?=?3.0; 95 % CI: 1.3–6.7) were predictors of sexual violence. About 24.4 % of women justified wife beating. The most common reason for justification was that the woman had been unfaithful (28 %).

Conclusion

IPV is a common experience among Nigerian rural women. Partners need education on dangers of alcohol use and its association with IPV. Different strategies are needed to prevent and reduce IPV.     

Organizational and psychosocial risk factors for carpal tunnel syndrome: a cross-sectional study of French workers

Purpose

The aim of the study was to examine the organizational and psychosocial risk factors for carpal tunnel syndrome (CTS) in workers exposed to various levels of work-related constraints, with a special focus on factors related to the work organization.

Methods

From 3,710 workers, representative of a French region’s working population, trained occupational physicians diagnosed a total of 156 cases of CTS between 2002 and 2005. Diagnoses were established by standardized physical examination, while personal factors and work exposure were assessed by self-administered questionnaires. Statistical associations between CTS and personal and work-related factors were analyzed for each gender using logistic regression modeling.

Results

Among the factors related to work organization, working with temporary workers was associated with CTS for women (OR = 1.99, 95 % CI 1.23–3.25), but not for men. Task rotation during the job (OR = 2.45 95 % CI 1.41–4.24) and work pace dependent on quantified targets (OR = 1.93 95 % CI 1.08–3.46) were associated with CTS only for men. The work-related psychosocial factors highlighted by the logistic modeling were high psychological demand for women (OR = 1.90, 95 % CI 1.17–3.09) and low skill discretion (OR = 1.77, 95 % CI 1.01–3.11) for men.

Conclusion

This study has identified some psychosocial factors and factors related to work organization associated with clinically diagnosed and symptom-only cases of CTS as well as personal and biomechanical factors. However, due to the cross-sectional design of the study, no causal conclusion could be drawn and longitudinal studies are necessary to confirm these results.     

Circulating adiponectin levels are associated with peak oxygen uptake in Japanese

Objective

The aim of this study was to investigate the link between circulating adiponectin levels and peak oxygen uptake and/or physical activity in Japanese.

Methods

A total of 528 subjects (188 men and 340 women) were enrolled in this cross-sectional study. Circulating adiponectin levels, physical activity measured by tri-axial accelerometers, peak oxygen uptake and metabolic risk parameters were evaluated. We also assessed anthropometric factors, blood pressure, blood examinations and energy intake.

Results

Circulating adiponectin levels were 6.7 ± 3.0 μg/mL in men and 11.0 ± 4.9 μg/mL in women. Circulating adiponectin levels were positively correlated with physical fitness after adjusting for age, physical activity evaluated by Σ [metabolic equivalents × h per week (METs h/w)], cigarette smoking habit and energy intake in both sexes. However, these associations were attenuated further after adjusting for body mass index including other confounding factors, especially in men. However, circulating adiponectin levels were not associated with physical activity in either sex.

Conclusion

Circulating adiponectin levels were associated with peak oxygen uptake rather than physical activity.     

Body mass index and health-related quality of life in apparently healthy individuals

Purpose

Obesity is known to be associated with a range of chronic medical comorbidities, but little is known about the impact of overweight and obesity on health-related quality of life (HRQoL) in persons without chronic diseases. The aim of this study was to assess HRQoL, body mass index (BMI) and health behavior patterns in a community sample of subjects who had no long-lasting medical comorbidities

Methods

We assessed HRQoL in 1,187 apparently healthy individuals (mean age 57 ± 7 years), of whom 24 % were classified as normal weight, 49 % as overweight, 20 % as obese and 7 % as very obese. Two different instruments of HRQoL were used: the generic Short-Form Health Survey (SF-36) questionnaire and the preference-based instrument EuroQol (EQ-5D).

Results

All physical components of the SF-36 decreased linearly according to BMI categories in women. In men, only poorer physical functioning scale showed linearity with rising BMI. Scores on the mental components of the SF-36 did not differ by BMI categories in either gender. The EQ-5D index and EuroQol visual analogue scale scores decreased linearly with rising BMI only in women.

Conclusions

In apparently healthy middle-aged subjects, physical HRQoL decreases with increasing level of BMI and more so in women than in men. Mental components of HRQoL do not differ between the categories of BMI in either gender.     

Unfavourable life-course social gradient of coronary heart disease within Spain: a low-incidence welfare-state country

Objective

Social position has yet to be established as a risk factor of coronary heart disease (CHD). Our aim was to investigate an individual life-course social position gradient link with CHD incidence in the EPIC-Spain cohort.

Methods

41,066 participants, mostly 30–65 years old, and free of cardiovascular disease at baseline (1992–1996) were followed up for a mean of 10.4 years. A combined score of paternal occupation in childhood and own adult education was used to assess individual life-course risk accumulation. Hazard ratios of CHD were estimated using Cox models, stratifying by centre, and age, and adjusting for cardiovascular risk factors.

Results

583 participants (80 % men) developed a definite CHD event. Paternal occupational class IV was associated with CHD in all models in men. The educational gradient remained significant after adjusting for diet and physical activity (p = 0.01). All adjusted risk of incident CHD rose by 23 % (95 % CI 6–42 %) per category increase of life-course social position score in men. No significant associations were found in women.

Conclusions

Individual life-course social position gradient was adversely related to incident CHD in Spanish men.     

The use of household cleaning products during pregnancy and lower respiratory tract infections and wheezing during early life

Objective

To evaluate the effects of household use of cleaning products during pregnancy on infant wheezing and lower respiratory tract infections (LRTI).

