title: Comparison of health-related quality of life and associated psychological factors between younger and older patients with established rheumatic disorders.
abstract: OBJECTIVE
  To compare health-related quality of life (HRQOL) between younger and older patients with established rheumatic disorders and to assess the relative impact of a number of psychosocial parameters on HRQOL.
  
  
  METHODS
  In a cross-sectional study of 320 patients (245 < 65 and 75 > or = 65 years old, response rate: 74.9%) with various rheumatic disorders (rheumatoid arthritis, 168; systemic lupus, 56; scleroderma, 56; and Sjogren's syndrome, 40) attending a follow-up clinic, HRQOL was assessed by the WHOQOL-BREF. Functional limitations (Health Assessment Questionnaire), psychological distress (Symptom Distress Checklist-90-R), defense mechanisms (Defense Style Questionnaire and Life Style Index), sense of coherence, and interpersonal difficulties (Inventory of Interpersonal Problems-40) were also assessed.
  
  
  RESULTS
  Older patients presented more impaired physical HRQOL (p = 0.018) and social relationships HRQOL (p = 0.041) independent of disease type, education, and pain. Functional limitations were more prominent in the older group (p = 0.030). Pain, functional limitations, and psychological distress were independently associated with physical HRQOL in both groups. Psychological distress was the only common independent correlate of social relationships HRQOL. Personality factors were significant correlates of physical and social relationships HRQOLs only in the younger group, while the impact of pain in physical HRQOL was greater for younger than older patients, as shown by a moderator analysis.
  
  
  CONCLUSIONS
  Older patients with rheumatic diseases experience more impaired HRQOL than the younger ones, and the management and prevention of functional limitations and psychological distress should be a priority, since they are strongly associated with HRQOL. Pain also warrants attention in all age groups, but especially in younger patients. Personality factors impact on HRQOL in younger patients, and this might be relevant to psychological interventions.
authors.affiliation: Consultation-Liaison Psychiatry Unit, Department of Psychiatry, Medical School, University of Ioannina, 45110 Ioannina, Greece.
authors.forename: Panagiota
authors.initials: P
authors.lastname: Goulia
authors.forename: Paraskevi V
authors.initials: PV
authors.lastname: Voulgari
authors.forename: Niki
authors.initials: N
authors.lastname: Tsifetaki
authors.forename: Alexandros A
authors.initials: AA
authors.lastname: Drosos
authors.forename: Thomas
authors.initials: T
authors.lastname: Hyphantis
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003674:Defense Mechanisms; D006115:Greece / Q000453:epidemiology; D006304:Health Status; D006801:Humans; D007398:Interpersonal Relations; D008180:Lupus Erythematosus, Systemic / Q000503:physiopathology / Q000523:psychology; D008875:Middle Aged; D010551:Personality; D011788:Quality of Life / Q000523:psychology; D012216:Rheumatic Diseases / Q000503:physiopathology / Q000523:psychology; D012737:Sex Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000503:physiopathology / Q000523:psychology; D011795:Surveys and Questionnaires