National study of chronic disease self-management: age comparison of outcome findings.
INTRODUCTION
The adult population is increasingly experiencing one or more chronic illnesses and living with such conditions longer. The Chronic Disease Self-Management Program (CDSMP) helps participants cope with chronic disease-related symptomatology and improve their health-related quality of life. Nevertheless, the long-term effectiveness of this evidence-based program on older adults as compared to the middle-aged populations has not been examined in a large-scale, national rollout.


METHOD
We identified baseline characteristics of CDSMP participants aged 65 years or older (n = 687, M = 74.8 years) in the National Study of CDSMP from 2010 to 2012. Comparisons were made to middle-aged participants aged 50 to 64 (n = 325, M = 58.3 years). Assessments were conducted at baseline and 12-month follow-up. Linear and generalized linear mixed models were performed to assess changes in primary and secondary outcomes, controlling the key sociodemographics and number of chronic conditions.


RESULTS
All primary outcomes (i.e., social/role activities limitation, depression, communication with doctors) significantly improved in both the older and middle-aged cohorts. Although improvements in illness symptomatology (e.g., fatigue, pain, shortness of breath, and sleep problems) were similar across both cohorts, only the middle-aged cohort benefitted significantly in terms of overall quality of life and unhealthy mental health days. Effect sizes were larger among the middle-aged population who were also more likely to enter the program in poorer health and be from minority backgrounds.


CONCLUSIONS
The current study documented improved health outcomes but more so among the middle-aged population. Findings suggest the importance of examining how age and interacting life circumstances may affect chronic disease self-management.
['Ory|Marcia G|MG|', 'Smith|Matthew Lee|ML|', 'Ahn|SangNam|S|', 'Jiang|Luohua|L|', 'Lorig|Kate|K|', 'Whitelaw|Nancy|N|']
D000367:Age Factors D000368:Aged D002908:Chronic Disease D015331:Cohort Studies D003863:Depression D005260:Female D006293:Health Promotion D006801:Humans D008297:Male D008875:Middle Aged D010817:Physician-Patient Relations D012648:Self Care D011795:Surveys and Questionnaires
aging and health chronic disease management community health evaluation health promotion