Le projet Esprit: une étude longitudinale en population générale des troubles psychiatriques en France chez des sujets de plus de 65 ans

Change of depressive symptoms in a French nine-year longitudinal study of aging: Gender differences and relationships between social support, health status and depressive symptoms

OBJECTIVES

The aims of this study were to examine the trajectory of depressive symptoms among older French people, to investigate the role of gender in the developmental trajectory of depressive symptoms and to explore whether the linear increase in depressive symptoms might be accentuated or attenuated at time points during which the older adults' scores on social support and health satisfaction scales were higher than their individual averages.

METHODS/MATERIALS

Data were used from a subsample of older adults living at home who participated in a longitudinal study initiated by researchers from the University of Tours. They were collected at five time points over a 9-year period (T1: 2003; T2: 2005; T3: 2007; T4: 2009; T5: 2011). This study included 707 participants, and multilevel growth curve analysis was used on measures of depressive symptoms, gender differences, social support and health satisfaction.

RESULTS

Results indicated (1) a significant positive linear effect of age on depressive symptoms; (2) that women reported significantly higher scores of depressive symptoms than men at 63 years old (i.e., intercept) and that this gender difference remained constant across age; (3) that the slope of depressive symptoms appeared to increase at time points during which participants had higher levels of social support and to decrease when they had greater health satisfaction.

CONCLUSION

This study provides pertinent information about the change of depressive symptoms in older people living at home and particularly highlights the interest in studying gender, social support and health satisfaction.

[Spouses' health-related quality of life evaluation of elderly patients with depression]

OBJECTIVE

To assess and compare the health-related quality of life (HRQoL) of spouses living at home with a patient aged 65 years or more suffering from a major depressive disorder and that of matched controls. Secondly, to investigate whether the HRQoL of spouses was correlated with the assessment of their partner's depression, their own depression and the self-perceived level of care burden experienced by the caregiver partner.

METHODS

Assessment of patients was based on the clinical diagnosis of a major depressive disorder as established by the criteria of the DSM-IV-TR, the geriatric depression scale GDS-15 and the LEIPAD questionnaire specific to subjects aged 65 or over living at home. Spouses were assessed by GDS-15, the Zarit scale for assessing caregiver burden and the LEIPAD questionnaire. The HRQoL of controls, who were matched for age, sex and educational level, was assessed by LEIPAD.

RESULTS

The study sample (n=38) was made up of 19 patients (mean age of 76.6 years, standard deviation 8.1) and their spouses (mean age of 75.3 years, standard deviation 8.2). The HRQoL score of the spouses was significantly poorer for the scale "Sexual functioning" (P=0.0007) than that of controls and was negatively affected by their partner's depression (P=0.02). The HRQoL scores of the spouses for "Physical function", "Depression and anxiety" and "Sexual functioning" were negatively affected by their own depression (correlation coefficients r=0.50, 0.53 and 0.54, respectively). The HRQoL scores for "Self-care", "Sexual functioning" and "Life satisfaction" were also negatively affected in spouses by the self-perceived burden of care (correlation coefficients r=0.59, 0.57 and 0.51, respectively).

CONCLUSION

The sexual quality of life of spouses of elderly patients suffering from a major depressive disorder was significantly impaired. The patients' and spouses' depression and the caregivers' burden also had a negative impact on several aspects of the HRQoL of the spouses. It seems to be important, therefore, to assess the mental state, care burden and HRQoL of spouses caring for elderly patients suffering from depression so as to offer help when required to partners in difficulty.