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Assessing Quality of Life in Older Persons With Schizophrenia

Received June 27, 2003; revised August 11, 2003; accepted September 4, 2003. From the Division of Geriatric Psychiatry, SUNY Downstate Medical Center, Brooklyn, NY (CIC,RB), the Department of Psychology, Long Island University, Brooklyn, NY (PMR,MK,CM), and Community Research Applications, Bronx, NY (JE). Send correspondence to Carl I. Cohen, M.D., Professor and Director, Division of Geriatric Psychiatry, SUNY Downstate Medical Center, Box 1203, 450 Clarkson Avenue, Brooklyn, NY 11203. e-mail: cohen_c{at}hscbklyn.edu

Objective: There have been few studies of quality of life (QOL) indicators in older schizophrenic persons, and these studies have used narrow measures of QOL. The authors sought to demonstrate that self-appraisals of QOL are useful and valid in older schizophrenic persons. A second aim was to provide provisional support for a model of QOL in this population. Methods: The sample was 99 community-dwelling schizophrenic persons age 55+ and a community-comparison group (N=84). Using the Quality of Life Index (QLI), they compared the variable sets of their model (Objective, Subjective, and Psychiatric domains) for the schizophrenic and the community samples to determine whether the explained variance in the QLI was equivalent between groups for each of the three variable sets. To assess the model of QOL, for the entire sample, the global scale score of the QLI was regressed on three predictor variable sets, the three demographic covariates, and group membership. Results: All of the group differences were considered "small effect sizes." There were no significant differences between groups in the individual-variable regression coefficients. For the entire sample, when the QLI was regressed on the three predictor variable sets simultaneously, the model explained 61% of the variance in the QLI, and group membership was not significant. Conclusions: The analyses demonstrated the reliability and validity of the QLI in older schizophrenic persons and supported its validity by producing results comparable to general-community residents. The overall model was highly significant and should serve as basis for future studies of QOL.

Key Words: Schizophrenia • Quality of Life