云南省宁洱县农村老年人抑郁状况及其对生命质量的影响研究

目的 分析云南省宁洱县农村老年人的抑郁状况及其对生命质量的影响.方法 采用多阶段分层随机法抽取宁洱县1629名60岁及以上农村老年人进行现场面访,问卷内容包括基本信息、抑郁量表GDS-30和简明健康量表SF-36,采用GDS-30评价其抑郁程度,SF-36量表评估其生命质量得分.结果 云南省宁洱县农村老年人的抑郁率为1...     

Five-year stability in associations of health-related quality of life measures in community-dwelling older adults: the Rancho Bernardo Study

Objective  

This study examines the five-year stability of the association of SF-12 and SF-6D scores with scores on the longer SF-36 and its domains in community-dwelling older men and women.     

Validation of the Kiswahili version of the SF-36 Health Survey in a representative sample of an urban population in Tanzania

The objective of this study was to assess the validity of a Kiswahili translation of the SF-36 Health Survey (SF-36) among an urban population in Tanzania, using the method of known-groups validation. People were randomly selected from a demographic surveillance system in Dar es Salaam. The representative sample consisted of 3,802 adults (15 years and older). Health status differences were hypothesized among groups, who differed in sex, age, socio-economic status and self-reported morbidity. Mean SF-36 scale scores were calculated and compared using t-test and ANOVA. Women had significantly lower mean SF-36 scale scores (indicating worse health status) than men on all scales and scores were lower for older people than younger on all domains, as hypothesized. On five of the eight SF-36 scales, means were higher for people of higher socio-economic status compared to those of lower socio-economic status. People who reported an illness within the previous 2 weeks scored significantly lower on all scales compared to those who were healthy, as did people who said they had a disability or a chronic condition.     

Norms for the Physical and Mental Health Component Summary Scores of the SF-36 for Young,Middle-Aged and Older Australian Women

The SF-36 was developed in the USA to provide an eight-scale health profile and two component summary scores representing physical and mental health. The published norms and scoring procedures are based on data from the US general population. The Australian Longitudinal Study on Women's Health (Women's Health Australia) undertook a survey in 1996 of approximately 42,000 Australian women in three age groups of 18–22, 45–49 and 70–74 years and provided age- and gender-specific norms for the SF-36 health profile. From these data, factor weights and factor score coefficients were calculated for these age- and gender-specific populations of Australian women. Thus, component summary scores for physical and mental health can now be calculated using a formula standardized to the relevant Australian population. This will facilitate the interpretation of the physical and mental health component summary scores in the Australian context and will allow more meaningful comparisons within the young, middle-aged and older cohorts of Australian women in the Australian Longitudinal Study on Women's Health. This revised version was published online in June 2006 with corrections to the Cover Date.     

Has the Prevalence of Disability Increased Over the Past Decade (2000–2007) in Elderly People? A Spanish Population-based Survey

ObjectivesThe main objectives of the current study were (1) to describe the prevalence of disability according to sociodemographic features, self-perceived health status, comorbidity, and lifestyle habits; (2) to determine factors associated with disability in men and women; and (3) to study the time trends prevalence of disability in the period 2000 to 2007.MethodsWe analyzed data taken from the Spanish National Health Surveys conducted in 2001 (n = 21,058), 2003 (n = 21,650), and 2006 (n = 29,478). For the current study, we included answers from adults aged 65 years and older. The main variable was disability including basic activities of daily living (ADLs), instrumental ADLs (IADLs), and mobility disability. We stratified the adjusted models by the main variables. We analyzed sociodemographic characteristics, self-perceived health status, lifestyle habits, and comorbid conditions using multivariate logistic regression models.ResultsThe total number of individuals aged 65 years and older was 18,325 (11,346 women, 6,979 men). Women were significantly older than men in all the surveys (P < .001). Women showed higher prevalence of disability (ADL, IADL, and mobility) as compared with men in all surveys. Time trends in the total disability prevalence and whole age range showed a significant increase from 2000 to 2007 in both men and women (OR 1.13, 95% CI 1.1–1.7), particularly in individuals with older age. The variables significantly associated with a higher likelihood of reporting ADL and IADL disability were age older than 84, lower educational level, 2 or more comorbid chronic conditions, obesity (only in women), sleeping more than 8 hours per day, and not practicing physical exercise. Finally, variables that increased the probability of having mobility disability were age older than 84 years, lower educational level, 2 or more comorbid chronic conditions, and not practicing physical exercise. In addition, subjects with disability had a worse self-reported health status.ConclusionsThe current study revealed an increase in disability from 2000 to 2007 in the older Spanish population. We found that age older than 84 years, lower education levels, obesity, not practicing physical activity and sleeping more than 8 hours per day were associated with higher disability. Individuals with disability reported a worse self-perceived health status and a greater number of comorbid conditions.     

