Trajectories of health-related quality of life and their association with disability in older Australians

Abstract

Background: The relationship between various disabilities and the trajectories of HRQoL in older populations remains largely unexplored. Therefore, we aim to investigate the connections between HRQoL trajectories and different types of disabilities in older Australians.

Methods: The study participants' HRQoL was measured using the SF-6D utility index. We applied the group-based trajectory model to identify distinct HRQoL trajectories and employed multinomial logistic regression to examine the relationship between HRQoL trajectories and various types of disabilities.

Results: We identified three distinct trajectories of HRQoL among older Australians: low-declining, moderate-declining, and high-stable HRQoL groups. We found evidence indicating that the relative risks of being in the low-declining HRQoL group are greater for all types of disabilities. Older Australians living with physical disabilities (Relative Risk Ratio [RRR]: 6.62, 95 % CI: 4.76-9.22), psychosocial disabilities (RRR: 14.06, 95 % CI: 2.85-69.46), and other disabilities (RRR: 4.64, 95 % CI: 3.51-6.12) face a higher relative risk of being in the low-declining HRQoL group compared to their counterparts. Similarly, older Australians with work-limiting disabilities (RRR: 15.96, 95 % CI: 11.99- 21.24), disability onset (RRR: 10.61, 95 % CI: 8.19- 13.75), and multiple disabilities (RRR: 19.12, 95 % CI: 13.96- 26.18) also have a higher relative risk of being in a low-declining HRQoL group compared to their counterparts.

Conclusions: Our findings emphasise the urgent need for targeted interventions and support services for older Australians with physical, psychosocial, and work-limiting disabilities to address their elevated risk of declining HRQoL and enhance their overall well-being.

Keywords: Disability; Group-based trajectory model; Health-related quality of life; Older Australians.