Predictors of improvement in health-related quality of life among elderly patients with depression

Background: Depression is the most prevalent disabling psychiatric syndrome of aging and may lead to important decrements in the elderly depressed pat ient's health-related quality of life (HRQL). The goal of this study was to determine whether severity of chronic illness at admission, severity of de pressive symptoms at admission, or living alone before admission was associ ated with lack of improvement in HRQL at 3 months postdischarge among elder ly depressed inpatients. Methods: Subjects were 100 consecutive patients ad mitted to a 26-bed inpatient geriatric psychiatry unit from 1994 through 19 97, who were residing in the community and were not demented. At admission, severity of depressive symptoms was assessed using the Geriatric Depressio n Scale and severity of chronic physical illness was measured using the Cum ulative Illness Rating Scale (Geriatrics). HRQL was assessed at admission a nd again at 3 months postdischarge using the Medical Outcomes Study (MOS) 6 -Item General Health Survey. Results: This study found large improvements i n all MOS items between admission and 3 months postdischarge. Severity of c hronic physical disease was negatively associated with the probability of i mprovement in three MOS items (role functioning, psychological functioning, and general health perceptions) whereas the severity of depressive symptom s on admission was negatively associated with the probability of improvemen t in role functioning, social functioning, and bodily pain. Living alone wa s negatively associated with social functioning but not with any of the oth er MOS items. Conclusion: The results of this study suggest that the inpati ent treatment of depression in the elderly brings about improvements in qua lity of life that persist for at least 3 months following discharge. The pa tient's initial level of depression and initial level of physical health ma y be important factors to be considered when evaluating a patient's prognos is.