Selecting a generic measure of health-related quality of life for use among older adults. A comparison of candidate instruments

Selecting an outcomes assessment instrument requires knowledge of their relative merits, especially head-to-head comparisons. The authors compare health-related quality-of-life (HRQOL) instruments among older adults for their psychometric properties and subject burden, specifically the Sickness Impact Profile (SIP) and Medical Outcomes Study Short-Form 36 (SF-36). Subjects were 282 of 373 eligible older adults (75.6% response) ranging in age from 65 to 96. SIP scores demonstrated a strong skew toward low (good health) scores with a mean of 11.1% (+/- SD 11.5) on the Total SIP index score. Similar components of the SIP and SF-36 were moderately to strongly correlated. The SIP suffered from a ceiling (good health) scaling effect, and the SF-36 scales also demonstrated some scaling extremes. These results demonstrate the relative scaling limits, especially the ceiling effect, of the SIP compared to the SF-36, and in general, the SF-36 is preferred for use among community-living older adults.     

Explaining health differences between men and women in later life: A cross-city comparison in Latin America and the Caribbean

This paper describes differences in health and functional status among older men and women and attempts to anchor the explanations for these differences within a lifecourse perspective. Seven health outcomes for men and women 60 years and older from seven Latin American and Caribbean cities are examined, using data from the 2000 SABE survey (Salud, Bienestar y Envejecimiento—n = 10,587). Age-adjusted as well as city- and sex-specific prevalence was estimated for poor self-rated health, comorbidity, mobility limitations, cognitive impairment, depressive symptoms and disability in basic and instrumental activities of daily living. Logistic regressions were fitted to determine if the differences between men and women in each outcome could be explained by differential exposures in childhood (hunger, poverty), adulthood (education, occupation) and old age (income) and/or by differential vulnerability of men and women to these exposures. Sao Paulo, Santiago and Mexico, cities in countries with a high level of income inequalities, presented the highest prevalence of disability, functional limitations and poor physical health for both women and men. Women showed poorer health outcomes as compared with men for all health indicators and in all cities. Controlling for lifecourse exposures in childhood, adulthood and old age did not attenuate these differences. Women's unadjusted and adjusted odds of reporting poor self-rated health, cognitive impairment and basic activities of daily living disability were approximately 50% higher than for men, twice as high for number of comorbidities, depressive symptoms and instrumental activities of daily living disability, and almost three times as high for mobility limitations. Higher vulnerability to lifecourse exposures in women as compared with men was not found, meaning that lifecourse exposures have similar odds of poor health outcomes for men and women. A more integrated understanding of how sex and gender act together to influence health and function in old age needs consideration of additional biological and social factors.     

Measuring Stroke Impact with SIS: Construct Validity of SIS Telephone Administration

Objectives: The purpose of this study was to examine the construct validity of the Stroke Impact Scale (SIS) using telephone mode of administration. Methods: Stroke patients were identified using national VA administrative data and ICD-9 codes in 13 participating VA hospitals. Stroke was confirmed by reviewing electronic medical records. Patients were administered SIS by telephone at 12-weeks post-stroke, and administered the Functional Independence Measure (FIM) and SF-36V at 16 weeks post-stroke. The instrument’s convergent validity and its ability to differentiate between groups of stroke patients with different disability levels were examined using Pearson’s correlations and Kruskal–Wallis one way ANOVA tests. Results: All the relevant relationships yielded high correlation coefficients with statistical significance: 0.86 for FIM-motor vs. SIS-ADL, and 0.77 for PF in SF-36V vs. SIS-PHYSICAL. The SIS presented better score discrimination and distribution for different severity of stroke than FIM and SF-36V without severe ceiling and floor effects. Kruskal–Wallis tests showed the Physical Component Score of SF-36V did not discriminate any disability levels. Physical functioning (PF) in SF-36V, FIM-motor, SIS-PHYSICAL, SIS-16, and SIS-ADL showed better discrimination in person’s functioning. The pairwise comparisons showed that SIS-PHYSICAL, SIS-16, and SIS-ADL discriminated more Rankin levels than FIM-motor and PF in SF-36V. Conclusions: SIS telephone survey had superior convergent validity and was better at differentiating between groups of stroke patients with different disability levels than the FIM and SF-36V with no evidence of ceiling and floor effects. Telephone administration of SIS would be a useful and cost-effective method to follow-up community dwelling veterans with stroke.     

