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<jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      To prospectively assess the effects of newly developed chronic conditions on changes in health\u2010related quality of life (\n                      <jats:styled-content style=\"fixed-case\">HRQ<\/jats:styled-content>\n                      oL) in postmenopausal women.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Forty clinical centers in the United States.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Women aged 50 to 79 enrolled in the Women's Health Initiative Observational Study during 1993\u201398 (N = 75,198).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>\n                      Onset of seven chronic conditions (hypertension, heart disease, stroke, cancer, osteoporosis, diabetes mellitus, arthritis),\n                      <jats:styled-content style=\"fixed-case\">HRQ<\/jats:styled-content>\n                      oL based on the Medical Outcomes Study 36\u2010item Short Form survey (\n                      <jats:styled-content style=\"fixed-case\">SF<\/jats:styled-content>\n                      \u201036), and change in\n                      <jats:styled-content style=\"fixed-case\">HRQ<\/jats:styled-content>\n                      oL from baseline to Year 3 in scores on the Physical (\n                      <jats:styled-content style=\"fixed-case\">PCS<\/jats:styled-content>\n                      ) and Mental (\n                      <jats:styled-content style=\"fixed-case\">MCS<\/jats:styled-content>\n                      ) Component Summary of the\n                      <jats:styled-content style=\"fixed-case\">SF<\/jats:styled-content>\n                      \u201036.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Each of the seven chronic conditions was statistically significantly associated with\n                      <jats:styled-content style=\"fixed-case\">HRQ<\/jats:styled-content>\n                      oL for physical and mental health. Women with incident stroke had the greatest decline in\n                      <jats:styled-content style=\"fixed-case\">HRQ<\/jats:styled-content>\n                      oL for physical and mental health (\n                      <jats:styled-content style=\"fixed-case\">PCS<\/jats:styled-content>\n                      : 10.2, 95% confidence interval (\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      ) = 8.3\u201312.1;\n                      <jats:styled-content style=\"fixed-case\">MCS<\/jats:styled-content>\n                      : 10.4, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      = 8.8\u201312.1), which exceeded minimal clinically important differences (\n                      <jats:styled-content style=\"fixed-case\">MCID<\/jats:styled-content>\n                      ). Having more new chronic conditions was associated with greater decrease in\n                      <jats:styled-content style=\"fixed-case\">HRQ<\/jats:styled-content>\n                      oL. Declines in\n                      <jats:styled-content style=\"fixed-case\">HRQ<\/jats:styled-content>\n                      oL in women with two or more chronic conditions exceeded\n                      <jats:styled-content style=\"fixed-case\">MCID<\/jats:styled-content>\n                      . Those with heart disease and stroke had the largest decline in physical health, and those with stroke and arthritis had the greatest decline in mental health. For all conditions other than stroke and diabetes mellitus, the more recently a condition was diagnosed, the greater the decrease in\n                      <jats:styled-content style=\"fixed-case\">PCS<\/jats:styled-content>\n                      . For stroke and cancer, a similar pattern was observed for\n                      <jats:styled-content style=\"fixed-case\">MCS<\/jats:styled-content>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The more conditions a woman developed, the greater reduction in\n                      <jats:styled-content style=\"fixed-case\">HRQ<\/jats:styled-content>\n                      oL she experienced. Declines in\n                      <jats:styled-content style=\"fixed-case\">HRQ<\/jats:styled-content>\n                      oL in women with stroke, cancer, and some combinations exceeded\n                      <jats:styled-content style=\"fixed-case\">MCID<\/jats:styled-content>\n                      . Findings from this study might lead to more\u2010effective patient\u2010centered approaches to health care for women with multiple chronic conditions.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.13796","type":"journal-article","created":{"date-parts":[[2015,10,27]],"date-time":"2015-10-27T07:26:12Z","timestamp":1445930772000},"page":"2349-2357","source":"Crossref","is-referenced-by-count":17,"title":["Newly Developed Chronic Conditions and Changes in Health\u2010Related Quality of Life in Postmenopausal Women"],"prefix":"10.1111","volume":"63","author":[{"given":"Juhua","family":"Luo","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics School of Public Health Indiana University Bloomington Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Hendryx","sequence":"additional","affiliation":[{"name":"Department of Applied Health Science School of Public Health Indiana University Bloomington Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monika M.","family":"Safford","sequence":"additional","affiliation":[{"name":"Division of Preventive Medicine Department of Medicine University of Alabama at Birmingham Birmingham Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Wallace","sequence":"additional","affiliation":[{"name":"Department of Epidemiology College of Public Health University of Iowa Iowa City Iowa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Rossom","sequence":"additional","affiliation":[{"name":"HealthPartners Institute for Education and Research Minneapolis Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Eaton","sequence":"additional","affiliation":[{"name":"Department of Family Medicine Alpert Medical School Brown University Providence Rhode Island"},{"name":"Department of Epidemiology School of Public Health Brown University Providence Rhode Island"},{"name":"Family Care Center Memorial Hospital of Rhode Island Pawtucket Rhode Island"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shari","family":"Bassuk","sequence":"additional","affiliation":[{"name":"Division of Preventive Medicine Brigham and Women's Hospital Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen L.","family":"Margolis","sequence":"additional","affiliation":[{"name":"HealthPartners Institute for Education and Research Minneapolis Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,10,27]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"AndersonG.Chronic Care: Making the Case for Ongoing Care [on\u2010line]. 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