Rationale: Due to improvements of haemophilia care over the last three decades the life expectancy of people with haemophilia (PWH) has increased enormously resulting in more PWHs reaching an old age. However, only few information are available on health status and health-related quality of life (HR-QoL) in elderly PWHs. Therefore a retrospective case-control study was carried out in Italy. Methods: Patients ≥ 65 years with severe haemophilia were enrolled matched to male controls without bleeding disorders for age, geography and social status. Emotional well-being was assessed with the Geriatric Depression Scale and various HR-QoL instruments, namely the generic EQ-5D, WHOQOL-BREF, WHOQOL-Old and a disease-specific questionnaire (Haem-A-QoLElderly). Results: 84.6% of the in Italy registered elderly PWHs were enrolled (n = 39) with a median age of 68 years (65–78). PWHs suffered significantly more from viral infections (chronic hepatitis C: 87% vs. 5%; HIV: 13% vs. 0%), hypertension, arthropathy (OJS: M = 18.1 vs. M = 1.19) and had more impairments in physical functioning and showed a trend to mild depression (M = 9.9 vs. M = 5.3). By contrast more controls suffered from hypercholesterolemia and cardiovascular diseases, but had similar cognitive functioning. PWHs showed significantly higher impairments in their generic HR-QoL compared to matched controls (WHOQOL-BREF: P < 0.0001; WHOQOL-OLD: P < 0.041; EQ-5D: P < 0.0001). In regression models including infections, no of total bleeds, invalidity, OJS, marital status and depression the latter could explain up to 67% of the variance in HR-QoL. In turn depression correlated significantly with orthopaedic status, physical and mental functioning. Conclusions: Elderly PWHs show not only impairments in their health status and daily activities, but reveal to have as well significantly more emotional problems compared to controls. Since impairments in physical and mental functioning are correlated to depression and HR-QoL special care should be provided to this patient population
Health-related quality of life in elderly haemophilia patients / S. Von Mackensen, A. Gringeri, S.M. Siboni, M. Ferretti, F. Tradati, M. Franchini, A. Tagliaferri, E. Santagostino, P.M. Mannucci. - In: JOURNAL OF THROMBOSIS AND HAEMOSTASIS. - ISSN 1538-7933. - 7:Suppl. 2(2009 Jul), pp. 1119-1119. ((Intervento presentato al 22. convegno Congress of the International Society of Thrombosis and Haemostasis tenutosi a Boston, USA nel 2009 [10.1111/j.1538-7836.2009.03473_2.x].
Health-related quality of life in elderly haemophilia patients
A. GringeriSecondo
;S.M. Siboni;F. Tradati;P.M. MannucciUltimo
2009
Abstract
Rationale: Due to improvements of haemophilia care over the last three decades the life expectancy of people with haemophilia (PWH) has increased enormously resulting in more PWHs reaching an old age. However, only few information are available on health status and health-related quality of life (HR-QoL) in elderly PWHs. Therefore a retrospective case-control study was carried out in Italy. Methods: Patients ≥ 65 years with severe haemophilia were enrolled matched to male controls without bleeding disorders for age, geography and social status. Emotional well-being was assessed with the Geriatric Depression Scale and various HR-QoL instruments, namely the generic EQ-5D, WHOQOL-BREF, WHOQOL-Old and a disease-specific questionnaire (Haem-A-QoLElderly). Results: 84.6% of the in Italy registered elderly PWHs were enrolled (n = 39) with a median age of 68 years (65–78). PWHs suffered significantly more from viral infections (chronic hepatitis C: 87% vs. 5%; HIV: 13% vs. 0%), hypertension, arthropathy (OJS: M = 18.1 vs. M = 1.19) and had more impairments in physical functioning and showed a trend to mild depression (M = 9.9 vs. M = 5.3). By contrast more controls suffered from hypercholesterolemia and cardiovascular diseases, but had similar cognitive functioning. PWHs showed significantly higher impairments in their generic HR-QoL compared to matched controls (WHOQOL-BREF: P < 0.0001; WHOQOL-OLD: P < 0.041; EQ-5D: P < 0.0001). In regression models including infections, no of total bleeds, invalidity, OJS, marital status and depression the latter could explain up to 67% of the variance in HR-QoL. In turn depression correlated significantly with orthopaedic status, physical and mental functioning. Conclusions: Elderly PWHs show not only impairments in their health status and daily activities, but reveal to have as well significantly more emotional problems compared to controls. Since impairments in physical and mental functioning are correlated to depression and HR-QoL special care should be provided to this patient population
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