Methods

In four prospective Spanish birth cohorts (n = 2,292), pregnant women reported the use of household cleaning products. When infants were 12–18 months old, current cleaning product use and infant’s wheezing and LRTI were reported. Cohort-specific associations between the use of specific products and respiratory outcomes were evaluated using multivariable regression analyses and estimates were combined using random-effects meta-analyses.

Results

The period prevalence of LRTI was higher when sprays (combined odds ratio (OR) = 1.29; 95 % confidence interval (CI) 1.04–1.59) or air fresheners (OR = 1.29; CI 1.03–1.63) were used during pregnancy. The odds of wheezing increased with spray (OR = 1.37; CI 1.10–1.69) and solvent (OR = 1.30; CI 1.03–1.62) use. The associations between spray and air freshener use during pregnancy and both outcomes remained apparent when these products were not used after pregnancy. Nevertheless, the estimates were higher when post-natal exposure was included.

Conclusion

The use of cleaning sprays, air fresheners and solvents during pregnancy may increase the risk of wheezing and infections in the offspring.     

Health-related quality of life among adults with work-related asthma in the United States

Purpose

The objective of this study was to examine health-related quality of life among adults with work-related asthma.

Methods

We analyzed 2006–2009 Behavioral Risk Factor Surveillance System Asthma Call-back Survey data for ever-employed adults with current asthma from 38 states and District of Columbia. Individuals with work-related asthma had been told by a doctor or other health professional that their asthma was related to any job they ever had. Health-related quality of life indicators included poor self-rated health, impaired physical health, impaired mental health, and activity limitation. We calculated prevalence ratios (PRs) adjusted for age, sex, race/ethnicity, education, income, employment, and health insurance.

Results

Of ever-employed adults with current asthma, an estimated 9.0 % had work-related asthma, 26.9 % had poor self-rated health, 20.6 % had impaired physical health, 18.2 % had impaired mental health, and 10.2 % had activity limitation. Individuals with work-related asthma were significantly more likely than those with non-work-related asthma to have poor self-rated health [PR, 1.45; 95 % confidence interval (CI), 1.31–1.60], impaired physical health (PR, 1.60; 95 % CI, 1.42–1.80), impaired mental health (PR, 1.55; 95 % CI, 1.34–1.80), and activity limitation (PR, 2.16; 95 % CI, 1.81–2.56).

Conclusions

Future research should examine opportunities to improve health-related quality of life among individuals with work-related asthma.     

Association between subjective memory complaints and depressive symptoms after adjustment for genetic and family environmental factors in a Japanese twin study

Objectives

The aim of this study was to investigate the association between subjective memory complaints (SMCs) and depressive symptoms, with and without adjustment for genetic and family environmental factors.

Methods

We conducted a cross-sectional study using twins and measured SMCs and depressive symptoms as outcomes and explanatory variables, respectively. First, we performed regression analyses using generalized estimating equations to investigate the associations between SMCs and depressive symptoms without adjustment for genetic and family environmental factors (individual-level analyses). We then performed regression analyses for within-pair differences using monozygotic (MZ) and dizygotic (DZ) twin pairs and MZ twin pairs to investigate these associations with adjustment for genetic and family environmental factors by subtracting the values of one twin from those of co-twin variables (within-pair level analyses). Therefore, differences between the associations at individual- and within-pair level analyses suggested confounding by genetic factors.

Results

We included 556 twins aged ≥20 years. In the individual-level analyses, SMCs were significantly associated with depressive symptoms in both males and females [standardized coefficients: males, 0.23 (95 % CI 0.08–0.38); females, 0.35 (95 % CI 0.23–0.46)]. In the within-pair level analyses using MZ and same-sex DZ twin pairs, SMCs were significantly associated with depressive symptoms. In the within-pair level analyses using the MZ twin pairs, SMCs were significantly associated with depressive symptoms [standardized coefficients: males, 0.32 (95 % CI 0.08–0.56); females, 0.24 (95 % CI 0.13–0.42)].

Conclusions

This study suggested that SMCs were significantly associated with depressive symptoms after adjustment for genetic and family environmental factors.

     

Correcting bias in self-rated quality of life: an application of anchoring vignettes and ordinal regression models to better understand QoL differences across commuting modes

Purpose

Likert scales are frequently used in public health research, but are subject to scale perception bias. This study sought to explore scale perception bias in quality-of-life (QoL) self-assessment and assess its relationships with commuting mode in the Sydney Travel and Health Study.

Methods

Multilevel ordinal logistic regression analysis was used to analyse the association between two global QoL items about overall QoL and health satisfaction, with usual travel mode to work or study. Anchoring vignettes were applied using parametric and simpler nonparametric methods to detect and adjust for differences in reporting behaviour across age, sex, education, and income groups.

Results

The anchoring vignettes exposed differences in scale responses across demographic groups. After adjusting for these biases, public transport users (OR = 0.37, 95 % CI 0.21–0.65), walkers (OR = 0.44, 95 % CI 0.24–0.82), and motor vehicle users (OR = 0.47, 95 % CI 0.25–0.86) were all found to have lower odds of reporting high QoL compared with bicycle commuters. Similarly, the odds of reporting high health satisfaction were found to be proportionally lower amongst all competing travel modes: motor vehicle users (OR = 0.31, 95 % CI 0.18–0.56), public transport users (OR = 0.34, 95 % CI 0.20–0.57), and walkers (OR = 0.35, 95 % CI 0.20–0.64) when compared with cyclists. Fewer differences were observed in the unadjusted models.

Conclusion

Application of the vignettes by the two approaches removed scaling biases, thereby improving the accuracy of the analyses of the associations between travel mode and quality of life. The adjusted results revealed higher quality of life in bicycle commuters compared with all other travel mode users.