342
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S-605￭
Impaired health-related quality of life in elderly females is associated with multimorbidity
분당서울대학교병원 내과, 서울대학교 의과대학 내과학교실
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김광일, 김철호
Background: Multimorbidity is a common problem in the elderly and is significantly associated with functional decline, disability, and mortality.
However, the gender-specific characteristic of multimorbidity and its effect on patients’ quality of life (QOL) have not been clearly established.
Methods: We analyzed the Korean National Health and Nutrition Examination Survey database. EuroQol 5D (which includes two dimensions, the EuroQol 5D index score (EQ-5D) and the EuroQol visual analogue scale (EQ-VAS)) was used to evaluate QOL. Multimorbidity was eval- uated using data on blood pressure measurements, blood chemistry examinations, and anthropometric assessments, as well as a survey that as- sessed health status. Results: A total of 1,419 subjects older than 65 years of age were included in the analysis (age: 72.40 ± 0.19 years, male:
39.3%). Multimorbidity was significantly associated with female gender; however, it was not associated with age. The EQ-5D index and EQ-VAS scores were significantly lower in the patients with multimorbidity, especially among the elderly females. The inverse association between QOL and the number of chronic diseases was maintained without a floor effect. Hypertension was the most common disease; however, QOL was sig- nificantly associated with musculoskeletal disease, stroke, and depression, all of which were more common in the female subjects. There was no significant difference in QOL between male and female subjects with similar levels of multimorbidity. Conclusion: Both the amount and pat- tern of chronic diseases have been associated with QOL in the elderly. Elderly women have low levels of QOL due to multimorbidity and a higher prevalence of chronic disease, which is related with impaired QOL.
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S-606￭
Differential white blood cell count and all-cause mortality in the healthy elderly Korean
서울대학교 의과대학 내과학교실, 분당서울대학교병원 내과
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김광일, 정희원, 김선욱, 진호준, 김철호
Background: The circulating white blood cell (WBC) count has been considered as one of biomarkers of systemic inflammation, but this inex- pensive and universally obtained test result has not been fully explored for its predictive ability in the elderly population. The objective of this study was to assess the independent association of WBC types with mortality in the elderly population. Methods: We studied a total of 9,996 participants older than 65 years who underwent routine health examination at the two healthcare centers affiliated with Seoul National University.
Mortality data were obtained from the National Statistics Office of Korea. Results: The mean age of the study population was 69.7 (SD 4.3 years), and 5,491 of the subjects (54.9%) were male. The median lengths of follow-up were 44.9 months (range 1.2-78.7 months). There were 118 deaths (1.2%) during the follow up. The leading cause of death was cancer. Compared with the survivors, the deceased subjects were older, had increased level of inflammatory marker and a poor nutritional status. A significant mortality difference was identified according to the quartile groups of WBC and its subtype. In Cox-proportional hazards analysis, monocyte (HR: 5.18, 95% CI: 2.44-11.02) was the stronger predictor of all-cause mortality than WBC (HR: 1.57, 95% CI: 0.88-2.80), granulocyte (HR: 2.11, 95% CI: 1.15-3.88), and lymphocyte subtype (HR: 1.11, 95% CI: 0.66-1.86). Conclusions: Total WBC count is confirmed to be an independent predictor of mortality in the older adults, but greater pre- dictive ability is provided by monocyte subtype.
