{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T17:50:49Z","timestamp":1777917049907,"version":"3.51.4"},"reference-count":39,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T00:00:00Z","timestamp":1749686400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Med Decis Making"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Many contributing factors can influence individuals\u2019 health, and these factors may not affect health outcomes equally. This study compared the importance of 38 predictors of health-related quality of life (HRQOL) and 2-y mortality for US older adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Data were from the Medicare Health Outcome Survey Cohort 23 (baseline 2020, follow-up 2022). This study included participants \u226565\u2009y (\n                      <jats:italic>N<\/jats:italic>\n                      = 142,551). HRQOL measures included physically unhealthy days (PUD), mentally unhealthy days (MUD), and activity limitation days (ALD) from the Healthy Days questions and 3 measures from the Veterans RAND 12-Item Health Survey (VR-12). A variable\u2019s importance was measured as the average gain in\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      after adding the variable in all submodels.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>For physical health (PUD), pain interfered with daily activities was the most important predictor with an importance score (I) of 8.4, indicating that this variable contributed 8.4% variance of PUD. Other leading predictors included pain interfered with socializing (I = 7.3) and pain rating (I = 6.7). For mental health (MUD), depression (I = 11.6) was far more important than any of the other predictors, contributing 38% of the total importance. For perceived disability (ALD), pain interfered with socializing was the most important predictor (I = 8.3), followed by difficulty doing errands (I = 6.1) and pain interfered with activities (I = 6.0). Of note, this general pattern was consistent for VR-12 HRQOL measures. Variables\u2019 importance scores for 2-y morality were very different from that for HRQOL. Age (I = 2.8) and difficulty doing errands (I = 2.6) were the most important variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study demonstrated a large discrepancy in the variables\u2019 importance for HRQOL and 2-y mortality. Functional limitations\/disabilities and geriatric syndromes were more important for the prediction of HRQOL than were chronic conditions and other factors combined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                    <jats:list list-type=\"bullet\">\n                      <jats:list-item>\n                        <jats:p>For older adults, large differences were found in variable importance for explaining health-related quality of life (HRQOL) and 2-y mortality among 38 explanatory variables, including functional limitations, geriatric syndromes, chronic conditions, and other factors.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Pain and pain interference, difficulty doing errands, difficulty concentrating, memory problems, problems with walking\/balance, and depression were the most important predictors of HRQOL.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Age, marital status, education, difficulty doing errands, congestive heart failure, chronic obstructive pulmonary disease, and any cancer were more important for 2-y mortality than HRQOL.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Health care providers and policy makers should focus on the impact of multimorbidity and the interaction between often multifactorial conditions, as opposed to focusing only on individual diseases.<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:sec>","DOI":"10.1177\/0272989x251340709","type":"journal-article","created":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T08:19:02Z","timestamp":1749716342000},"page":"675-689","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparing Potential Contributors of Health-Related Quality of Life and Mortality Among US Older Adults"],"prefix":"10.1177","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1391-8190","authenticated-orcid":false,"given":"Haomiao","family":"Jia","sequence":"first","affiliation":[{"name":"Department of Biostatistics, Mailman School of Public Health and School of Nursing, Columbia University, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erica I.","family":"Lubetkin","sequence":"additional","affiliation":[{"name":"Department of Community Health and Social Medicine, CUNY School of Medicine, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,6,12]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"National Institute for Health and Care Excellence (NICE). Multimorbidity: clinical assessment and management. NICE guideline 2016. Available from: https:\/\/www.nice.org.uk\/guidance\/ng56. [Accessed 1 July 2024]."},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.5888\/pcd12.140478"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-016-3590-9"},{"key":"e_1_3_3_5_2","volume-title":"Multiple Chronic Conditions\u2014A Strategic Framework: Optimum Health and Quality of Life for Individuals with Multiple Chronic Conditions","author":"US Department of Health and Human Services","year":"2010","unstructured":"US Department of Health and Human Services. Multiple Chronic Conditions\u2014A Strategic Framework: Optimum Health and Quality of Life for Individuals with Multiple Chronic Conditions. 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