Health-related quality of life and its influencing factors in elderly people with hypertension and type 2 diabetes mellitus based on Multi-level model: take the east coastal area of China as an example

Abstract

Abstract Purpose This study aimed to evaluate the relationship between hypertension (HTN) and type 2 diabetes mellitus (T2DM) on health-related quality of life (HRQoL) in elderly patients in the eastern coastal regions of China, which correspond to socio-demographic conditions, comorbidities and health outcomes. Methods From September 2021 to December 2021, 750 participants with HTN and T2DM over the age of 60 were recruited through multi-stage stratified sampling to conduct a cross-sectional study in the eastern coastal region of China. HRQoL was assessed using the EQ-5D-3L questionnaire. The multi-level model was developed to analyze the effects of patients' own factors and regional factors on HRQoL in patients with HTN and T2DM, using patients as level 1 and regions as level. Results The percentage of co-morbidity of HTN and T2DM in community-dwelling older adults was 14.3%, with a health utility index (0.778 ± 0.270). The multi-level model showed that the ICC was 0.797 and 0.815, respectively, which means that about 79.7% of the variance in EQ-5D health utility index was due to older adults' own factors and 20.3% of the variance was from urban level aggregation; about 81.5% of the variance in EQ-VAS scores was due to own factors and 18.5% of the variance was from urban level aggregation. Multi-level model results show that age, marital status, monthly income, number of chronic diseases, and alcohol consumption (P < 0.05) were significantly related to HrQoL in elderly patients with HTN and T2DM. Conclusion The HRQoL of older adults with HTN and T2DM is significantly lower than that of the general population, and emphasis should be placed on the prevention and management of older adults with the disease. Meanwhile, a central aspect to the management of HTN and T2DM is promoting a healthy lifestyle, and health-related knowledge should be promoted more, with emphasis on patients' mental health, to improve the HTN and T2DM of older adults.