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Levels of depressive symptoms may modify the relationship between the WHOQOL-BREF and its determining factors in community-dwelling older adults

Published online by Cambridge University Press:  17 December 2015

Yu-Chen Chang
Affiliation:
Department of Community Health, Chia-Yi Christian Hospital, Chia-Yi, Taiwan Division of Geriatrics, Chia-Yi Christian Hospital, Chia-Yi, Taiwan
Wen-Chen Ouyang
Affiliation:
Department of Psychiatry, Changhua Christian Hospital & Changhua Christian Healthcare System, Changhua, Taiwan Section of Psychiatry, Lutung Christian Hospital, Changhua, Taiwan Department of Psychiatry, Kaohsiung Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
Mei-Chun Lu
Affiliation:
Department of Community Health, Chia-Yi Christian Hospital, Chia-Yi, Taiwan
Jung-Der Wang
Affiliation:
Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan Departments of Internal Medicine and Occupational and Environmental Medicine, National Cheng Kung University, Tainan, Taiwan
Susan C. Hu*
Affiliation:
Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
*
Correspondence should be addressed to: Susan C. Hu, Ph.D. Dept. of Public Health, College of Medicine, National Cheng Kung University, No. 1, University Rd, Tainan 70101, Taiwan. Phone: +886-972-967800; Fax: +886-6-2359033. Email: shuhu@mail.ncku.edu.tw.

Abstract

Background:

Depression is closely associated with quality of life (QOL) in older adults. Being elderly and exhibiting mild depressive symptoms may not lead to a depression diagnosis, but these attributes are clinically important. However, the extent to which these factors influence QOL and its determinants in older adults remains unclear.

Methods:

Questionnaires were administered to people aged 65 years or older at community senior centers in Taiwan to collect socio-demographic information and to assess results from the brief version of the World Health Organization's Quality of Life instrument (WHOQOL-BREF), Modified Barthel Index (MBI), 15-item Geriatric Depression Scale (GDS), and Mini-Mental State Examination (MMSE). Levels of depressive symptoms were classified as no depressive symptoms (NDS), lower level of depressive symptoms (LLDS), and higher level of depressive symptoms (HLDS), corresponding to GDS = 0, 1≦GDS≦5, and GDS>5, respectively. Multiple linear regression analyses were conducted to assess associations between the WHOQOL-BREF and its covariates for different levels of depressive symptoms.

Results:

A total of 454 older adults participated. The GDS and MBI scores significantly affected the WHOQOL-BREF physical and psychological domain scores in the LLDS group. Gender influenced the WHOQOL-BREF scores in the NDS group, and increased age demonstrated protective effects on the three domains in the HLDS group. Moreover, the association between the WHOQOL-BREF and its covariates varied for different levels of depressive symptoms.

Conclusions:

Treatment for depressive symptoms is of high priority, and early recognition of and appropriate intervention for mild depressive symptoms may improve community-dwelling older adults’ QOLs.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2015 

