Relationship between obesity, hypertension and diabetes, and health-related quality of life among the elderly

Background The purpose of this study was to study the cumulative effects of cardiovascular risk factors on all the health-related quality of life dimensions among the elderly in this era of epidemic obesity and diabetes. Design and methods The population-based study covered 3567 participants, representative of the Spanish noninstitutionalized population aged 60 years and above. Data were gathered from home-based interviews and from the measurements of blood pressure and other anthropometric variables. Multiple linear regression was used to examine the relationships between health-related quality of life, on each scale of the SF-36 questionnaire, and obesity (waist circumference > 102 cm in men and > 88 cm in women), hypertension (blood pressure; 140/90 mmHg), and known diabetes, after adjusting for sociodemographic and lifestyle factors. Results Patients with obesity, hypertension, and diabetes, or a combination of these factors were, in general, associated with a worse health-related quality of life, on both the physical and the mental scales, than those without these factors, though statistical significance (P<0.05) was only attained for some relationships. Obesity in women (-2.9 to -6.7 points, according to the scale) and diabetes in men (-6.1 to -16.4 points, according to the scale) were the factors most closely and significantly associated with diminished health-related quality of life. Women who had all three factors showed the maximum decline in health-related quality of life (-10.2 to -177 points, according to the scale). Conclusions Obesity in old women and diabetes in old men are the most decisive factors adversely affecting the health-related quality of life. The association with worse health-related quality of life is especially marked (greater than additive) in women with all three factors, thereby rendering them a group that calls for special study and attention.