Quality of Life Outcomes for Depressed and Nondepressed Older Adults in Community Long-Term Care

Abstract

Structured AbstractObjective-To compare outcomes of mortality, institutionalization, physical and mental quality of life, overall life satisfaction, and satisfaction with living arrangements, for depressed and nondepressed clients after one-year of community long-term care (CLTC) services.Design-Prospective cohort study with repeated assessments at 6 and 12 months.Setting-A publicly-funded CLTC agency that coordinates in-home care such as meal delivery, personal care and nursing care to functionally disabled and low income adults throughout a Midwestern State.Participants-Adults 60 years and older, starting CLTC services with minimal or no cognitive impairment (n=551).Measurements-Outcomes included the Medical Outcome Study's Short-Form (SF-8) for physical and mental quality of life and single-items for life satisfaction and satisfaction with living arrangements. Diagnostic Interview Schedule and the Center for Epidemiological Studies Depression Scale determined clients' depression status.Results-Depressed clients (n = 266) had significantly worse scores for all outcomes than nondepressed clients (n = 285), but mortality and institutionalization were not significantly related to depression. Depression was significantly associated with more positive change in mental health (mean change: depressed group = 4.60, S.D. = 14.0; non-depressed group = -1.50, S.D. =11.2) and overall life satisfaction (mean change: depressed group = 0.10, S.D. = 1.1; non-depressed group = -0.10, S.D. = 0.8).Conclusion-After one year of CLTC services, depressed clients experienced more improvement in quality of life and life satisfaction, yet their outcomes remained significantly lower than nona Direct correspondence and request for reprints to Leslie K. Hasche.Presented at: Gerontological Society of America, Maryland, November, 2008. No Disclosures to Report.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author ManuscriptAm J Geriatr Psychiatry. Author manuscript; available in PMC 2011 June 1. Every state provides publicly-funded community long-term care (CLTC) through a range of case management, in-home and community-based services for low-income, functionally disabled older adults. CLTC services can include but are not limited to personal care, homedelivered meals, homemaker/chore services, adult day services, and respite. Almost one in four older adults within this rapidly growing service sector experience depression (major depression: 7%, subthreshold depression: 18%) (1), and CLTC workers report that depression complicates the delivery of services (2). Evidence that the c...

Depression and Quality of Life in Older Persons: A Review

“…Generally, most of the generic HQOL domains were affected in a negative way by a depressive disorder or a severe degree of depressive symptoms, except for physical functioning (role limitations due to physical health) and in the mental domain (emotional, psychological functioning) [3,10,21,25,45,82]. Two studies found that general health and vitality (and energy level) were not affected by depression [2,21] while spiritual, body pain, and satisfaction with living arrangements domains were not affected by depression in 1 study each [2,25,45].…”

“…In all, 45 studies reported that they excluded individuals with cognitive impairment or a diagnosis of dementia, of which 30 were cross-sectional studies (58.8%) [11,12,17,19,24,30,31,32,33,37,58,59,60,62,63,64,65,66,69,72,73,75,76,77,78,88,89,90,91,92] and 15 were longitudinal studies (68.2%) [2,3,4,8,10,18,20,21,25,26,34,45,46,48,49]. Cognitive function was equally assessed in clinical studies (n = 11) and in community-based studies (n = 12).…”

“…global QOL including WB and general LS and secondly generic HQOL. QOL was assessed at two concept levels in 6 studies [10,33,45,78,84,91], and one study used a previously unknown assessment instrument that we categorized as a global QOL assessment [50]. The global QOL and generic HQOL assessment instruments were employed equally often, i.e.…”

“…The wide range of definitions of QOL complicates the research field and may make comparisons between studies difficult. Furthermore, the wide variety of assessment instruments for both depression/depressive symptoms and QOL [2,3,4,5,6,7,8,10,18,20,21,25,26,34,44,45,46,47,48,49,50,51] increases the need for a review of the existing research. Given these challenges, the aim of the present study was to review the literature on the association between depression and QOL in older persons.…”

An Evaluation of the Central Nervous System Medication Use and Frailty among Residents of Aged Care Homes in Malaysia

“…Pearson's correlation test was used to assess the correlation between the variables (e.g., between GFI score and MAI score). The potential covariates were selected based on a priori knowledge or their association with main variables (e.g., frailty) [44,45,46,47,48]. …”