Individuals with asthma are more likely to have lower health-related quality of life (HRQoL) as younger adults than as adolescents, and those who are physically inactive or have uncontrolled asthma are most likely to have lower HRQoL as younger adults, according to study findings published in BMC Pulmonary Medicine.
Investigators in Sweden sought to assess HRQoL among younger people with asthma during the transition from adolescence to adulthood. Researchers also evaluated the effect of physical activity and asthma control levels on the association between asthma and HRQoL in this population.
The researchers conducted cross-sectional analyses of BAMSE, an ongoing allergy-related population-based prospective birth cohort, which includes 4809 individuals, followed since birth, who were newborns living in defined areas of Stockholm, Sweden, from 1994 to 1996. Parents of individuals in this cohort answered a baseline questionnaire for children who had reached 2 months of age. HRQoL was measured in 2268 participants (55.5% of the original cohort; 55.8% female) who took part in follow-up, responding to questionnaires at 16 and 24 years of age and undergoing a clinical examination at age 24.
Investigators measured HRQoL using the European Quality of Life 5 Dimensions 3 Level Version (EQ-5D 3L) tool (a measure of social, mental, and physical functioning that uses the EQ-5D descriptive system plus the EQ visual analogue scale [EQ-VAS]). This tool drew upon data on general health, lifestyle factors, and symptoms and treatment of asthma gathered during the 16- and 24-year follow-ups. Also taken into account in the HRQoL measurement were participants’ responses to 3 questions posed during follow-up: how are you feeling, how healthy do you consider yourself to be, and how happy are you with your life right now?
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In the present study, both young adults with adolescent onset and those with persistent asthma had increased odds of not considering themselves healthy compared with participants without asthma.
Asthma prevalence at the 24-year follow-up was 14.7%. Among those participants with asthma, 16.4% had uncontrolled asthma and 83.6% had controlled/partly controlled asthma. Additionally, 88.4% of participants with asthma fulfilled the World Health Organization (WHO) recommendations of physical activity, and 11.6% did not. Among those with asthma, 62.2% were women and 7.7% had adolescent-onset asthma.
Investigators found the adjusted median values of EQ VAS were lower at the 24-year follow-up vs the 16-year follow-up for participants with asthma (80 vs 85; P <.01), and participants without asthma (80 vs 87; P <.01). Participants with uncontrolled asthma had a lower median EQ VAS score at the 24-year follow-up vs peers with controlled/partly controlled asthma (75 vs 80; P =.03).
Among the younger adults with asthma, the researchers noted lower EQ VAS scores in those who did not fulfill the WHO recommendations on physical activity vs those who did (70 vs 80; P <.01).
Overall, younger adults with asthma reported more pain or discomfort than those without asthma (P <.01). Additionally, younger adults with asthma reported some problems or extreme problems in usual activities, pain or discomfort, and anxiety or depression at the 24-year follow-up than at the 16-year follow-up. Participants without asthma reported similar health attributes at the 24-year follow-up. More women with and without asthma reported some problems or extreme problems related to anxiety and depression vs men.
Study limitations include the variety of HRQoL instruments used in relation to asthma; the inability of the generic EQ-5D to reflect the full impact of exacerbations and clinically important changes in asthma control; possible nonresponse bias; and the fact that questionnaire responses were based on asthma control over the preceding 12 months whereas the Global Initiative for Asthma guidelines bases asthma control on the preceding 4 weeks.
The study authors noted that “In the present study, both young adults with adolescent onset and those with persistent asthma had increased odds of not considering themselves healthy compared with participants without asthma.” The researchers concluded that “HRQoL is lower in young adulthood than in adolescence. Young adults with asthma having uncontrolled disease or who are physically inactive appear to be particularly vulnerable.”
Disclosure: 1 study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