Stability of normative data for the SF-36: results of a three-year prospective study in middle-aged Canadians

BACKGROUND: The SF-36 is widely used to assess health-related quality of life (HRQOL), but with few longitudinal studies in healthy populations, it is difficult to quantify its natural history. This is important because any measure of change following an intervention may be confounded by natural changes in HRQOL. This paper assesses mean changes in SF-36 scores over a 3-year period in men and women between the ages of 40 and 59 years at baseline. METHODS: Subjects were randomly selected from nine Canadian cities. Mean SF-36 changes over a 3-year period (1996/1997-1999/2000) were calculated for each gender within 5-year age categories. Multiple imputation was used to correct for potential bias due to missing data. RESULTS: The baseline cohort included 1,974 women and 975 men between 40 and 59 years. Mean changes in HRQOL tended to be small. Women demonstrated small average declines in 22 of the 32 age and domain groupings (4 age groups, 8 SF-36 domains) while men showed declines in 14/32. Most participants stayed within 10 points of their original baseline score. INTERPRETATION: Mean SF-36 scores change only slightly over three years in middle-aged Canadians, although there is much individual variation. It may be necessary to adjust for the natural evolution of SF-36 scores when interpreting results from longitudinal studies.     

Predicting an SF-6D Preference-Based Score Using MCS and PCS Scores from the SF-12 or SF-36

Background:  The SF-6D preference-based scoring system was developed several years after the SF-12 and SF-36 instruments. A method to predict SF-6D scores from information in previous reports would facilitate backwards comparisons and the use of these reports in cost-effectiveness analyses.
Methods:  This report uses data from the 2001–2003 Medical Expenditures Panel Survey (MEPS), the Beaver Dam Health Outcomes Survey, and the National Health Measurement Study. SF-6D scores were modeled using age, sex, mental component summary (MCS) score, and physical component summary (PCS) score from the 2002 MEPS. The resulting SF-6D prediction equation was tested with the other datasets for groups of different sizes and groups stratified by age, MCS score, PCS score, sum of MCS and PCS scores, and SF-6D score.
Results:  The equation can be used to predict an average SF-6D score using average age, proportion female, average MCS score, and average PCS score. Mean differences between actual and predicted average SF-6D scores in out-of-sample tests was −0.001 (SF-12 version 1), −0.013 (SF-12 version 2), −0.007 (SF-36 version 1), and −0.010 (SF-36 version 2). Ninety-five percent credible intervals around these point estimates range from ±0.045 for groups with 10 subjects to ±0.008 for groups with more than 300 subjects. These results were consistent for a wide range of ages, MCS scores, PCS scores, sum of MCS and PCS scores, and SF-6D scores. SF-6D scores from the SF-36 and SF-12 from the same data set were found to be substantially different.
Conclusions:  Simple equation predicts an average SF-6D preference-based score from widely published information.     

Social determinants of sex differences in disability among older adults: a multi-country decomposition analysis using the World Health Survey

ABSTRACT: INTRODUCTION: Women represent a growing proportion of older people and experience increasing disability in their longer lives. Using a universally agreed definition of disability based on the International Classification of Functioning, Disability and Health, this paper examines how, apart from age, social and economic factors contribute to disability differences between older men and women. METHODS: World Health Survey data were analyzed from 57 countries drawn from all income groups defined by the World Bank. The final sample comprises 63638 respondents aged 50 and older (28568 males and 35070 females). Item Response Theory was applied to derive a measure of disability which ensured cross country comparability. Individuals with scores at or above a threshold score were those who experienced significant difficulty in their everyday lives, irrespective of the underlying etiology. The population was then divided into "disabled" vs. "not disabled". We firstly computed disability prevalence for males and females by socio-demographic factors, secondly used multiple logistic regression to estimate the adjusted effects of each social determinant on disability for males and females, and thirdly used a variant of the Blinder-Oaxaca decomposition technique to partition the measured inequality in disability between males and females into the "explained" part that arises because of differences between males and females in terms of age and social and economic characteristics, and an "unexplained" part attributed to the differential effects of these characteristics. RESULTS: Prevalence of disability among women compared with men aged 50+ years was 40.1% vs. 23.8%. Lower levels of education and economic status are associated with disability in women and men. Approximately 45% of the sex inequality in disability can be attributed to differences in the distribution of socio-demographic factors. Approximately 55% of the inequality results from differences in the effects of the determinants. CONCLUSIONS: There is an urgent need for data and methodologies that can identify how social, biological and other factors separately contribute to the health decrements facing men and women as they age. This study highlights the need for action to address social structures and institutional practices that impact unfairly on the health of older men and women.     

