Journal of Clinical Geropsychology

, Volume 7, Issue 3, pp 189–200

Depression, Psychological Resources, and Health-Related Quality of Life in Older Adults 75 and Above

  • Terry A. Badger


The purposes of this study were (1) to compare psychological resources and health-related quality of life between two groups of community-dwelling elders, 75 years of age and older, with similar chronic illnesses, but with varying levels of depression, and (2) to examine the relationships among depression, psychological resources, and health-related quality of life. Fifty-two elders (14 men and 38 women) were divided into mildly (n = 18) and severely (n = 34) depressed groups based on their depression scores. There were no significant differences between the two groups for demographic and illness characteristics. There were significant differences for number of medications, mastery, health perceptions, mental health functioning, and well-being. Severely depressed elders had poorer health perceptions, and decreased mastery, functioning, and well-being as compared with mildly depressed elders. An explanatory model was developed using factor analysis that fit the data well. Health perceptions and mastery had direct influences on depression, and depression directly impacted well-being.

health-related quality of life depression mastery health perceptions functioning elders 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Badger, T. A. (1993). Physical health impairment and depression among older adults. Image: J. Nurs. Scholarship 25: 325–330.Google Scholar
  2. Badger, T. A. (1998). Depression, physical health impairment, and service use among older adults. Public Health Nurs. 15: 136–145.Google Scholar
  3. Baltes, P. B., and Baltes, M. M. (eds.). (1990). Successful Aging: Perspectives from the Behavioral Sciences, Cambridge University Press, New York.Google Scholar
  4. Blaum, C. S., Liang, J., and Liu, X. (1994). The relationship of chronic diseases and health status to the health services utilization of older Americans. J. Am. Geriatr. Soc. 42: 1087–1093.Google Scholar
  5. Blazer, D. G., Burchett, B., Service, C., and George, L. K. (1991). The association of age and depression among the elderly: An epidemiological exploration. J. Gerontol. 46: 210–215.Google Scholar
  6. Blixen, C., and Lion, J. (1991). Psychiatric visits to general hospital clinics by elderly persons and younger adults. Hosp. Community Psychiatry 42: 171–175.Google Scholar
  7. Callahan, C. M., Hendrie, H. C., Dittus, R. S., Brater, D. C., and Tierney, W. M. (1994). Depression in late life: The use of clinical characteristics to focus screening efforts. J. Gerontol. 49: M9–M14.Google Scholar
  8. Callahan, C. M., Hui, S. L., Nienaber, N. A., Musick, B. S., and Tierney, W. M. (1994). Longitudinal study of depression and health services use among elderly primary care patients. J. Am. Geriatr. Soc. 42: 833–888.Google Scholar
  9. Campbell, A., Converse, P. E., and Rodgers, W. L. (1976). The Quality of American Life: Perceptions, Evaluations and Satisfactions, Russell Sage, New York.Google Scholar
  10. Davidson, H., Feldman, P. H., and Crawford, S. (1994). Measuring depresive symptoms in the frail elderly. J. Gerontol. B Psychol. Sci. Soc. Sci. 49: P159–P184.Google Scholar
  11. Dean, A., Kolodny, B., and Woods, P. (1990). Effects of social support from various sources on depression in elderly persons. J. Health Soc. Behav. 31: 148–161.Google Scholar
  12. Femia, E. E., Zarit, S. H., and Johansson, B. (1997). Predicting change in activities of daily living: A longitudinal study of the oldest-old in Sweden. J. Gerontol. Psychol. Sci. 52B: P294–P302.Google Scholar
  13. Fillenbaum, G. (1988). Multidimensional Functional Assessment of Older Adults: The Duke Older Americans Resources and Services Procedures. Lawrence Erlbaum Associates, Hillsdale, N.J.Google Scholar
