242482 Longitudinal Associations between Activities of Daily Living, Chronic Medical Conditions, and Health-Related Quality of Life in Older Adults: Moderated Mediation

Sunday, October 30, 2011

John P. Barile, PhD , Division of Adult and Community Health, Centers for Disease Control and Prevention, Atlanta, GA
William W. Thompson, PhD , NCCDPHP, Division of Population Health, Arthritis, Epilepsy, and Quality of Life Branch, Centers for Disease Control and Prevention, Atlanta, GA
Matthew M. Zack, MD, MPH , NCCDPHP, Division of Adult and Community Health, State Support, Arthritis, Epilepsy, and Quality of Life Branch, Centers for Disease Control and Prevention, Atlanta, GA
Gloria L. Krahn, PhD, MPH , National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
Willi Horner-Johnson, PhD , Center on Community Accessibility, Oregon Health & Science University, Portland, OR
Samuel C. Haffer, PhD , Health Outcomes Survey, Centers for Medicare & Medicaid Services, Baltimore, MD

Understanding the complex relationships between chronic medical conditions, functioning, and health-related quality of life (HRQOL) is important for identifying potential opportunities for health promotion and prevention. Previous research has shown that older adults with chronic medical conditions report more functional limitations and that both may be directly associated with HRQOL. Additionally, recent findings suggest that functional limitations may also moderate the association between multiple chronic medical conditions and HRQOL.


Assess the contributions and possible interactions between chronic medical conditions and function limitations on older adults' HRQOL.


Using data from 32,133 older adults who responded to the Medical Health Outcomes Survey, we assessed mediating and moderating effects of baseline chronic medical conditions and functioning on HRQOL at a 2-year follow-up period. Functioning was assessed using activities of daily living (ADLs) and HRQOL was assessed using physically and mentally unhealthy days.


Our findings suggest that the number of chronic medical conditions an older adult reports is associated with more ADL limitations (b=.19, p<.001) and that the association between their number of chronic medical conditions and their HRQOL at follow-up is dependent upon their ADL limitations (physically unhealthy, b=-.05, p<.001 and mentally unhealthy, b=-.03, p<.001). Specifically, we find that the association between having multiple chronic conditions and HRQOL is stronger for those with no ADL limitations than those with at least one limitation.


These data provide practitioners important information regarding how chronic medical conditions and functional limitations may differentially affect HRQOL, both concurrently and over time.

Learning Areas:
Other professions or practice related to public health
Public health or related research

Learning Objectives:
Demonstrate how limitations in adultsí ability to complete activities of daily living and the presence of chronic conditions may differentially affect health-related quality of life over a two-year period.

Keywords: Quality of Life, Disability Studies

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have researched, published, and presented findings associated with older adults with functional limitations. I earned a PhD in community psychology.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.