André Hajek1, Christian Brettschneider2, Annette Ernst3, Carolin Lange3, Birgitt Wiese4, Jana Prokein4, Siegfried Weyerer5, Jochen Werle5, Michael Pentzek6, Angela Fuchs6, Janine Stein7, Horst Bickel8, Edelgard Mösch8, Kathrin Heser9, Frank Jessen10,11, Wolfgang Maier9,11, Martin Scherer3, Steffi G Riedel-Heller7, Hans-Helmut König2. 1. Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany. a.hajek@uke.de. 2. Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany. 3. Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany. 4. Institute of General Practice, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. 5. Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, J5, 68159, Mannheim, Germany. 6. Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany. 7. Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Ph.-Rosenthal-Str. 55, 04103, Leipzig, Germany. 8. Department of Psychiatry, Technical University of Munich, Arcisstr. 21, 80333, Munich, Germany. 9. Department of Psychiatry, University of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany. 10. Department of Psychiatry and Psychotherapy, University of Cologne, Kerpener Strasse 62, 50924, Cologne, Germany. 11. German Center for Neurodegenerative Diseases, Ludwig-Erhard-Allee 2, 53175, Bonn, Germany.
Abstract
PURPOSE: To investigate the coevolution of depression and health-related quality of life (HRQoL) in old age. METHODS: In a representative survey of the German general population aged 75 years and older, the course of HRQoL and depression was observed over 4.5 years (3 waves). HRQoL was assessed by the Visual Analogue Scale (EQ VAS) of the EQ-5D instrument, while the Geriatric Depression Scale was used to measure depression. A panel vector autoregressive model was used to account for the complex coevolution of depression and HRQoL. Unobserved heterogeneity was taken into account by taking the first differences. RESULTS: We revealed a robust negative association between an initial change in HRQoL and a subsequent change in depression score, with substantial sex differences: In women there was a robust association, while in men the significance of this association depended on the model specification. Surprisingly, in the total sample and in both sexes, no robust association between an initial increase in depression and a subsequent change in HRQoL was found. CONCLUSION: Findings indicate that the direction of evolution from HRQoL to depression deserves more attention. Furthermore, treatment of depression in late life should aim at improving HRQoL in which remission of depressive symptoms is necessary but not sufficient.
PURPOSE: To investigate the coevolution of depression and health-related quality of life (HRQoL) in old age. METHODS: In a representative survey of the German general population aged 75 years and older, the course of HRQoL and depression was observed over 4.5 years (3 waves). HRQoL was assessed by the Visual Analogue Scale (EQ VAS) of the EQ-5D instrument, while the Geriatric Depression Scale was used to measure depression. A panel vector autoregressive model was used to account for the complex coevolution of depression and HRQoL. Unobserved heterogeneity was taken into account by taking the first differences. RESULTS: We revealed a robust negative association between an initial change in HRQoL and a subsequent change in depression score, with substantial sex differences: In women there was a robust association, while in men the significance of this association depended on the model specification. Surprisingly, in the total sample and in both sexes, no robust association between an initial increase in depression and a subsequent change in HRQoL was found. CONCLUSION: Findings indicate that the direction of evolution from HRQoL to depression deserves more attention. Furthermore, treatment of depression in late life should aim at improving HRQoL in which remission of depressive symptoms is necessary but not sufficient.
Entities:
Keywords:
Depression; Depressive symptoms; Health-related quality of life; Longitudinal studies; Older people; Vector autoregressive model
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