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The Spectrum of Quality-of-Life Impairments in Recurrent Geriatric Depression

^a Department of Psychiatry, Duke University Medical Center, Durham, North Carolina
^b Health Outcomes, North America Medical Affairs, GlaxoSmithKline, Research Triangle Park, North Carolina
^c Medical Data Sciences, North America Medical Affairs, GlaxoSmithKline, Research Triangle Park, North Carolina

P. Murali Doraiswamy, Director of Clinical Trials, Department of Psychiatry, Box 3018, Duke University Medical Center, Durham, NC 27710 E-mail: dorai001{at}mc.duke.edu.

Background. Although recurrent major depression in elderly individuals is a disabling condition, only a few studies have systematically examined the magnitude and specificity of quality-of-life (QOL) impairments in such patients in comparison with matched controls or the elderly population.

Methods. We examined the variations in QOL scores of 100 elderly (age range 60–88 years) patients with moderate to severe recurrent major depression and compared them with published elderly population norms. Disease-specific Quality of Life in Depression Scale (QLDS) and generic Medical Outcomes Short Form-36 Health Survey (SF-36) QOL ratings obtained at baseline were analyzed.

Results. Compared with published elderly population norms, depressed subjects showed significant QOL impairments in five of eight baseline SF-36 items (p < .01). Women rated their QOL as worse than men on physical functioning and role physical (p < .01) and showed similar trends on all other QOL items. Compared with younger subjects, subjects aged older than 70 years reported lower QOL on the summary physical component (p < .01) and a trend for higher QOL on the summary mental component (p < .05) of the SF-36. Depression symptom ratings were correlated with some QOL measures, but accounted for less than 10% of the variance.

Conclusions. Despite limitations, such as a cross-sectional design and indirect comparisons with norms generated from another study, our findings confirm the disabling nature of recurrent late-life depression and the importance of targeting both depressive symptoms and broader QOL outcomes in intervention trials.

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