Comparison between exploratory factor-analytic and SEM-based approaches to constructing SF-36 summary scores

Objective To compare the two higher order factor structures of the Short-Form 36 (SF-36) Health Survey, using exploratory factor analytic methods and structural equation modeling (SEM). Methods Two population data sets were used. A stratified representative sample (n = 1,005) of the Greek general population was approached for interview. This survey containing the SF-36 was used to obtain component score coefficients from principal components analysis and orthogonal rotation. These coefficients were then used in the second data set (n = 1,007) of the Greek adult general population to compute scores for the physical component summary and the mental component summary of the SF-36. The second data set was also used to obtain factor scores for physical and mental health measures, applying SEM. Results Exploratory factor analysis supported the existence of two principal components that are the basis for summary physical and mental health measures. SEM showed that models assuming that physical and mental health are correlated provided a better fit to the data than models assuming independence between physical and mental health. However, all eight dimensions of SF-36 should be included in the construction of summary scores. Conclusions These results confirm the multidimensional structure of the SF-36, the correlational equivalence between standard summary measures and SEM-based second-order factor scores, and underscore the feasibility of multinational comparisons of health status using this instrument.     

Willingness to undergo surgery again validated clinically important differences in health-related quality of life after total hip replacement or total knee replacement surgery

ObjectivesTo determine clinically important differences (CIDs) in health-related quality of life (HRQoL) after total hip replacement (THR) or total knee replacement (TKR) surgery, using the Short Form 36 (SF-36).Study Design and SettingSF-36 scores were collected 2 weeks before and at 1.5–6 years after joint replacement in 586 THR and 400 TKR patients in a multicenter cohort study. We calculated distribution-based CIDs (0.8 standard deviations of the preoperative score) for each SF-36 subscale. Responders (patients with an improvement in HRQoL ≥ CID of a particular subscale) were compared with nonresponders using an external validation question: willingness to undergo surgery again.ResultsCIDs for THR/TKR were physical functioning (PF), 17.9/16.7; role-physical (RP), 31.1/33.4; bodily pain (BP), 16.8/16.2; general health, 15.5/15.7; vitality, 17.3/16.7; social functioning (SF), 22.0/19.9; role-emotional, 33.7/33.6; and mental health, 14.8/14.1. CIDs of PF, RP, BP, and SF were validated by the validation question.ConclusionValid and precise CIDs are estimated of PF, RP, BP, and SF, which are relevant in HRQoL subscales for THR and TKR patients. CIDs of all other subscales should be used cautiously.     

Sleep disturbance in relation to health-related quality of life in adults: The fels longitudinal study

Objective  Sleep disturbances are prevalent problems in the general population. Symptoms of insomnia can impact various physical and mental conditions. Furthermore, sleep disturbances may worsen the quality of life independently of co-occurring medical conditions. In this study, we examined the relationships between self-reported sleep disturbance symptoms and health-related quality of life measures in the Fels Longitudinal Study. Design  Cross-sectional study. Participants  A total of 397 adults (175 men and 222 women) aged 40 years and older were included in the present study. Measurements  Three self-reported sleep disturbance measures (difficulty falling asleep, nocturnal awakenings and maintaining sleep, and daytime tiredness) were collected between 2003 and 2006. Health-related quality of life measures were assessed using the Medical Outcomes Survey Short Form (SF)-36. Socio-demographic status (marital status, employment status, and education) and current medical conditions were collected from participants during study visits. Results  Individuals who reported frequent sleep disturbances showed significantly worse quality of life on all SF-36 subscales examined. The odds ratio (OR) ranged from 1.71 to 18.32 based on symptoms of insomnia across seven SF-36 domains in analyses adjusted for significant covariates influencing quality of life. Participants with severe sleep disturbances (both sleep problems and daytime impairment) showed generally higher odds of reporting poor SF-36 scores (adjusted ORs; 5.88–17.09) compared to participants with no problems. Conclusion  Sleep disturbance is comprehensively and independently associated with poor health-related quality of life in middle-aged and older adults.     

