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Quality Adjusted Life Years in Older Adults With Depressive Symptoms and Chronic Medical Disorders

Published online by Cambridge University Press:  10 January 2005

Jürgen Unützer
Affiliation:
Center for Health Services Research, UCLA Neuropsychiatric Institute, Los Angeles, California, USA
Donald L. Patrick
Affiliation:
Department of Health Services, University of Washington, Seattle, Washington, USA
Paula Diehr
Affiliation:
Department of Biostatistics, University of Washington, Seattle, Washington, USA
Greg Simon
Affiliation:
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle, Washington, USA
David Grembowski
Affiliation:
Department of Health Services, University of Washington, Seattle, Washington, USA
Wayne Katon
Affiliation:
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA

Abstract

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 (QALYs). We developed linear regression models to examine the association of clinically significant depressive symptoms as defined by a score of 16 or greater on the Center for Epidemiological Studies Depression Scale and eight common chronic medical disorders at baseline with QALYs over the 4-year study 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. Individuals with clinically significant depressive symptoms at baseline had significantly lower QALYs over the 4-year study period than nondepressed subjects, even after adjusting for differences in age, gender, and the eight other chronic medical conditions. In terms of the entire study population, only arthritis and heart disease were more strongly associated with QALYs than depression.

Type
First Place 1999 IPA/Bayer Research Awards in Psychogeriatrics
Copyright
© 2000 International Psychogeriatric Association

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