International Psychogeriatrics



First Place 1999 IPA/Bayer Research Awards in Psychogeriatrics

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


Jürgen Unützer a1, Donald L. Patrick a2, Paula Diehr a3, Greg Simon a4a5, David Grembowski a2 and Wayne Katon a4
a1 Center for Health Services Research, UCLA Neuropsychiatric Institute, Los Angeles, California, USA
a2 Department of Health Services, University of Washington, Seattle, Washington, USA
a3 Department of Biostatistics, University of Washington, Seattle, Washington, USA
a4 Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
a5 Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle, Washington, USA

Article author query
unützer j   [PubMed][Google Scholar] 
patrick d   [PubMed][Google Scholar] 
diehr p   [PubMed][Google Scholar] 
simon g   [PubMed][Google Scholar] 
grembowski d   [PubMed][Google Scholar] 
katon w   [PubMed][Google Scholar] 

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.



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