Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
BMC Psychiatry
Published in: BMC Psychiatry 1/2013

Open Access 01-12-2013 | Research article

Psychological distress and quality of life in older persons: relative contributions of fixed and modifiable risk factors

Authors: Joanna Atkins, Sharon L Naismith, Georgina M Luscombe, Ian B Hickie

Published in: BMC Psychiatry | Issue 1/2013

Login to get access

Abstract

Background

With a rapidly ageing population and increasing life expectancy, programs directed at improving the mental health and quality of life (QOL) of older persons are extremely important. This issue may be particularly relevant in the aged-care residential sector, where very high rates of depression and poor QOL are evident. This study aims to investigate the fixed and modifiable risk factors of psychological distress and QOL in a cohort of Australians aged 60 and over living in residential and community settings.

Methods

The study examined the relationship between demographic, health and lifestyle factors and the outcome variables of self-reported QOL and psychological distress (K10 scores) based on data from 626 Australians aged 60 and over from the 45 and Up Study dataset. Univariate and multivariate regression analyses (performed on a subset of 496) examined risk factors related to psychological distress and QOL adjusting for age and residential status.

Results

Significant psychological distress was experienced by 15% of the residential sample and 7% of the community sample and in multivariate analyses was predicted by older age, more functional limitations, more time spent sleeping and lower levels of social support (accounting for 18% of the variance). Poorer QOL was predicted by more functional limitations and greater levels of psychological distress. Together these variables accounted for 35% of the variance in QOL ratings.

