Original Article
Factors Associated with SF-12 Physical and Mental Health Quality of Life Scores in Adults with Stroke

https://doi.org/10.1016/j.jstrokecerebrovasdis.2011.09.007Get rights and content

Background

Studies of poststroke quality of life (QOL) have not consistently identified which factors are most likely to independently influence the physical and mental aspects of QOL. In this study, we sought to identify which sociodemographic, comorbid disease conditions, and disability factors independently influenced the physical and mental aspects of poststroke QOL.

Methods

We completed a cross-sectional study of 666 US adults with a history of stroke from the 2007 Medical Expenditure Panel Survey (MEPS). We used sequentially built multiple linear regression models to identify sociodemographic, comorbidity, and stroke-related disability factors that independently affected short form-12 (SF-12) physical component summary (PCS) and mental component summary (MCS) scores. STATA software (version 10; StataCorp LP, College Station, TX) was used to perform the analysis to account for the complex survey design of the MEPS.

Results

In fully adjusted models using a nationally representative sample of US adults, being non-Hispanic black (β = 3.58), 45 to 64 years of age (β = −3.48), 65 years of age or older (β = −2.90), married (β = −3.50), middle (β = 2.78) and high income (β = 3.73), or having hypertension (β = −2.25), cardiovascular disease (β = −2.05), arthritis (β = −4.49), depression (β = −2.98), physical limitations (β = −7.60), social limitations (β = −4.12), and a need for assistance with instrumental activities of daily living (β = −4.49) were independently correlated with PCS scores. Being 45 to 64 years of age (β = 3.96), depressed (β = −15.92), or having social limitations (β = −3.62) were independently correlated with MCS scores.

Conclusions

Sociodemographic, comorbidity, and stroke-related disability factors have differential effect on physical and mental aspects of QOL in poststroke patients.

Section snippets

Sample

We analyzed data from all respondents to the Medical Expenditure Panel Survey (MEPS) Household Component for 2007 that were ≥17 years of age with a history of stroke. The MEPS is cosponsored by the Agency for Healthcare Research and Quality (AHRQ) and the National Center for Health Statistics.23 The MEPS sample is drawn from reporting units in the previous year’s National Health Interview Survey and is a nationally representative sample (with oversampling for blacks and Hispanics) of the US

Results

The 2007 MEPS sample included 666 adults ≥18 years of age who reported a history of stroke. Table 1 reports the percentages of individuals with stroke by sociodemographic and clinical characteristics. Approximately 75% of the sample classified themselves as non-Hispanic white, 56% were female, 60% were ≥65 years of age, 74% had at least a high school education, and 40% were classified as low income. Significant comorbidity existed in the sample, with 75% reporting hypertension, 51% heart

Discussion

In this study, we examined data from 666 adults with stroke who responded to the 2007 MEPS to determine the impact of stroke on quality of life. Four key findings emerged from this study. First, a range of variables varied with regard to their effect on the physical and mental aspects of QOL. For example, being female, married, ≥45 years of age, or having cardiovascular disease, arthritis, depression, physical limitations, cognitive limitations, social limitations, or difficulty with IADLs were

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    Supported by the use of facilities at the Charleston, South Carolina HSR&D-funded Center for Disease Prevention and Health Interventions for Diverse Populations (REA 08-261). Dr Ellis is supported by a career development award (CDA #07-012-3) from the Veterans Health Administration Health Services Research and Development program. Dr Grubaugh is supported by a career development award (CDA2 #07-015-2) from the Veterans Health Administration Health Services Research and Development program.

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