The spectrum of quality-of-life impairments in recurrent geriatric depression

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.