Annual Meeting Abstracts: View
(Abst. 3.386), 2017
Quality of Life Across the Lifecourse
Authors: Peter Scal, Medical School, University of Minnesota; Ross Shegog, The University of Texas; Cam Escoffery, Emory University; Hongyan Liu, Case Western Reserve University, School of Medicine; Martha Sajatovic, Case Western Reserve University, School of Medicine; Barbara C. Jobst, Dartmouth-Hitchcock Medical Center; and Yvan Bamps, Emory University
Content: Rationale: Life-course perspective on health and human development articulates the importance of examining lives as a dynamic interaction between individuals’ characteristics and their socio-economic contexts. From this perspective it is reasonable to believe that appraisals of quality of life (QoL) will vary by age and socio-economic circumstances. To date this premise is supported by research that identifies variations in quality of life by various individual characteristics and circumstances. Yet, there is little research examining the relationship between age or stage of life and QoL. This gap in our understanding is relevant to systems of care for persons with epilepsy (PWE) because healthcare services and supports are often provided in age-specific settings (pediatric, adult and geriatric) and programs. Understanding whether and how QoL varies by age may have important implications for healthcare and policy. Methods: This secondary data analysis from the Managing Epilepsy Well (MEW) Network Integrated Database (MEW DB) evaluated whether QoL, as measured by the QOLIE-10, varied by stage of life among PWE. The MEW DB is a repository for data collected by independent research programs across the United States. This analysis uses pooled baseline data from MEW Network studies that included QoL as a measured variable. The analysis also is investigating whether domain-specific sub-scores in the QOLIE-10, specifically Epilepsy Effects, Mental Health, and Role Functioning may vary by life-stage. Baseline demographic and clinical assessments in relation to QoL were gender, ethnicity, race, education, employment, household composition, and 30-day seizure frequency. The primary independent variable groups were categorized as adolescent (13-17 years old), young adult (18-26), adult (27-64) and senior (65+). The QOLIE-10 (dependent variable) was considered with respect to summary score, and QOLIE -10 domain sub-scores. PHQ-9 Total Scores are presented . The datasets used in the analysis is WebEase (Emory), Paces ( U of Washington), FocusPilot (U of Michigan), Focus_RCT (U of Michigan), CTSI-More Phase I (New York University), FACES ( New York University), SMART(Case Western reserve university), TIME(Case Western reserve university) and YESS (Youth Epilepsy and Successful Selfmanagement, U of Minnesota). Results: Sociodemographic characteristics of the sample (N=786) by age group varied significantly by proportion who are Hispanic, and as expected by education. Gender proportions (total sample 63.5% female) and 30-day seizure frequency (total sample mean = 6.2, SD 23.5) were similar across age groups. QOLIE 10 scores were significantly lowest (indicating significantly better quality of life) among the senior (age 65+) age group. PHQ9 scores were lowest among adolescents and elderly. Conclusions: Understanding of factors related to QoL in epilepsy across the life span can help inform health delivery systems and community- based services. The finding that QoL varies significantly by age group suggests a need to further explore sub-elements of QoL which may account for this variability. Ongoing analysis are evaluating the potential association of QoL sub-domains across age groups. Growing sample size of the MEW DB, use of common data elements, and coordinated analytic expertise facilitate pursuit of a finer-grained evaluation of QoL across the life-span in PWE. Funding: Centers for Disease Prevention and Control through the National Center for Chronic Disease Prevention and Health Promotion | Division of Population Health to the respective institutions.