Conclusions

While psychological distress was more common in residential settings, programs targeting modifiable risk factors have the potential to improve QOL and reduce psychological distress in older persons living in both residential and community settings. In particular, promoting health and mobility, optimising sleep-wake cycles and increasing social support may reduce levels of psychological distress and improve QOL.
Appendix
Available only for authorised users
Literature
1.
Jongenelis K, Pot A, Eisses A, et al: Depression among older nursing home patients: a review. Tijdschr Gerontol Geriatr. 2003, 34: 52-59.PubMed
2.
Blazer DG, Hybels CF, Pieper CF: The association of depression and mortality in elderly persons: a case for multiple, independent pathways. J Gerontol A Biol Sci Med Sci. 2001, 56: M505-M509. 10.1093/gerona/56.8.M505.CrossRefPubMed
3.
Katon W: The impact of major depression on chronic medical illness. Gen Hosp Psychiatry. 1996, 18: 215-219. 10.1016/0163-8343(96)00065-5.CrossRefPubMed
4.
Ormel J, Kempen GI, Deeg DJ, Brilman EI, van Sonderen E, Relyveld J: Functioning, well-being, and health perception in late middle-aged and older people: comparing the effects of depressive symptoms and chronic medical conditions. J Am Geriatr Soc. 1998, 46: 39-48.CrossRefPubMed
5.
Beekman A, Deeg D, Braam A, Smit J, van Tilburg W: Consequences of major and minor depression in later life: a study of disability, well-being and service utilization. Psychol Med. 1997, 27: 1397-1409. 10.1017/S0033291797005734.CrossRefPubMed
6.
Hickie I, Scott E, Wilhelm K, Brodaty H: Subcortical hyperintensities on magnetic resonance imaging in patients with severe depression–a longitudinal evaluation. Biol Psychiatry. 1997, 42: 367-374. 10.1016/S0006-3223(96)00363-0.CrossRefPubMed
7.
Naismith SL, Glozier N, Burke D, Carter PE, Scott E, Hickie IB: Early intervention for cognitive decline: is there a role for multiple medical or behavioural interventions?. Early Interv Psychiatry. 2009, 3: 19-27. 10.1111/j.1751-7893.2008.00102.x.CrossRefPubMed
8.
Byles JE, Gallienne L, Blyth F, Banks E: Relationship of age and gender to the prevalence and correlates of psychological distress. Int Psychogeriatr. 2012, 24: 1009-1018. 10.1017/S1041610211002602.CrossRefPubMed
9.
Unutzer J, Patrick DL, Diehr P, Simon G, Grembowski D, Katon W: Quality adjusted life years in older adults with depressive symptoms and chronic medical disorders. Int Psychogeriatr. 2000, 12: 15-33. 10.1017/S1041610200006177.CrossRefPubMed
10.
Strawbridge WJ, Deleger S, Roberts RE, Kaplan GA: Physical activity reduces the risk of subsequent depression for older adults. Am J Epidemiol. 2002, 156: 328-334. 10.1093/aje/kwf047.CrossRefPubMed
11.
Golden J, Conroy RM, Lawlor BA: Social support network structure in older people: underlying dimensions and association with psychological and physical health. Psychol Health Med. 2009, 14: 280-290. 10.1080/13548500902730135.CrossRefPubMed
12.
Golden J, Conroy RM, Bruce I, et al: Loneliness, social support networks, mood and wellbeing in community-dwelling elderly. Int J Geriatr Psychiatry. 2009, 24: 694-700. 10.1002/gps.2181.CrossRefPubMed
13.
Lader M: Limitations of current medical treatments for depression: disturbed circadian rhythms as a possible therapeutic target. Eur Neuropsychopharmacol. 2007, 17: 743-755. 10.1016/j.euroneuro.2007.05.004.CrossRefPubMed
14.
Stuck AE, Walthert JM, Nikolaus T, Bula CJ, Hohmann C, Beck JC: Risk factors for functional status decline in community-living elderly people: a systematic literature review. Soc Sci Med. 1999, 48: 445-469. 10.1016/S0277-9536(98)00370-0.CrossRefPubMed
15.
Xavier FM, Ferraz MP, Marc N, Escosteguy NU, Moriguchi EH: Elderly people’s definition of quality of life. Rev Bras Psiquiatr. 2003, 25: 31-39. 10.1590/S1516-44462003000100007.CrossRefPubMed
16.
Reifman A, Welte JW: Depressive symptoms in the elderly: differences by adult drinking history. J Appl Gerontol. 2001, 20: 322-337. 10.1177/073346480102000305.CrossRef
