The Relationship Between the Number of Chronic Diseases and Health-Related Quality of Life Among Middle-Aged and Older Adults in Rural Areas of Yunnan Province, China: moderating Effect of Health Lifestyle

Figures & data

Table 1 Variable Description

Variable type	Variable Name	Description of Variable Categories and Score Setting
Independent variable	The number of NCDs	0, 1, 2, 3+
Dependent variable	Health-related quality of life (HRQoL)	Higher health utility value indicating better health-related quality of life
Moderating variable	Health lifestyle	Higher health lifestyle score indicating healthier lifestyle
	Smoking status	Non-smoker=3, Light/moderate smoker=2, Heavy smoker=1
	Alcohol consumption	Non-drinker=3, Light/moderate drinker=2, Heavy drinker=1
	Sleep duration	Adequate sleep=2, Inadequate/excess sleep=1
	Physical examination attendance	Regular=3, Irregular=2, Not at all=1
	Physical activity	Regular=3, Irregular=2, Not at all=1
Control variable	Gender	Female, Male
	Age	45–59, 60–74, ≥75
	Marital status	Married, Unmarried/divorced/widowed
	Education level	Primary school and below, Junior high school, Senior high school and above
	Occupation	Technician/office workers/civil servant, Individual business, Retired, Worker, Farmer, Unemployed, Others
	Monthly household income	0–2999, 3000–4999, 5000–6999, 7000–8999, ≥9000
	SES	The higher score indicating higher socioeconomic status

Abbreviations: NCDs, chronic non-communicable diseases; HRQoL, health-related quality of life; SES, socioeconomic status index.

Table 2 Correlation Analysis Between Variables

Variables	1	2	3	4	5	6	7	8
1 The number of NCDs	—
2 Health utility value	−0.324***	—
3 Health lifestyle score	0.119***	0.003	—
4 Smoking status	0.124***	−0.087***	0.482***	—
5 Alcohol consumption	0.125***	−0.111***	0.479***	0.430***	—
6 Sleep duration	−0.094***	0.123***	0.254***	−0.066***	−0.059***	—
7 Physical examination attendance	0.102***	−0.030	0.602***	0.081***	0.080***	−0.018	—
8 Physical activity	0.049*	0.084***	0.617***	0.067***	0.077***	−0.002	0.148***	—

Notes: *P-value<0.05, ***P-value<0.001.

Abbreviation: NCDs, chronic non-communicable diseases.

Table 3 Moderating Effect of Health Lifestyle on the Relationship Between the Number of NCDs and HRQoL

Variables	Mode l	Mode 2	Mode 3	Mode 4
Step 1
Gender (ref:Male)
Female	−0.007	−0.004	−0.012**	−0.011*
Age(ref:45–59)
60–74	−0.019***	−0.008	−0.011*	−0.012**
≥75	−0.059***	−0.044***	−0.049***	−0.051***
Marital status (ref:Married)
Unmarried/divorced/widowed	−0.014**	−0.013**	−0.012*	−0.013**
SES	0.007**	0.007**	0.006*	0.005*
Step 2
The number of NCDs		−0.026***	−0.027***	−0.027***
Step 3
Health lifestyle score			0.008***	0.008***
Step 4
The number of NCDs×Health lifestyle score				0.006***
F	26.350	49.710	48.020	45.410
R^2	0.047	0.100	0.111	0.119

Notes: *P-value<0.05, **P-value<0.01, ***P-value<0.001.

Abbreviations: NCDs, chronic non-communicable diseases; HRQoL, health-related quality of life; SES, socioeconomic status index.

Figure 1 Simple slope plot of the interaction between the number of NCDs and health lifestyle on HRQoL.

Notes: Low, 1 SD below the mean on health lifestyle score; High, 1 SD above the mean on health lifestyle score; The values of number of NCDs and health lifestyle score were centered before regression analysis; Gender, age, marital status and SES were adjusted.

Abbreviations: NCDs, chronic non-communicable diseases; HRQoL, health-related quality of life; SES, socioeconomic status index; SD, standard deviation.

Table 4 Moderating Effect of Each Health-Related Behaviors on the Relationship Between the Number of NCDs and HRQoL

Variables	Smoking Status	Alcohol Consumption	Sleep Duration	Physical Examination Attendance	Physical Activity
Step 1
Gender(ref:Male)
Female	−0.003	−0.001	−0.002	−0.005	−0.005
Age(ref:45–59)
60–74	−0.008	−0.007	−0.007	−0.009*	−0.012**
≥75	−0.044***	−0.043***	−0.043***	−0.046***	−0.049***
Marital status(ref:Married)
Unmarried/divorced/widowed	−0.014**	−0.014**	−0.012*	−0.014**	−0.013**
SES	0.007**	0.007**	0.006**	0.007**	0.004
Step 2
The number of NCDs	−0.026***	−0.026***	−0.026***	−0.027***	−0.027***
Step 3
Smoking status	−0.002
Alcohol consumption		−0.007
Sleep duration			0.018***
Physical examination attendance				0.006*
Physical activity					0.019***
Step 4
The number of NCDs×Smoking status	0.001
The number of NCDs×Alcohol consumption		−0.004
The number of NCDs×Sleep duration			0.013***
The number of NCDs×Physical examination attendance				0.006*
The number of NCDs×Physical activity					0.013***
F	37.300	37.740	44.290	38.650	49.420
R^2	0.100	0.101	0.116	0.103	0.128

Notes: *P-value<0.05, **P-value<0.01, ***P-value<0.001.

Abbreviations: NCDs, chronic non-communicable diseases; HRQoL, health-related quality of life; SES, socioeconomic status index.

Figure 2 Simple slope plot of the interactions between the number of NCDs and health-related behaviors on HRQoL. (A) The moderating effect of sleep duration on the relationship between the number of NCDs and HRQoL. (B) The moderating effect of physical examination attendance on the relationship between the number of NCDs and HRQoL. (C) The moderating effect of physical activity on the relationship between the number of NCDs and HRQoL.

Notes: Low, 1 SD below the mean on sleep duration (A) /physical examination attendance (B) /physical activity (C) score; High, 1 SD above the mean on sleep duration/physical examination attendance/physical activity score; The values of number of NCDs and health-related behaviors score were centered before regression analysis; Gender, age, marital status and SES were adjusted.

Abbreviations: NCDs, chronic non-communicable diseases; HRQoL, health-related quality of life; SES, socioeconomic status index; SD, standard deviation.