TY - JOUR
T1 - Area-level and individual-level socio-economic differences in health-related quality of life trajectories
T2 - Results from a 10-year longitudinal stroke study
AU - Sun, Yichao A.
AU - Phan, Hoang
AU - Buscot, Marie Jeanne
AU - Thrift, Amanda G.
AU - Gall, Seana
N1 - Funding Information:
Funding for the NEMESIS was obtained from the National Health & Medical Research Council of Australia including project grant funding ( GNT154600; GNT307900; GNT526601 ) and fellowship support to AGT ( GNT238304; GNT438700 ). Support was also provided by the VicHealth (formerly the Victorian Health Promotion Foundation). SLG is funded by a Heart Foundation Future Leader Fellowship ( GNT102061 ) and National Health and Medical Research Council Synergy Grant ( STOPstroke GNT1182071 ). YAS is funded by Commonwealth Friendship Medical Research Trust.
Funding Information:
Funding for the NEMESIS was obtained from the National Health & Medical Research Council of Australia including project grant funding (GNT154600; GNT307900; GNT526601) and fellowship support to AGT (GNT238304; GNT438700). Support was also provided by the VicHealth (formerly the Victorian Health Promotion Foundation). SLG is funded by a Heart Foundation Future Leader Fellowship (GNT102061) and National Health and Medical Research Council Synergy Grant (STOPstroke GNT1182071). YAS is funded by Commonwealth Friendship Medical Research Trust.
Publisher Copyright:
© 2023 The Author(s)
PY - 2023/8
Y1 - 2023/8
N2 - Background: We examined area-level (aSES) and individual-level (iSES) socio-economic status on trajectories of HRQoL to 10 years following stroke. Methods: Participants with strokes between 1/5/1996 and 30/4/1999 completed the Assessment of Quality of Life instrument (AQoL, range: -0.04 [worse than death] to 0 [death] to 1 [full health]) at ≥one of 3month, 6-month, 1-year, 2-year, 3-year, 4-year, 5-year, 7-year and 10-year interviews after stroke. Sociodemographic and health information were collected at baseline. We derived aSES from postcode using the Australian Socio-Economic Indexes For Area (2006) (categories: high, medium, low), and iSES from lifetime occupation (categories: non-manual, manual). Multivariable linear mixed effects modelling was used to estimate trajectories of HRQoL over 10 years, by aSES and iSES, adjusting for age, sex, cardiovascular disease, smoking, diabetes, stroke severity, stroke type, and the time influence on age and health conditions. Results: Of 1,686 participants enrolled, we excluded 239 with ‘possible’ stroke and 284 with missing iSES. Among the remaining 1,163 participants, 1,123 (96.6%) had AQoL assessed at ≥3 timepoints. In multivariable analysis, over time, people in the medium aSES group had mean 0.02 (95% CI -0.06, 0.02) greater reduction in AQoL score, and people in the low aSES group had mean 0.04 (95% CI, -0.07, -0.001) greater reduction, than those in the high aSES group. Manual workers had an average 0.04 (95% CI, -0.07, -0.01) greater reduction in AQoL score over time than non-manual workers. Conclusions: Over time, HRQoL declines in all people with stroke, declining most rapidly in lower SES groups.
AB - Background: We examined area-level (aSES) and individual-level (iSES) socio-economic status on trajectories of HRQoL to 10 years following stroke. Methods: Participants with strokes between 1/5/1996 and 30/4/1999 completed the Assessment of Quality of Life instrument (AQoL, range: -0.04 [worse than death] to 0 [death] to 1 [full health]) at ≥one of 3month, 6-month, 1-year, 2-year, 3-year, 4-year, 5-year, 7-year and 10-year interviews after stroke. Sociodemographic and health information were collected at baseline. We derived aSES from postcode using the Australian Socio-Economic Indexes For Area (2006) (categories: high, medium, low), and iSES from lifetime occupation (categories: non-manual, manual). Multivariable linear mixed effects modelling was used to estimate trajectories of HRQoL over 10 years, by aSES and iSES, adjusting for age, sex, cardiovascular disease, smoking, diabetes, stroke severity, stroke type, and the time influence on age and health conditions. Results: Of 1,686 participants enrolled, we excluded 239 with ‘possible’ stroke and 284 with missing iSES. Among the remaining 1,163 participants, 1,123 (96.6%) had AQoL assessed at ≥3 timepoints. In multivariable analysis, over time, people in the medium aSES group had mean 0.02 (95% CI -0.06, 0.02) greater reduction in AQoL score, and people in the low aSES group had mean 0.04 (95% CI, -0.07, -0.001) greater reduction, than those in the high aSES group. Manual workers had an average 0.04 (95% CI, -0.07, -0.01) greater reduction in AQoL score over time than non-manual workers. Conclusions: Over time, HRQoL declines in all people with stroke, declining most rapidly in lower SES groups.
KW - Area-level
KW - Health-related quality of life
KW - Individual-level
KW - Longitudinal study
KW - Socio-economic status
UR - http://www.scopus.com/inward/record.url?scp=85162848550&partnerID=8YFLogxK
U2 - 10.1016/j.jstrokecerebrovasdis.2023.107188
DO - 10.1016/j.jstrokecerebrovasdis.2023.107188
M3 - Article
C2 - 37216749
AN - SCOPUS:85162848550
SN - 1052-3057
VL - 32
JO - Journal of Stroke and Cerebrovascular Diseases
JF - Journal of Stroke and Cerebrovascular Diseases
IS - 8
M1 - 107188
ER -