Quality of Life Outcomes for Depressed and Nondepressed Older Adults in Community Long-Term Care

Objective: To compare outcomes of mortality, institutionalization, physical and mental quality of life, overall life satisfaction, and satisfaction with living arrangements, for depressed and nondepressed clients after 1 year of community long-term care (CLTC) services. Design: Prospective cohort study with repeated assessments at 6 and 12 months. Setting: A publicly funded CLTC agency that coordinates in-home care such as meal delivery, personal care, and nursing care to functionally disabled and low-income adults throughout a Midwestern State. Participants: Adults aged 60 years and older, starting CLTC services with minimal or no cognitive impairment (N = 551). Measurements: Outcomes included the Medical Outcome Study's Short-Form for physical and mental quality of life and single items for life satisfaction and satisfaction with living arrangements. Diagnostic Interview Schedule and the Center for Epidemiologic Studies Depression Scale determined clients' depression status. Results: Depressed clients (N = 266) had significantly worse scores for all outcomes than nondepressed clients (N = 285), but mortality and institutionalization were not significantly related to depression. Depression was significantly associated with more positive change in mental health (mean change: depressed group = 4.60, standard deviation [SD] = 14.0; nondepressed group = -1.50, SD = 11.2) and overall life satisfaction (mean change: depressed group = 0.10, SD = 1.1; nondepressed group = -0.10, SD = 0.8). Conclusion: After 1 year of CLTC services, depressed clients experienced more improvement in quality of life and life satisfaction, but their outcomes remained significantly lower than nondepressed clients. Depression was consistently and negatively associated with quality of life and satisfaction outcomes. (Am J Geriatr Psychiatry 2010; 18:544-553)