Quality adjusted life years in older adults with depressive symptoms and chronic medical disorders

We used data from a 4-year prospective study of 2,558 primary care patients age 65 and older in a large staff model health maintenance organization to examine the association of clinically significant depressive symptoms and eight other chronic medical conditions with quality adjusted life years (QA LYs). We developed linear regression models to examine the association of c linically significant depressive symptoms as defined by a score of 16 or gr eater on the Center for Epidemiological Studies Depression Scale and eight common chronic medical disorders at baseline with QALYs over the 4-year stu dy period. Estimates of QALYs were derived from Quality of Well-Being Scale scores at baseline, at 2-year follow-up, and at 4-year follow-up. Individu als with clinically significant depressive symptoms at baseline had signifi cantly lower QALYs over the 4-year study period than nondepressed subjects, even after adjusting for differences in age, gender, and the eight other c hronic medical conditions. In terms of the entire study population, only ar thritis and heart disease were more strongly associated with QALYs than dep ression.