In the Journals

Quality of life significantly declines in US adults

Between 2001–2002 and 2012–2013, the average quality of life rating among U.S. adults significantly declined, according to findings recently published in the American Journal of Preventive Medicine.

“In terms of monitoring public health, a great deal of emphasis has been placed on life expectancy,” Mark Olfson, MD, MPH, of the department of psychiatry, College of Physicians and Surgeons, Columbia University, told Healio Family Medicine. “Describing national trends in quality of life and identifying factors that may lead to declining quality of life can help primary care physicians, social workers and other health professionals to include a focus on issues that influence their patients’ well-being.”

Researchers assessed 43,093 responses to the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions and 36,309 responses in the 2012–2013 cohort for participants aged 18 and older. They measured health-related quality of life from participants’ SF-6D scores, which measured economic and social risk factors, substance use, mental health and medical risk factors.

Olfson and colleagues found SF-6D ratings decreased from 0.82 among the 2001–2002 cohort to 0.79 in the 2012–2013 cohort (P < .0001). In age-, education-, race-, and sex-adjusted regressions, variable proportions of this decline were traced back to social risk factors, such as partner, neighbor or coworker problems (11.2%); mental health risk factors, including depression and anxiety disorders (13.1%); substance use risk factors, particularly substance use disorder or marijuana use (15.3%); economic risk factors, such as financial crisis and job loss (15.6%); and medical risk factors, including obesity, cardiac disease, hypertension, arthritis, medical injury (21.9%).

“For young adults, increasing rates of substance use of mental health problems played an especially prominent role in declining quality of life,” Olfson said. “This trend underscores the importance of increasing clinical attention to the assessment and management of alcohol misuse, drug use, depression and anxiety problems of young adults.”

Researchers also found that in corresponding adjusted models among participants 55 years and older, a larger percentage of the decline in SF-6D ratings was traced back to medical (35.3%) rather than substance use (7.4%) risk factors, whereas the reverse was true for participants aged 18 to 44 years.

“It is possible that declining quality of life among older adults may be partly a consequence of increasingly high public expectations of health,” Olfson said. “In addition to seeking to prevent and manage medical problems, primary care physicians have opportunities to help their older patients adopt realistic expectations concerning their health.”

Researchers also wrote that their findings are consistent with the Behavioral Risk Factor Surveillance System, Bureau of Labor Statistics and National Drug Use and Health surveys.

“The increase in health risk factors crossed social, economic, mental health, substance use, and medical domains. The breadth of the increases in risk factors highlights threats to health facing the U.S. and the health challenges ahead,” Olfson added.- by Janel Miller

Disclosure: The authors report no relevant financial disclosures.

Between 2001–2002 and 2012–2013, the average quality of life rating among U.S. adults significantly declined, according to findings recently published in the American Journal of Preventive Medicine.

“In terms of monitoring public health, a great deal of emphasis has been placed on life expectancy,” Mark Olfson, MD, MPH, of the department of psychiatry, College of Physicians and Surgeons, Columbia University, told Healio Family Medicine. “Describing national trends in quality of life and identifying factors that may lead to declining quality of life can help primary care physicians, social workers and other health professionals to include a focus on issues that influence their patients’ well-being.”

Researchers assessed 43,093 responses to the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions and 36,309 responses in the 2012–2013 cohort for participants aged 18 and older. They measured health-related quality of life from participants’ SF-6D scores, which measured economic and social risk factors, substance use, mental health and medical risk factors.

Olfson and colleagues found SF-6D ratings decreased from 0.82 among the 2001–2002 cohort to 0.79 in the 2012–2013 cohort (P < .0001). In age-, education-, race-, and sex-adjusted regressions, variable proportions of this decline were traced back to social risk factors, such as partner, neighbor or coworker problems (11.2%); mental health risk factors, including depression and anxiety disorders (13.1%); substance use risk factors, particularly substance use disorder or marijuana use (15.3%); economic risk factors, such as financial crisis and job loss (15.6%); and medical risk factors, including obesity, cardiac disease, hypertension, arthritis, medical injury (21.9%).

“For young adults, increasing rates of substance use of mental health problems played an especially prominent role in declining quality of life,” Olfson said. “This trend underscores the importance of increasing clinical attention to the assessment and management of alcohol misuse, drug use, depression and anxiety problems of young adults.”

Researchers also found that in corresponding adjusted models among participants 55 years and older, a larger percentage of the decline in SF-6D ratings was traced back to medical (35.3%) rather than substance use (7.4%) risk factors, whereas the reverse was true for participants aged 18 to 44 years.

“It is possible that declining quality of life among older adults may be partly a consequence of increasingly high public expectations of health,” Olfson said. “In addition to seeking to prevent and manage medical problems, primary care physicians have opportunities to help their older patients adopt realistic expectations concerning their health.”

Researchers also wrote that their findings are consistent with the Behavioral Risk Factor Surveillance System, Bureau of Labor Statistics and National Drug Use and Health surveys.

“The increase in health risk factors crossed social, economic, mental health, substance use, and medical domains. The breadth of the increases in risk factors highlights threats to health facing the U.S. and the health challenges ahead,” Olfson added.- by Janel Miller

Disclosure: The authors report no relevant financial disclosures.