Secular changes in disability among middle-aged and elderly Finns with and without coronary heart disease from 1978-1980 to 2000-2001

PURPOSE: To examine time trends in the prevalence of coronary heart disease (CHD) and disability. METHODS: Data were used from two large nationally representative cross-sectional health examination surveys conducted in Finland (1978-1980 and 2000-2001). RESULTS: The prevalence of CHD decreased in men and women aged 45 to 64 years and increased among those aged 75 years or more. In men with and without CHD, and in women without CHD, the prevalence of disability decreased until the age of 75 years, but in women with CHD no statistically significant decrease was observed. CONCLUSIONS: Favorable changes in prevalence of CHD and disability have occurred in people aged 45 to 75 years, but not in older people particularly in women. The proportion of decrease in disability attributable to CHD was estimated to be up to 25%. The causes of unequal development by age and gender should be ascertained.     

Visual impairment and quality of life: gender differences in the elderly in Cuenca,Spain

Purpose To estimate the prevalence of visual impairment (VI) in a population sample of older adults of the province of Cuenca, Spain and to evaluate the impact of VI on health-related quality of life (HRQOL) in this population group. Methods Cross-sectional observational study of the cohort of all persons over the age of 64 years from an urban area and rural nucleus of the province of Cuenca, Spain. Sociodemographic data were obtained and the VF-14 and SF-12 questionnaires were administered in an interview. One ophthalmologist evaluated the visual acuity (VA) and the presence of lens opacities, glaucoma, diabetic retinopathy, and age-related maculopathy. Prevalence of VI and blindness was defined according to the WHO criteria (0.5 log MAR ≤ VA < 1.2 log MAR and VA ≥ 1.2 log MAR) and the European criteria (0.3 log MAR ≤ VA < 1 log MAR and VA ≥ 1 log MAR) in the better eye. Results The study enrolled 1155 people out of a total of 1435 who were invited to participate (response rate 80.5%). The prevalence of VI and blindness according to the WHO criteria was 6.3 and 2%, respectively. Using the European criteria, the prevalence of VI was 21.1 and 2.4% the prevalence of blindness. The prevalence of VI was greater in older subjects (p < 0.0001); no significant gender-related differences were observed. The mean VF-14 score and means of the Physical Composite Score (PCS) and Mental Composite Score (MCS) of the SF-12 were lower in women than in men for all categories of visual acuity. The mean VF-14 score diminished as the degree of VI increased in all the pathologies studied, except glaucoma. The mean PCS score differed significantly by categories of VI, cataract, and diabetic retinopathy. The mean MCS score only differed with the degree of impairment of diabetic retinopathy. Conclusions The prevalence of VI was among the highest reported until now in adults over 64 years old and increased with age. The deterioration in quality of life related to visual function increased with increased degree of VI for all the pathologies studied (cataract, diabetic retinopathy, age-related maculopathy) except glaucoma. The HRQOL was consistently worse in women than in men for all categories of deterioration of visual acuity.     

Prevalence and causes of functional disability in an elderly general population of Japanese: the Hisayama study

Background

There are limited data on the prevalence and causes of disability in the elderly general population in Japan.

Methods

In a population-based cross-sectional study of 1550 Japanese aged 65 years or older, we examined the prevalence of functional disability (defined as a Barthel Index score of ≤95) and its causes.

Results

A total of 311 of the participants had a disability (prevalence 20.1%). The prevalence of disability increased with age and doubled with every 5-year increment in age. Prevalence was higher in women than in men, especially among those aged 85 years or older. With respect to the cause of functional disability, dementia accounted for 23.5%, stroke for 24.7%, orthopedic disease for 12.9%, and other disease for 38.9% of cases in men; in women, the respective values were 35.8%, 9.3%, 31.0%, and 23.9%. Regarding age, dementia was the most frequent cause of disability in subjects aged 75 years or older, whereas stroke was most common in subjects aged 65 to 74 years. Approximately two-thirds of cases of total dependence were attributed to dementia in both sexes, whereas the main cause of slight or moderate/severe dependence was stroke in men and orthopedic disease in women. Among participants with total dependence, 94.8% resided in a hospital or health care facility.

