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Quality of Life in Older Adults Receiving Medications for Anxiety, Depression, or Insomnia

Findings From a Community-Based Study

Received July 21, 2001; revised November 27, 2001, January 30, 2002; accepted February 6, 2002. From the Department of Psychiatry and the Department of Family and Preventive Medicine, School of Medicine, University of California, San Diego, La Jolla, CA, and the VA San Diego Healthcare System. Address correspondence to Dr. Stein, Anxiety and Traumatic Stress Disorders Research Program, Department of Psychiatry (0985), University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0985. e-mail: mstein{at}ucsd.edu

OBJECTIVE: Depression and anxiety are associated with substantially reduced health-related quality of life (HRQoL) in healthy and medically ill adults. The authors examined the association between these conditions, as indicated by the use of antidepressant, anxiolytic, or hypnotic medications, and HRQoL parameters in older men and women. METHODS: This is a cross-sectional study of white, middle-class, older (median age 75 years) men (n=533) and women (n=826) within a defined community setting. Short Form-36 Health Survey (SF-36) scores were compared between persons currently taking medicine(s) for depression, anxiety, and/or insomnia or none of these. RESULTS: The chronic physical illness summary score (dichotomized into scores of less than 2 versus 2 or more) was associated with significantly greater odds of perceiving oneself as ill and was also significantly correlated with poorer HRQoL in both men and women. Taking a psychotropic medication for anxiety, depression, or sleep was associated (in men and in women) with significantly greater odds of perceiving oneself as ill, before and after adjusting for age and chronic physical disorder scores. After these adjustments, use of medications remained significantly associated with lower scores on both the Physical and Mental Composite Scales of the SF-36 in women; a similar but nonsignificant association was seen in men. CONCLUSIONS: Among older, community-dwelling adults, anxiety, depression, and insomnia that require pharmacological treatment are associated with reductions in HRQoL that extend beyond the impact of comorbid physical illnesses.

Key Words: Depression • Antidepressants • Anxiolytics

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