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References

Baernholdt, M., Hinton, I., Yan, G., Rose, K. and Mattos, M. (2012). Factors associated with quality of life in older adults in the United States. Quality of Life Research, 21, 527534.CrossRefGoogle ScholarPubMed
Benton, M. J., Alexander, J. L. and Holland, J. D. (2014). Relationship between strength, function, and quality of life in older adults with chronic lung disease: is there an influence of gender? Journal of Cardiopulmonary Rehabilitation and Prevention, 34, 143149.CrossRefGoogle ScholarPubMed
Blanchflower, D. G. and Oswald, A. J. (2008). Is well-being U-shaped over the life cycle? Social Sciences & Medicine, 66, 17331749.CrossRefGoogle ScholarPubMed
Bland, P. (2012). Tackling anxiety and depression in older people in primary care. Practitioner, 256, 1720, 2–3.Google ScholarPubMed
Campos, A. C., Ferreira e Ferreira, E., Vargas, A. M. and Albala, C. (2014). Aging, gender and quality of life (AGEQOL) study: factors associated with good quality of life in older Brazilian community-dwelling adults. Health and Quality of Life Outcomes, 12, 166.CrossRefGoogle ScholarPubMed
Carstensen, L. L., Isaacowitz, D. M. and Charles, S. T. (1999). Taking time seriously. A theory of socioemotional selectivity. American Psychologist, 54, 165181.CrossRefGoogle ScholarPubMed
Chan, A. C. (1996). Clinical validation of the geriatric depression scale (GDS): Chinese version. Journal of Aging and Health, 8, 238253.CrossRefGoogle ScholarPubMed
Chang, Y. C., Yao, G., Hu, S. C. and Wang, J. D. (2015). Depression affects the scores of all facets of the WHOQOL-BREF and may mediate the effects of physical disability among community-dwelling older adults. PLoS One, 10, e0128356.CrossRefGoogle ScholarPubMed
Chen, C. S., Chong, M. Y. and Tsang, H. Y. (2007). Clinically significant non-major depression in a community-dwelling elderly population: epidemiological findings. International Journal of Geriatric Psychiatry, 22, 557562.CrossRefGoogle Scholar
Chong, M. Y. et al. (2001). Community study of depression in old age in Taiwan: prevalence, life events and socio-demographic correlates. British Journal of Psychiatry, 178, 2935.CrossRefGoogle ScholarPubMed
Cohen, C. I., Magai, C., Yaffee, R. and Walcott-Brown, L. (2005). Racial differences in syndromal and subsyndromal depression in an older urban population. Psychiatric Services, 56, 15561563.CrossRefGoogle Scholar
da Rocha, N. S., Schuch, F. B. and Fleck, M. P. (2014). Gender differences in perception of quality of life in adults with and without chronic health conditions: the role of depressive symptoms. Journal of Health Psychology, 19, 721729.CrossRefGoogle ScholarPubMed
da Silva Lima, A. F. and de Almeida Fleck, M. P. (2007). Subsyndromal depression: an impact on quality of life? Journal of Affective Disorders, 100, 163169.CrossRefGoogle ScholarPubMed
Emery, C. F. et al. (2004). Gender differences in quality of life among cardiac patients. Psychosomatic Medicine, 66, 190197.CrossRefGoogle ScholarPubMed
Fang, C. T., Hsiung, P. C., Yu, C. F., Chen, M. Y. and Wang, J. D. (2002). Validation of the world health organization quality of life instrument in patients with HIV infection. Quality of Life Research, 11, 753762.CrossRefGoogle ScholarPubMed
Fernandez-Mayoralas, G. et al. (2015). Active ageing and quality of life: factors associated with participation in leisure activities among institutionalized older adults, with and without dementia. Aging & Mental Health, 19, 10311041.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state.” A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.CrossRefGoogle ScholarPubMed
Forman, D. E., Berman, A. D., McCabe, C. H., Baim, D. S. and Wei, J. Y. (1992). PTCA in the elderly: the “young-old” versus the “old-old.” Journal of the American Geriatrics Society, 40, 1922.CrossRefGoogle ScholarPubMed
Fusco, O., Ferrini, A., Santoro, M., Lo Monaco, M. R., Gambassi, G. and Cesari, M. (2012). Physical function and perceived quality of life in older persons. Aging Clinical and Experimental Research, 24, 6873.CrossRefGoogle ScholarPubMed
Garin, N. et al. (2014). Impact of multimorbidity on disability and quality of life in the Spanish older population. PLoS One, 9, e111498.CrossRefGoogle ScholarPubMed
Granger, C. V., Dewis, L. S., Peters, N. C., Sherwood, C. C. and Barrett, J. E. (1979). Stroke rehabilitation: analysis of repeated Barthel index measures. Archives of Physical Medicine and Rehabilitation, 60, 1417.Google ScholarPubMed