Conclusions

Our findings indicate that functional disability is common among Japanese elderly adults and that its major cause is stroke in men and dementia in women.Key words: functional disability, dementia, stroke, prevalence, Japanese elderly     

The Healthy Nordic Diet and Mediterranean Diet and Incidence of Disability 10 Years Later in Home-Dwelling Old Adults

Background/ObjectiveDiet has a major impact on a person's health. However, limited information exists on the long-term role of the whole diet on disability. We investigated the association of the healthy Nordic diet and the Mediterranean diet with incident disability 10 years later.DesignLongitudinal, with a follow-up of 10 years.Settings/ParticipantsA total of 962 home-dwelling men and women from the Helsinki Birth Cohort Study, mean age 61.6 years, who were free of disability at baseline.MeasurementsAt baseline, 2001-2004, the Nordic diet score (NDS) and modified Mediterranean diet score (mMDS) were calculated using a validated 128-item food-frequency questionnaire. Higher scores indicated better adherence to the diet. Participants' incident disability was assessed during 2011-2013 by a self-reported questionnaire and was based on mobility limitations and difficulties to perform self-care activities. Analyses were performed using logistic regression and adjusted for potential confounding factors.ResultsIn total, 94 participants (9.8%) developed mobility limitations and 45 participants (4.7%) developed difficulties in self-care activities during 10 year follow-up. The likelihood of having mobility limitations (odds ratio (OR) 0.42, 95% confidence interval (CI) 0.22–0.80) and difficulties in self-care activities (OR 0.38, 95% CI 0.15–0.94) were lower among those in the highest NDS tertile than among those in the lowest NDS tertile. Greater mMDS was associated with a lower disability incidence; however, the association was not statistically significant.Conclusions/ImplicationsAdherence to the healthy Nordic diet predicts 10-year incidence of mobility limitations and difficulties to perform self-care activities in old age and may thus be protective against disability in Nordic population.     

Self-rated health in persons with spinal cord injury: relationship of secondary conditions, function and health status

Objective  Self-rated health is used frequently as a measure of health in the general population, and increasingly with persons with disabilities. However, its meaning and its relationship with other measures of self-reported health (health status and secondary conditions) are not well understood for this group. The purpose of the present study was to use a conceptual model to examine the structure of self-rated health with persons with spinal cord injuries. Methods  A US sample of 270 adults with mobility impairment stemming from spinal cord injury (SCI) provided data on three measures of self-reported health that differ in degree of subjectivity: physical problems common to SCI, four domains of health status from the SF-36, and a single item on self-rated health. Data were compared with the norm sample of the SF-36. The conceptual model was tested using path analyses. Results  SF-36 scores were lower on three of four domains compared with the norm sample. The conceptual model analyses indicated that 35% of variance in self-rated health is accounted for through direct relationship with physical secondary conditions common to persons with SCI and as mediated through SF-36 domains of Role Physical and Vitality. The SF-36 domain of Physical Function was statistically unrelated to self-rated health. Conclusion  The conceptual model of self-rated health was verified in a sample of persons with SCI. Importantly, the SF-36 domain of Physical Function does not relate to self-rated health for this group. Its inclusion in measures of self-reported for disability populations creates difficulty without apparent benefit.     

Household income is strongly associated with health-related quality of life among Japanese men but not women

OBJECTIVES: As socio-economic status (SES) strongly reflects individual economic status, evaluating the association between SES and health could provide information that is important for planning integrated economic and public health policies. We examined the association between annual household income as a measure of SES and the eight scale scores of the Medical Outcomes Study Short Form-36 Health Survey (SF-36) as a quantifier of health-related quality of life (HRQOL) in Japan. STUDY DESIGN: Cross-sectional survey. METHODS: Data were from the SF-36 national survey in Japan. A total of 4500 people aged 16 years or older were selected from the entire population of Japan using stratified-random sampling, and 3395 responded to the survey. RESULTS: Men with lower levels of annual household income had lower scores in all SF-36 domains. However, only 'general health perceptions' and 'social functioning' showed statistically significant trends among the women surveyed. In the subgroup of women working full-time, there were no domains that showed significant trends. CONCLUSIONS: A strong association exists between annual household income and SF-36 scores among men, but there is only a limited association among women. The employment and economic policies that affect annual household income potentially influence HRQOL.