17.
Pyne JM, Patterson TL, Kaplan RM, Gillin JC, Koch WL, Grant I: Assessment of the quality of life of patients with major depression. Psychiatr Serv. 1997, 48: 224-230.CrossRefPubMed
18.
Borowiak E, Kostka T: Predictors of quality of life in older people living at home and in institutions. Aging Clin. 2004, 16: 212-220. 10.1007/BF03327386.CrossRef
19.
Demura S, Sato S: Relationships between depression, lifestyle and quality of life in the community dwelling elderly: a comparison between gender and age groups. J Physiol Anthropol Appl Human Sci. 2003, 22: 159-166. 10.2114/jpa.22.159.CrossRefPubMed
20.
Eisses A, Kluiter H, Jongenelis K, Pot A, Beekman A, Ormel J: Risk indicators of depression in residential homes. Int J Geriatr Psychiatry. 2004, 19: 634-640. 10.1002/gps.1137.CrossRefPubMed
21.
Callahan CM, Wolinsky FD, Stump TE, Nienaber NA, Hui SL, Tierney WM: Mortality, symptoms, and functional impairment in late-life depression. J Gen Intern Med. 1998, 13: 746-752. 10.1046/j.1525-1497.1998.00226.x.CrossRefPubMedPubMedCentral
22.
Luber MP, Meyers BS, Williams-Russo PG, et al: Depression and service utilization in elderly primary care patients. Am J Geriatr Psychiatr. 2001, 9: 169-176.CrossRef
23.
Alexopoulos GS, Buckwalter K, Olin J, Martinez R, Wainscott C, Krishnan KR: Comorbidity of late life depression: an opportunity for research on mechanisms and treatment. Biol Psychiatry. 2002, 52: 543-558. 10.1016/S0006-3223(02)01468-3.CrossRefPubMed
24.
Yohannes AM: Depression and COPD in older people: a review and discussion. Br J Community Nurs. 2005, 10: 42-46.CrossRefPubMed
25.
Romanelli J, Fauerbach JA, Bush DE, Ziegelstein RC: The significance of depression in older patients after myocardial infarction. J Am Geriatr Soc. 2002, 50: 817-822. 10.1046/j.1532-5415.2002.50205.x.CrossRefPubMed
26.
Rugulies R: Depression as a predictor for coronary heart disease: A review and meta-analysis. Am J Prev Med. 2002, 23: 51-61. 10.1016/S0749-3797(02)00439-7.CrossRefPubMed
27.
Kawakami N, Takatsuka N, Shimizu H, Ishibashi H: Depressive symptoms and occurrence of type 2 diabetes among Japanese men. Diabetes Care. 1999, 22: 1071-1076. 10.2337/diacare.22.7.1071.CrossRefPubMed
28.
Himelhoch S, Lehman A, Kreyenbuhl J, Daumit G, Brown C, Dixon L: Prevalence of chronic obstructive pulmonary disease among those with serious mental illness. Am J Psychiatry. 2004, 161: 2317-2319. 10.1176/appi.ajp.161.12.2317.CrossRefPubMed
29.
McIntyre RS, Soczynska JK, Beyer JL, et al: Medical comorbidity in bipolar disorder: re-prioritizing unmet needs. Curr Opin Psychiatry. 2007, 20: 406-416. 10.1097/YCO.0b013e3281938102.CrossRefPubMed
30.
World Federation for Mental Health: World Mental Health Day. 2004, Alexandria, VA
31.
Patten SB, Williams JV, Wang J: Mental disorders in a population sample with musculoskeletal disorders. BMC Musculoskel Disord. 2006, 7: 37-10.1186/1471-2474-7-37.CrossRef
32.
Tylee A, Gastpar M, Lepine JP, Mendlewicz J: DEPRES II (Depression Research in European Society II): a patient survey of the symptoms, disability and current management of depression in the community. DEPRES Steering Committee. Int Clin Psychopharmacol. 1999, 14: 139-151.PubMed
33.
Diagnositic and Statistical Manual of Mental Disorders (4th ed., text rev.). 2000, Washington, DC: American Psychiatric Association
34.
Ohayon MM, Roth T: Place of chronic insomnia in the course of depressive and anxiety disorders. J Psychiatr Res. 2003, 37: 9-15. 10.1016/S0022-3956(02)00052-3.CrossRefPubMed
35.
Riemann D, Voderholzer U: Primary insomnia: a risk factor to develop depression?. J Affect Disord. 2003, 76: 255-259. 10.1016/S0165-0327(02)00072-1.CrossRefPubMed
36.
Livingston G, Blizard B, Mann A: Does sleep disturbance predict depression in elderly people? A study in inner London. Br J Gen Pract. 1993, 43: 445-448.PubMedPubMedCentral
37.