  14. George, L. K. (1994). Multidimensional assessment instruments: Present status and future prospects. In Lawton, M. P., and Teresi, J. A. (eds.), Annual Review of Gerontology and Geriatrics, Springer, New York, (pp. 353–375).Google Scholar
  15. Hays, R. D., Wells, K. B., Sherbourne, C. D., Rogers, W., and Spitzer, K. (1995). Functioning and well-being of patients with depression compared with chronic general medical illness. Arch. Gen. Psychiatry 52: 11–19.Google Scholar
  16. Heidrich, S. M., and D'Amico, D. (1993). Physical and mental health relationships among the very old. J. Community Health Nurs. 10: 11–21.Google Scholar
  17. Holahan, C. K. (1998). Change in psychosocial functioning and health from age 70 to 80: Findings from the Terman sample. J. Ment. Health Aging 4: 335–345.Google Scholar
  18. Horwath, E., Johnson, J., Klerman, G. L., and Weissman, M. M. (1994). What are the public health implications of subclinical depressive symptoms? Psychiatr. Q. 65: 323–327.Google Scholar
  19. Johnson, J., Weissman, M. M., and Klerman, G. L. (1992). Service utilization and social morbidity associated with depressive symptoms in the community. J. Am. Med. Assoc. 267: 1478–1483.Google Scholar
  20. Kanacki, L. S., Jones, P. S., and Galbraith, M. E. (1996). Social support and depression in widows and widowers. J. Gerontol. Nurs. 22: 39–45.Google Scholar
  21. Katz, I. K., Streim, J., and Parmelee, P. (1994). Prevention of depression, recurrences, and complications in late life. Prev. Med. 23: 743–750.Google Scholar
  22. Kempen, G. I. J. M., van Sonderen, E., and Ormel, J. (1999). The impact of psychological attributes on changes in disability among low-functioning older persons. J. Gerontol. Psychol. Sci. 54B: P23–P29.Google Scholar
  23. Koenig, H. G., Shelp, F., Goli, V., Cohen, H. J., and Blazer, D. G. (1989). Survival and health care utilization in elderly medicaL inpatients with major depression. J. Am. Geriatr. Soc. 37: 599–606.Google Scholar
  24. Krause, N. (1987). Life stress, social support and self-esteem in an elderly population. Psychol. Aging 2: 349–356.Google Scholar
  25. Lazarus, R., and Folkman, S. (1984). Stress, Appraisal and Coping, Springer, New York.Google Scholar
  26. Luber, M. P., Alexopoulos, G. S., Hollenberg, J., Charlson, M., and Callahan, M. (1996). Recognition, treatment, comorbidity and resource utlizatin of depressed patients in a general medical practice. Annual Meeting of the Society of General Internal Medicine. Cited in G. S. Alexopoulos, Geriatric depression in primary care, Int. J. Geriatr. Psychiatry 11: 397–400.Google Scholar
  27. Matt, G. E., and Dean, A. (1993). Social support from friends and psychological distress among elderly persons: Moderator effects of age. J. Health Soc. Behav. 34: 187–200.Google Scholar
  28. National Center for Health Statistics. (1994). Trends in the Health of Older Americans, United States, 1994, (Series 3, No. 30), U.S. Government Printing Office, Washington, DC.Google Scholar
  29. Neese, J. B., and Abraham, I. V. (1997). Cluster analysis of psychogeriatric characteristics and service use among rural elders. Issues Ment. Health Nurs. 18: 1–18.Google Scholar
  30. Nelson, M. A. (1993). Race, gender, and the effect of social support on the use of health services by elderly individuals. Int. J. Aging Hum. Dev. 37: 227–246.Google Scholar
  31. Nunnally, J. C., and Bernstein, I. R. (1994). Psychometric Theory, 3rd edn., McGraw-Hill, New York.Google Scholar
  32. Ormel, J., Kempen, G. I. J. M., Deeg, D. J. H., Bulman, E. I., van Sonderen, E., and Relyveld, J. (1998). Functioning, well-being, and health perceptions and older people: Comparing the effects of depressive symptoms and chronic medical conditions. J. Am. Gerontol. Soc. 46: 39–48.Google Scholar
