Quality of life impact of cardiovascular and affective conditions among older residents from urban and rural communities.

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dc.citation.volume11
dc.contributor.authorAllen J
dc.contributor.authorInder KJ
dc.contributor.authorHarris ML
dc.contributor.authorLewin TJ
dc.contributor.authorAttia JR
dc.contributor.authorKelly BJ
dc.date.available2013-08-14
dc.date.available2013-08-12
dc.date.issued14/08/2013
dc.description.abstractBACKGROUND: The demographic, health and contextual factors associated with quality of life impairment are investigated in older persons from New South Wales, Australia. We examine the impact of cardiovascular and affective conditions on impairment and the potential moderating influence of comorbidity and remoteness. METHODS: Data from persons aged 55 and over were drawn from two community cohorts sampling from across urban to very remote areas. Hierarchical linear regressions were used to assess: 1) the impact of cardiovascular and affective conditions on physical and psychological quality of life impairment; and 2) any influence of remoteness on these effects (N = 4364). Remoteness was geocoded to participants at the postal code level. Secondary data sources were used to examine the social capital and health service accessibility correlates of remoteness. RESULTS: Physical impairment was consistently associated with increased age, male gender, lower education, being unmarried, retirement, stroke, heart attack/angina, depression/anxiety, diabetes, hypertension, current obesity and low social support. Psychological impairment was consistently associated with lower age, being unmarried, stroke, heart attack/angina, depression/anxiety and low social support. Remoteness tended to be associated with lower psychological impairment, largely reflecting overall urban versus rural differences. The impacts of cardiovascular and affective conditions on quality of life were not influenced by remoteness. Social capital increased and health service accessibility decreased with remoteness, though no differences between outer-regional and remote/very remote areas were observed. Trends suggested that social capital was associated with lower psychological impairment and that the influence of cardiovascular conditions and social capital on psychological impairment was greater for persons with a history of affective conditions. The beneficial impact of social capital in reducing psychological impairment was more marked for those experiencing financial difficulty. CONCLUSIONS: Cardiovascular and affective conditions are key determinants of physical and psychological impairment. Persons affected by physical-psychological comorbidity experience greater psychological impairment. Social capital is associated with community remoteness and may ameliorate the psychological impairment associated with affective disorders and financial difficulties. The use of classifications of remoteness that are sensitive to social and health service accessibility determinants of health may better inform future investigations into the impact of context on quality of life outcomes.
dc.description.publication-statusPublished
dc.identifierhttp://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000323269600001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=c5bb3b2499afac691c2e3c1a83ef6fef
dc.identifierARTN 140
dc.identifier.citationHEALTH AND QUALITY OF LIFE OUTCOMES, 2013, 11
dc.identifier.doi10.1186/1477-7525-11-140
dc.identifier.elements-id232936
dc.identifier.harvestedMassey_Dark
dc.identifier.issn1477-7525
dc.identifier.urihttps://hdl.handle.net/10179/11827
dc.relation.isPartOfHEALTH AND QUALITY OF LIFE OUTCOMES
dc.relation.urihttps://hqlo.biomedcentral.com/articles/10.1186/1477-7525-11-140
dc.subjectCardiovascular disease
dc.subjectUrban-rural
dc.subjectSocial capital
dc.subjectQuality of life
dc.subjectPhysical and psychological health
dc.subjectOver 55 years
dc.subject.anzsrc1117 Public Health and Health Services
dc.titleQuality of life impact of cardiovascular and affective conditions among older residents from urban and rural communities.
dc.typeJournal article
pubs.notesNot known
pubs.organisational-group/Massey University
pubs.organisational-group/Massey University/College of Humanities and Social Sciences
pubs.organisational-group/Massey University/College of Humanities and Social Sciences/School of Psychology
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