Perlis ML, Smith LJ, Lyness JM, et al: Insomnia as a risk factor for onset of depression in the elderly. Behav Sleep Med. 2006, 4: 104-113. 10.1207/s15402010bsm0402_3.CrossRefPubMed
38.
Blumenthal JA, Babyak MA, Moore KA, et al: Effects of exercise training on older patients with major depression. Arch Intern Med. 1999, 159: 2349-2356. 10.1001/archinte.159.19.2349.CrossRefPubMed
39.
Chen KM, Chen MH, Chao HC, Hung HM, Lin HS, Li CH: Sleep quality, depression state, and health status of older adults after silver yoga exercises: cluster randomized trial. Int J Nurs Stud. 2009, 46: 154-163. 10.1016/j.ijnurstu.2008.09.005.CrossRefPubMed
40.
Chen KM, Chen MH, Lin MH, Fan JT, Lin HS, Li CH: Effects of yoga on sleep quality and depression in elders in assisted living facilities. J Nurs Res. 2010, 18: 53-61. 10.1097/JNR.0b013e3181ce5189.CrossRefPubMed
41.
Motl RW, Konopack JF, McAuley E, Elavsky S, Jerome GJ, Marquez DX: Depressive symptoms among older adults: long-term reduction after a physical activity intervention. J Behav Med. 2005, 28: 385-394. 10.1007/s10865-005-9005-5.CrossRefPubMed
42.
Singh N, Clements K, Singh M: The efficacy of exercise as a long-term anti-depressant in elderly subjects: a randomized controlled trial. J Gerontol. 2001, 56A: M497-M504.CrossRef
43.
Sjosten N, Kivela S: The effects of physical exercise on depressive symptoms among the aged: a systematic review. Int J Geriatr Psychiatry. 2006, 21: 410-418. 10.1002/gps.1494.CrossRefPubMed
44.
Lampinen P, Heikkinen RL, Kauppinen M, Heikkinen E: Activity as a predictor of mental well-being among older adults. Aging Ment Health. 2006, 10: 454-466. 10.1080/13607860600640962.CrossRefPubMed
45.
Fox KR, Stathi A, McKenna J, Davis MG: Physical activity and mental well-being in older people participating in the Better Ageing Project. Eur J Appl Physiol. 2007, 100: 591-602. 10.1007/s00421-007-0392-0.CrossRefPubMed
46.
45 and Up Study Collaborators: Cohort profile: the 45 and up study. Int J Epidemiol. 2008, 37: 941-947.CrossRef
47.
Furukawa TA, Kessler RC, Slade T, Andrews G: The performance of the K6 and K10 screening scales for psychological distress in the Australian National Survey of Mental Health and Well-Being. Psychol Med. 2003, 33: 357-362. 10.1017/S0033291702006700.CrossRefPubMed
48.
Kessler RC, Andrews G, Colpe LJ, et al: Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med. 2002, 32: 959-976. 10.1017/S0033291702006074.CrossRefPubMed
49.
Kessler R, Mroczek D: Final Versions of our Non-Specific Psychological Distress Scale. 1994, University of Michigan: Survey Research Center of the Institute for Social Research
50.
Australian Bureau of Statistics: Information Paper: Use of the Kessler Psychological Distress Scale in ABS Health Surveys, Australia, 2001. 2001, Canberra, 4817.0.55.001
51.
Ware JE, Sherbourne CD: The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992, 30: 473-483. 10.1097/00005650-199206000-00002.CrossRefPubMed
52.
Hays RD, Sherbourne CD, Mazel RM: The RAND 36-Item Health Survey 1.0. Health Econ. 1993, 2: 217-227. 10.1002/hec.4730020305.CrossRefPubMed
53.
Lyness JM, Niculescu A, Tu X, Reynolds CF, Caine ED: The relationship of medical comorbidity and depression in older, primary care patients. Psychosomatics. 2006, 47: 435-439. 10.1176/appi.psy.47.5.435.CrossRefPubMed
54.
Noel PH, Williams JW, Unutzer J, et al: Depression and comorbid illness in elderly primary care patients: impact on multiple domains of health status and well-being. Ann Fam Med. 2004, 2: 555-562. 10.1370/afm.143.CrossRefPubMedPubMedCentral
55.
Bogner HR, Cary MS, Bruce ML, et al: The role of medical comorbidity in outcome of major depression in primary care: the PROSPECT study. Am J Geriatr Psychiatr. 2005, 13: 861-868.CrossRef
56.
Goodger B, Byles J, Higganbotham N, Mishra G: Assessment of a short scale to measure social support among older people. Aust N Z J Public Health. 1999, 23: 260-265. 10.1111/j.1467-842X.1999.tb01253.x.CrossRefPubMed
