IMPACT OF CHRONIC SYSTEMIC AND NEUROLOGICAL DISORDERS ON DISABILITY, DEPRESSION AND LIFE SATISFACTION

Objective. To assess the effects of a range of chronic systemic and ne urological disorders on three life quality indicators: disability, dep ressive symptoms and life satisfaction. Methods. As part of the Sydney Older Persons Study, a community survey was carried out with 433 non- demented people aged 75 or over living in Sydney, Australia. Subjects were given a medical examination covering the following disorders: hea rt disease, chronic lung disease, bone and joint disease, stroke, visu al loss, peripheral vascular disease, obesity, other systemic diseases , gait ataxia, gait slowing (including Parkinsonism) and cognitive imp airment short of dementia. They were also assessed on a clinician-rate d disability scale and given self-report depression and life satisfact ion scales. Results. Gait slowing affected all three indicators of lif e quality. Heart disease and chronic lung disease affected disability and depressive symptoms, but not life satisfaction. These associations were present when the effects of age, sex, education and all other di sorders were controlled in multiple regression analyses. However, when disability was also controlled, none of the physical disorders predic ted life satisfaction and only heart disease continued to predict depr essive symptoms. Conclusion. Of the physical disorders considered in t he study, gait slowing, heart disease and chronic lung disease had the greatest impact on life quality. These disorders affect depressive sy mptoms and life satisfaction largely because they increase disability. (C) 1998 John Wiley & Sons, Ltd.