Fitness and health-related quality of life dimensions in community-dwelling middle aged and older adults

Abstract

Background: The aim of the present study was to identify the physical fitness (PF) tests of a multi-component battery more related to the perception of problems in each dimension of the health-related quality of life (HRQoL) assessed by the EuroQol 5 dimensions 3 level questionnaire (EQ-5D-3L) in community-dwelling middle-aged and older adults

Methods: A cross-sectional study was conducted with 7104 participants (6243 females and 861 males aged 50-99 years) who were recruited in the framework of the Exercise Looks After You Program, which is a public health program designed to promote physical activity (PA) in community-dwelling middle-aged and older adults. Participants were assessed by the EQ-5D-3L questionnaire and a battery of fitness tests. The responses to each EQ-5D-3L dimension were collapsed into a two-tier variable consisting of «perceive problems» and «do not perceive problems». Correlation coefficients for the relationships between the HRQoL variables, between the PF variables, and between the HRQoL and PF variables were obtained. Two logistic regression models, one adjusted and one unadjusted, were developed for each EQ-5D-3L dimension.

Results: There were significant correlations between all variables except anxiety/depression and the back scratch test. The PF tests that correlated best with the HRQoL dimensions were the Timed Up-and-Go Test (TUG) and the 6-min walk; pain/discomfort and anxiety/depression correlated less well. All PF tests correlated, especially the TUG and 6-min walk tests. Unadjusted logistic models showed significant goodness of fit for the mobility and pain/discomfort dimensions only. Adjusted logistic models showed significant goodness of fit for all dimensions when the following potential confounding variables were included: age, gender, weekly level of PA, smoking and alcohol habits, body mass index, and educational level. For all dimensions, the highest odds ratios for the association with PF tests were with the TUG; this was observed with both the unadjusted and adjusted models.

Conclusions: The perception of problems, as measured by the EQ-5D-3L dimensions, was associated with a lower level of fitness, particularly for those dimensions that relate more closely to physical components. The PF tests that associated most closely with the perception of problems in the HRQoL dimensions were the TUG and the 6-min walk. This information will aid the design and assessment of PA programs that aim to improve HRQoL.