“The higher their educational attainment and the lower their age, the higher the respondents rated their subjective health-related quality of life. The evaluation was also positively affected by active occupational or educational status, and by having more persons – up to six – living together in a household,” says head of research Dr. András Inotai, Associate Professor at the Centre for Health Technology Assessment, describing some of the findings of the questionnaire-based quality of life survey.
The moderate increase in life expectancy in recent decades is widely known, he adds. However, much less is discussed about the health-related quality of life during this time, hence the interest in this area of research.
The center’s three-member research team, head of research Dr. András Inotai, Director Dr. Zoltán Vokó, and biostatistician Dávid Nagy, used the internationally renowned EQ-5D questionnaire, which measures the patients’ self-rated health-related quality of life in five dimensions.
These dimensions are mobility, self-care, usual activities, pain/discomfort, and anxiety/depression, which are scored at three levels of severity, indicating no problem, some problems, and extreme problems, i.e. inability to perform a given activity.
Within the questionnaire’s five dimensions, a total of 243 possible health states can be distinguished, each of which can be assigned a numerical value describing the health-related quality of life, known as the EQ-5D index. The quantification of the questionnaire responses varies from country to country and culture to culture, for example, a European’s attitude to pain or anxiety might differ greatly from that of a person from East Asia. As the questionnaire was evaluated using a Hungarian algorithm, the results truly mirror the domestic circumstances, adds the associate professor.
“We opted for this questionnaire because, in addition to being perhaps the most widespread tool for measuring the overall quality of life in the world, it has also been used in numerous clinical studies at our university over the past 20 years. It was applied in the 2000 national health survey (OLEF 2000), too, which allows us to compare the results. The survey involved 5,503 respondents back then, while in 2022, the questionnaire was completed by 11,910 respondents from an extended age range, also including the 12-17 age band. The results were weighted to reflect the Hungarian population as a whole,” explains the head of research, the first author of the paper published in Quality of Life Research.
Co-author Dr. Zoltán Vokó, Professor and Director of the Center for Health Technology Assessment, participated in both the 2000 and 2022 surveys. Based on the research findings, the dimension of highest concern for the younger generation was anxiety/depression, while respondents of a higher age group reported pain/discomfort and limitation of usual activities as their most frequent problems.
The figures show that the 12 to 44 age group rated their health-related quality of life at almost 100 percent, above which the indicator declines for each ten-year age band. Men over 55 rated their quality of life slightly higher than women of the same age. – Dr. András Inotai
Although the reasons behind the results were not examined in this study, the fact remains that the elderly may suffer from more diseases, which have a significant impact on their quality of life. Higher educational attainment is associated with healthier lifestyle choices, increased participation in preventive and mental health programs, and an appreciation of health. Working or studying may result in increased physical and social activity, and the personal networks may be stronger in households or two or more people living together, these also lead to higher scores. On the other hand, inactive occupational status and living alone increase the risk of depression.
The research is considered pioneering in the sense that, according to the expert, no such repeated quality-of-life survey has ever been carried out with more than 10,000 respondents.
A comparison of the data across 22 years shows a significant improvement, i.e. a decrease of over thirty percent, in the anxiety/depression and pain/discomfort dimensions among middle-aged respondents, especially women. Compared to the 2000 figures, the improvement in quality of life as measured by the EQ-5D index is more than ten percent in these age bands, which is a significant and noticeable difference for an individual. In addition, the difference in the quality of life of men and women has narrowed noticeably.
The study is part of a broader research project run in a university collaboration to assess the quality of life of patients with long COVID. The present study provided population-based quality-of-life reference values for comparison. The research was funded by the 2020-1.1.6-JÖVŐ-2021-00013 program, with data collection performed by the Hungarian Central Statistical Office (KSH).
Orsolya Dávid
Translation: Judit Szabados-Dőtsch
Photos by Boglárka Zellei – Semmelweis University; featured image (illustration): freepik.com
