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Factors Influencing Quality of Life in Older Women With Heart Disease

Janz, Nancy K. PhD,*; Janevic, Mary R. MPH,*; Dodge, Julia A. MS,*; Fingerlin, Tasha E. MS,†; Anthony Schork, M. PhD; Mosca, Lori J. MD, PhD and,‡; Clark, Noreen M. PhD§

Original Articles

Background. Better understanding of factors influencing the quality of life (QOL) of cardiac patients can guide treatment decisions.

Objectives. To describe the impact of clinical and psychosocial factors on the QOL of older women with heart disease.

Research design.  Baseline and 12-month data from women participating in an intervention study.

Subjects. Eligible participants, identified from medical records, were female, ≥60 years of age, and diagnosed with cardiac disease. A volunteer sample of 570 women (87% white) completed baseline interviews, with 485 women completing the 12-month assessment.

Measures. Utilizing Wilson and Cleary’s conceptual framework (1995), measures of clinical, psychosocial, and functional status were examined for their associations with QOL.

Results. At baseline, General Health Perceptions and Symptom Status accounted for 38% and 26%, respectively, of the variation in the QOL rating. Using logistic regression models, seven measures were significant predictors (P <0.05) of maintenance/improvement versus decline in QOL over 12 months: baseline QOL rating; baseline value and change in satisfaction with social activities over 12 months; change in satisfaction with physical activities; change in satisfaction with mental activities; and baseline value and change in perceived stress. For women who maintained or improved their satisfaction with social activities, the odds for also maintaining or improving QOL were 4.5 times the odds for women whose satisfaction with social activities deteriorated.

Conclusions. Satisfaction with social activities and perceived stress are important predictors of subsequent QOL. Consideration of the impact of treatments on these factors may help to prevent deterioration of QOL among older female cardiac patients.

*From the Department of Health Behavior and Health Education, School of Public Health, University of Michigan.

†From the Department of Biostatistics, School of Public Health, University of Michigan.

‡From the Department of Epidemiology, School of Public Health, University of Michigan, and the Department of Internal Medicine University of Michigan Medical School.

§From the School of Public Health, University of Michigan.

Supported by Grant5-R01-HL38083 from the National Heart, Lung and Blood Institute.

Address correspondence and reprint requests to: Dr. Nancy K. Janz, Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 1420 Washington Heights, Ann Arbor, Michigan, 48109-2029, Tel: (734) 763-9939, Fax: (734) 763-9115, E-mail:

Received July 18, 2000; initial review completed September 20, 2000; accepted January 17, 2001.

© 2001 Lippincott Williams & Wilkins, Inc.