  33. Pachana, N. A., Gallagher-Thompson, D., and Thompson, L. W. (1994). Assessment of depression. In Lawton, M. P., and Teresi, J. A. (eds.), Annual Review of Gerontology and Geriatrics: Focus on Assessment Techniques, Springer, New York.Google Scholar
  34. Parmelee, P. A., Katz, I. R., and Lawton, M. P. (1992). Incidence of depression in long-term care settings. J. Gerontol. Med. Sci. 46: M189–M196.Google Scholar
  35. Pearlin, L. I., Lieberman, M. A., Menaghan, E. G., and Mullen, J. (1981). The stress process. J. Health Soc. Behav. 22: 337–356.Google Scholar
  36. Pfeiffer, E. (1975). SPMSQ: Short Portable Mental Status Questionnaire. J. Am. Geriatr. Soc. 23: 433–441.Google Scholar
  37. Puryear, D. A., Lovitt, R., and Miller, D. A. (1991). Characteristics of elderly persons seen in an urban psychiatric emergency room. Hosp. Community Psychiatry 42: 802–807.Google Scholar
  38. Radloff, L. S. (1977). The CES-D scale: A self report depression scale for research in the general population. Appl Psychol. Measures I: 385–394.Google Scholar
  39. Radloff, L. S., and Teri, L. (1986). Use of the Center for Epidemiological Studies-Depression Scale with older adults. Clin. Gerontol. 5(1/2): 119–137.Google Scholar
  40. Roberts, B. L., Dunkle, R., and Haug, M. (1994). Physical, psychological, and social resources as moderators of the relationship of stress to mental health in the very old. J. Gerontol. Soci. Sci. 49: 535–543.Google Scholar
  41. Roberts, B. L., Matecjyck, M. B., and Anthony, M. (1996). The effects of social support on the relationship of functional limitations and pain to depression. Arthritis Care Res. 9: 67–73.Google Scholar
  42. Schulberg, H. C., Saul, M., McClelland, M., Ganguli, M., Christy,W., and Frank, R. (1985). Assessing depression in primary medical and psychiatric practices. Arch. Gen. Psychiatry 42: 1164–1170.Google Scholar
  43. Simon, G. E., von Korff, and Barlow, W. (1995). Health care costs of primary care patients with recognized depression. Arch. Gen. Psychiatry 52: 850–856.Google Scholar
  44. Smith, A. L., and Weissman, M. M. (1992). Epidemiology. In Paykel, E. S. (ed.), Handbook of Affective Disorders, Guilford, New York, pp. 111–129.Google Scholar
  45. Stewart, A., Hays, R. D., and Ware, J. E. (1988). The MOS short-from general health survey. Med. Care 26: 724–732.Google Scholar
  46. Testa, M. A., and Simonson, D. C. (1996). Assessment of quality of life outcomes. N. Engl. J. Med. 334: 835–840.Google Scholar
  47. Tobin, S. S. (1991). Personhood in Advanced Old Age, Springer, New York.Google Scholar
  48. Turner, R. J., and Noh, S. (1988). Physical disability and depression: A longitudinal analysis. J. Health Soc. Behav. 29: 23–37.Google Scholar
  49. U.S. Department of Health and Human Services. (1993). Prevalence of Selected Chronic Conditions: 1986–1988, U.S. Government Printing Office, Washington, DC.Google Scholar
  50. Verbrugge, L. M., and Jette, A. M. (1990). The disablement process. Soc. Sci. Med. 38: 1–14.Google Scholar
  51. Weinert, C. (1987). A social support measure: PRQ85. Nurs. Res. 36: 273–277.Google Scholar
  52. Weinert, C., and Tilden, V. (1990). Measures of social support: Assessment of validity. Nurs. Res. 39: 212–216.Google Scholar
  53. Wells, K. B., Stewart, A., Hays, R. D., Burnam, A., Rogers, W., Daniels, M., Berry, S., Greenfield, S., and Ware, J. (1989). The functioning and well-being of depressed patients. J. Am. Med. Assoc. 262: 914–919.Google Scholar
  54. Whitelaw, N. A., and Laing, J. (1991). The structure of the OARS physical measure. Med. Care 29: 332–347.Google Scholar
  55. Zarit, S. H., Johansson, B., and Malmberg, B. (1995). Changes in functional competency in the oldest old: A longitudinal study. J. Aging Health 1: 3–23.Google Scholar

Copyright information

© Plenum Publishing Corporation 2001

Authors and Affiliations

  • Terry A. Badger
    • 1
  1. 1.The University of Arizona College of NursingTucson

Personalised recommendations