Socioeconomic status and the course of quality of life in older patients with coronary heart disease.
BACKGROUND
Previous research suggests that socioeconomic status (SES) might be related to the course of quality of life (QoL) in coronary heart disease (CHD) patients. The authors sought to determine whether there are differences in the course of QoL before and after the incidence of CHD among older persons of differing SES.


METHODS
Two hundred two CHD patients were followed up longitudinally using a community-based survey. Data on patients' QoL were collected before the diagnosis and at three follow-up assessments.


RESULTS
High SES patients reported better outcomes at the premorbid assessment with fewer depressive feelings and better physical functioning. In physical functioning, similar results were repeated 6 and 12 months after the diagnosis. Additionally, high SES patients showed better role and social functioning 1 year after CHD. A multivariate analysis of variance revealed differential longitudinal pathways in relation to SES in role, social, and physical functioning.


CONCLUSIONS
CHD modulates premorbid differences in depressive feelings. Conversely, high SES leads to better outcomes in all functional domains in the long-term after diagnosis. Postmorbid differences in physical functioning are not directly related to CHD, but rather the reestablishment of a premorbid situation. In contrast, socioeconomic inequalities in social and role functioning are a direct response to the impact of the disease.
Barbareschi
Giorgio
G
Health Psychology Section-Department of Health Sciences, University Medical Center Groningen, University of Groningen, P.O. Box 196, 9700 AD, Groningen, The Netherlands.
Sanderman
Robbert
R
Kempen
Gertrudis I J M
GI
Ranchor
Adelita V
AV
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D003327:Coronary Disease / Q000453:epidemiology / Q000523:psychology*; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D005260:Female; D054624:Health Status Disparities; D006333:Heart Failure / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000523:psychology; D009426:Netherlands; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D012803:Sick Role; D012959:Socioeconomic Factors