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[Influence of chronic diseases on health related quality of life in middle-aged and elderly people from rural communities: application of EQ-5D scale on a Health Survey in Fangshan, Beijing].

OBJECTIVE
To evaluate the health related quality of life (HRQoL) and to explore the influencing factors related to the prevalence of the essential hypertension, diabetes, coronary heart disease (CHD) and stroke in middle-aged and elderly people from rural communities.


METHODS
A total of 5345 individuals were chosen from a 2010 Health Survey in Fangshan, Beijing. Self-designed questionnaire was applied to collect the information on general health-related behaviors, chronic conditions, self-rated health, blood pressure and HRQoL with the EuroQoL questionnaire (EQ-5D) were measured. Probit regression model was used to identify the influencing factors on HRQoL, adjusting age, marriage status, education level, smoking, alcohol intake, physical activity and control of blood pressure. Population Attributable Risk Proportion (PARP) for estimating the influence of chronic disease on HRQoL was also calculated.


RESULTS
The average EQ-5D index was 0.923 ± 0.145, with 72.1% of the overall respondents in the status of having chronic diseases. Participants with chronic diseases had significantly lower EQ-5D index (0.907 ± 0.155) than those without (0.963 ± 0.105) (t = 15.082, P < 0.001). Significant relations were found between a lower HRQoL and chronic diseases. Relative risk (RR) and 95% confidence interval (95%CI) of poor HRQoL in populations with hypertension, diabetes, CHD and stroke were 1.686 (95%CI: 1.519 - 1.871), 1.725 (95%CI: 1.502 - 1.981), 1.869 (95%CI: 1.663 - 2.099), and 1.759 (95%CI: 1.474 - 2.089) respectively. The most influential disease appeared to be stroke in male (RR = 1.929, 95%CI: 1.462 - 2.546), whereas CHD in female individuals (RR = 1.926, 95%CI: 1.671 - 2.220). Rates of PARP (PAR%) for poor HRQoL in chronic disease subgroups were as follow: hypertension 31.05%, CHD 23.39%, diabetes 4.84% and stroke 4.44%, respectively.


CONCLUSION
This study suggested that stroke, at individual level, was the major influential factor to HRQoL. However, hypertension remained the leading preventable influential factor to HRQoL at the population level.