IsHak, W. W. et al. (2011). Quality of life: the ultimate outcome measure of interventions in major depressive disorder. Harvard Review of Psychiatry, 19, 229239.CrossRefGoogle ScholarPubMed
Jang, Y., Hsieh, C. L., Wang, Y. H. and Wu, Y. H. (2004). A validity study of the WHOQOL-BREF assessment in persons with traumatic spinal cord injury. Archives of Physical Medicine and Rehabilitation, 85, 18901895.CrossRefGoogle ScholarPubMed
Lapid, M. I. et al. (2011). What is the quality of life in the oldest old? International Psychogeriatrics, 23, 10031010.CrossRefGoogle ScholarPubMed
Leon-Salas, B. et al. (2015). Quality of life across three groups of older adults differing in cognitive status and place of residence. Geriatrics & Gerontology International, 15, 627635.CrossRefGoogle ScholarPubMed
Lyness, J. M., Chapman, B. P., McGriff, J., Drayer, R. and Duberstein, P. R. (2009a). One-year outcomes of minor and subsyndromal depression in older primary care patients. International Psychogeriatrics, 21, 6068.CrossRefGoogle ScholarPubMed
Lyness, J. M. et al. (2006). Outcomes of minor and subsyndromal depression among elderly patients in primary care settings. Annals of Internal Medicine, 144, 496504.CrossRefGoogle ScholarPubMed
Lyness, J. M. et al. (2007). The clinical significance of subsyndromal depression in older primary care patients. The American Journal of Geriatric Psychiatry, 15, 214223.CrossRefGoogle ScholarPubMed
Lyness, J. M., Yu, Q., Tang, W., Tu, X. and Conwell, Y. (2009b). Risks for depression onset in primary care elderly patients: potential targets for preventive interventions. The American Journal of Psychiatry, 166, 13751383.CrossRefGoogle ScholarPubMed
Mahoney, F. I. and Barthel, D. W. (1965). Functional evaluation: the barthel index. Maryland State Medical Journal, 14, 6165.Google ScholarPubMed
Marc, L. G., Raue, P. J. and Bruce, M. L. (2008). Screening performance of the 15-item geriatric depression scale in a diverse elderly home care population. The American Journal of Geriatric Psychiatry, 16, 914921.CrossRefGoogle Scholar
Naumann, V. J. and Byrne, G. J. (2004). WHOQOL-BREF as a measure of quality of life in older patients with depression. International Psychogeriatric, 16, 159173.CrossRefGoogle ScholarPubMed
Polyakova, M. et al. (2014). Prevalence of minor depression in elderly persons with and without mild cognitive impairment: a systematic review. Journal of Affective Disorders, 152–154, 2838.CrossRefGoogle ScholarPubMed
Sheikh, J. I. and Yesavage, J. A. (1986). Geriatric depression scale (GDS): recent evidence and development of a shorter version. Journal of Clinical Gerontology, 5, 165173.Google Scholar
Sinnige, J., Braspenning, J., Schellevis, F., Stirbu-Wagner, I., Westert, G. and Korevaar, J. (2013). The prevalence of disease clusters in older adults with multiple chronic diseases–a systematic literature review. PLoS One, 8, e79641.CrossRefGoogle ScholarPubMed
Sinoff, G. and Ore, L. (1997). The Barthel activities of daily living index: self-reporting versus actual performance in the old-old (> or = 75 years). Journal of the American Geriatrics Society, 45, 832836.CrossRefGoogle Scholar
Stone, A. A., Schwartz, J. E., Broderick, J. E. and Deaton, A. (2010). A snapshot of the age distribution of psychological well-being in the United States. Proceedings of the National Academy of Sciences of the United States of America, 107, 99859990.CrossRefGoogle ScholarPubMed
The WHOQOL Group (1998). Development of the world health organization WHOQOL-BREF quality of life assessment. Psychology Medicine, 28, 551558.CrossRefGoogle Scholar
Tombaugh, T. N. and McIntyre, N. J. (1992). The mini-mental state examination: a comprehensive review. Journal of the American Geriatrics Society, 40, 922935.CrossRefGoogle ScholarPubMed
Webb, E., Blane, D., McMunn, A. and Netuveli, G. (2011). Proximal predictors of change in quality of life at older ages. Journal of the Epidemiology & Community Health, 65, 542547.CrossRefGoogle ScholarPubMed
Wikman, A., Wardle, J. and Steptoe, A. (2011). Quality of life and affective well-being in middle-aged and older people with chronic medical illnesses: a cross-sectional population based study. PLoS One, 6, e18952.CrossRefGoogle ScholarPubMed
Zizza, C. A., Ellison, K. J. and Wernette, C. M. (2009). Total water intakes of community-living middle-old and oldest-old adults. The Journal of Gerontology A Biological Sciences and Medical Sciences, 64, 481486.CrossRefGoogle ScholarPubMed