57.
Alexopoulos GS, Raue PJ, Kiosses DN, et al: Problem-solving therapy and supportive therapy in older adults with major depression and executive dysfunction: effect on disability. Arch Gen Psychiatry. 2011, 68: 33-41. 10.1001/archgenpsychiatry.2010.177.CrossRefPubMedPubMedCentral
58.
Hirshkowitz M: Normal human sleep: an overview. Med Clin North Am. 2004, 88: 551-565. 10.1016/j.mcna.2004.01.001.CrossRefPubMed
59.
Naismith SL, Lewis SJ, Rogers NL: Sleep-wake changes and cognition in neurodegenerative disease. Prog Brain Res. 2011, 190: 21-52.CrossRefPubMed
60.
Papakostas GI, Petersen T, Mahal Y, Mischoulon D, Nierenberg AA, Fava M: Quality of life assessments in major depressive disorder: a review of the literature. Gen Hosp Psychiatry. 2004, 26: 13-17. 10.1016/j.genhosppsych.2003.07.004.CrossRefPubMed
61.
Jorge RE, Robinson RG, Arndt S, Starkstein S: Mortality and poststroke depression: a placebo-controlled trial of antidepressants. Am J Psychiatry. 2003, 160: 1823-1829. 10.1176/appi.ajp.160.10.1823.CrossRefPubMed
62.
Chapman DP, Perry GS, Strine TW: The vital link between chronic disease and depressive disorders. Prev Chronic Dis. 2005, 2: A14-PubMed
63.
Gunn JM, Ayton DR, Densley K, et al: The association between chronic illness, multimorbidity and depressive symptoms in an Australian primary care cohort. Soc Psychiatry Psychiatr Epidemiol. 2012, 47: 175-184. 10.1007/s00127-010-0330-z.CrossRefPubMed
64.
Kessler RC, McGonagle KA, Zhao S, et al: Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Arch Gen Psychiatry. 1994, 51: 8-19. 10.1001/archpsyc.1994.03950010008002.CrossRefPubMed
65.
Breslow NE, Day NE: Statistical methods in cancer research. Volume II--The design and analysis of cohort studies. IARC Sci Publ. 1987, 82: 1-406.
66.
Mealing NM, Banks E, Jorm LR, Steel DG, Clements MS, Rogers KD: Investigation of relative risk estimates from studies of the same population with contrasting response rates and designs. BMC Med Res Methodol. 2010, 10: 26-10.1186/1471-2288-10-26.CrossRefPubMedPubMedCentral
67.
Barr M, Baker D, Gorringe M, Fritsche L: NSW Population Health Survey: Description of Methods. 2008, Sydney: NSW Department of Health
68.
Naismith SL, Diamond K, Carter PE, et al: Enhancing memory in late-life depression: the effects of a combined psychoeducation and cognitive training program. Am J Geriatr Psychiatr. 2011, 19: 240-248. 10.1097/JGP.0b013e3181dba587.CrossRef
69.
Naismith SL, Glozier N, Burke D, Carter P, Scott E, Hickie I: Early intervention for cognitive decline and dementia: the potential benefits of targeting multiple interventions. Early Interv Psychiatry. 2009, 3: 19-27. 10.1111/j.1751-7893.2008.00102.x.CrossRefPubMed
Metadata
Title
Psychological distress and quality of life in older persons: relative contributions of fixed and modifiable risk factors
Authors
Joanna Atkins
Sharon L Naismith
Georgina M Luscombe
Ian B Hickie
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2013
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/1471-244X-13-249

Other articles of this Issue 1/2013

BMC Psychiatry 1/2013 Go to the issue

Research article

Prevalence and correlates of depressive symptoms in HIV-positive patients: a cross-sectional study among newly diagnosed patients in Yaoundé, Cameroon

Debate

Developmental trauma disorder: pros and cons of including formal criteria in the psychiatric diagnostic systems

Research article

A randomized, double-blind, placebo-controlled study of rapid-acting intramuscular olanzapine in Japanese patients for schizophrenia with acute agitation

Research article

Melancholic and reactive depression: a reappraisal of old categories

Research article

Effects of selective serotonin reuptake inhibitor treatment on plasma oxytocin and cortisol in major depressive disorder

Research article

Psychometric properties of the abbreviated version of the Scale to Assess Unawareness in Mental Disorder in schizophrenia