Major depressive disorder and impaired health‐related quality of life among <scp>US</scp> older adults
Taeho Greg Rhee, David C. Steffens
Abstract
OBJECTIVES: To examine the association of current and past major depressive disorder (MDD) and measures of health-related quality of life (HRQOL) in a nationally representative sample of older adults. METHODS: Cross-sectional analysis of the 2012 to 2013 National Epidemiological Survey on Alcohol and Related Conditions Wave III (NESARC-III) was used. NESARC-III is a nationally representative health interview survey on substance use and mental health in the US, and we limited our sample to survey respondents aged 65 or older (n = 5806 unweighted). Using DSM-5 criteria, we identified older adults with current MDD, past MDD (ie, prior but not current MDD), and no history of MDD. Using standardized algorithms, we also constructed HRQOL measures: mental component summary (MCS), physical component summary (PCS), and quality-adjusted life years (QALYs). We performed multivariable-adjusted linear regression analyzes to assess the associations of MDD types with HRQOL measures while adjusting for socio-demographics and clinical co-morbidities. RESULTS: Overall, 14.4% of the older adults, representative of 6.0 million nationwide, met criteria for lifetime MDD. About 2.2 million older adults (5.4%) had current MDD and 3.7 million older adults (9.0%) had past MDD. Older adults with current or past MDD had a moderate difference in HRQOL measures compared with never depressed (Cohen's d measures ranging from -1.02 to -0.07). When controlling for other covariates, MCS and QALYs measures were lowest in the current MDD group. CONCLUSION: Current MDD is associated with significantly lower HRQOL than never MDD, while adults with past MDD had minor (often insignificant) residual impairment in HRQOL.