Longitudinal changes in physical and mental health of older adults with chronic hepatitis B infection: Trajectories and predictors.
Despite the increasing health burden of chronic hepatitis B (CHB) in aging populations, little is known about the course of health-related quality of life (HRQoL) changes. We aimed to assess individual-level longitudinal HRQoL changes in elderly patients with CHB and to examine their correlates. A prospective 5.1 years-cohort study was conducted in community-dwelling adults aged 55 years with hepatitis B surface antigen-positive. Participants underwent serial measurement of HRQoL using the short-form (12) health survey version 2. Of 503 participants, 82.7% remained in good physical health throughout the study period, whereas 9.1% had declining physical health and 8.2% were in poor physical health. We likewise identified three trajectories of mental health changes ("good mental health" [86.9%], "declining mental health" [6.8%], and "poor mental health" [6.4%]). Three baseline characteristics were independently associated with a lower likelihood of remaining physically or mentally healthy: sarcopenic obesity (odds ratio [OR] with 95% confidence interval [95% CI] of 7.5 [2.8-20.5] for poor physical health, 3.1 [1.1-8.4] for declining physical health, 4.3 [1.4-13.0] for poor mental health), a higher number of metabolic abnormalities (OR [95% CI] of 3.6 [1.6-8.0] for poor physical health) and depressed mood (OR [95% CI] of 21.7 [5.8-81.0] for poor physical health, 5.3 [1.4-19.9] for declining physical health, 83.1 [19.7-350.2] for poor mental health, 13.6 [2.9-64.8] for declining mental health). In conclusion, in a cohort of elderly patients with CHB, we demonstrated the heterogeneity and nonlinearity of HRQoL changes and their associations with variations in specific extrahepatic organs/systems.
['Chen|Chang-Hua|CH|', 'Wu|Ming-Shiang|MS|', 'Yang|Yu-Wen|YW|', 'Liu|Yen-Tze|YT|', 'Chiu|Yen-Feng|YF|', 'Hsu|Chih-Cheng|CC|', 'Chuang|Shu-Chun|SC|', 'Chung|Tieh-Chi|TC|', 'Tsai|Tsung-Lung|TL|', 'Huang|Wen-Hao|WH|', 'Huang|Wei-Lin|WL|', 'Juan|Chung-Chou|CC|', 'Lien|Li-Ming|LM|', 'Hsiung|Chao A|CA|', 'Wu|I-Chien|IC|']
Aging Health-related quality of life 95% CI, 95% confidence interval ALT, alanine aminotransferase AST, aspartate aminotransferase BIC, Bayesian information criterion BMI, body mass index BP, blood pressure CES-D, Center for Epidemiological Studies Depression CHB, chronic hepatitis B CV, coefficient of variation FIB-4, Fibrosis-4 Index for Liver Fibrosis Geriatric assessment Group-based trajectory modeling HALST, Healthy Aging Longitudinal Study in Taiwan HBV, hepatitis B virus HBsAg, hepatitis B surface antigen HOMA-IR, Homeostasis Model Assessment of Insulin Resistance HRQoL, health-related quality of life Healthy Aging Longitudinal Study in Taiwan (HALST) MCS, Mental Component Summary MMSE, Mini-Mental State Examination OR, odds ratio PCS, Physical Component Summary SF-12v2, the Short Form (12) Health Survey version 2 hsCRP, high-sensitivity C-reactive protein