title: Levels of depressive symptoms may modify the relationship between the WHOQOL-BREF and its determining factors in community-dwelling older adults.
abstract: BACKGROUND
  Depression is closely associated with quality of life (QOL) in older adults. Being elderly and exhibiting mild depressive symptoms may not lead to a depression diagnosis, but these attributes are clinically important. However, the extent to which these factors influence QOL and its determinants in older adults remains unclear.
  
  
  METHODS
  Questionnaires were administered to people aged 65 years or older at community senior centers in Taiwan to collect socio-demographic information and to assess results from the brief version of the World Health Organization's Quality of Life instrument (WHOQOL-BREF), Modified Barthel Index (MBI), 15-item Geriatric Depression Scale (GDS), and Mini-Mental State Examination (MMSE). Levels of depressive symptoms were classified as no depressive symptoms (NDS), lower level of depressive symptoms (LLDS), and higher level of depressive symptoms (HLDS), corresponding to GDS = 0, 1≦GDS≦5, and GDS>5, respectively. Multiple linear regression analyses were conducted to assess associations between the WHOQOL-BREF and its covariates for different levels of depressive symptoms.
  
  
  RESULTS
  A total of 454 older adults participated. The GDS and MBI scores significantly affected the WHOQOL-BREF physical and psychological domain scores in the LLDS group. Gender influenced the WHOQOL-BREF scores in the NDS group, and increased age demonstrated protective effects on the three domains in the HLDS group. Moreover, the association between the WHOQOL-BREF and its covariates varied for different levels of depressive symptoms.
  
  
  CONCLUSIONS
  Treatment for depressive symptoms is of high priority, and early recognition of and appropriate intervention for mild depressive symptoms may improve community-dwelling older adults' QOLs.
authors.affiliation: Department of Community Health,Chia-Yi Christian Hospital,Chia-Yi,Taiwan.
authors.forename: Yu-Chen
authors.initials: YC
authors.lastname: Chang
authors.affiliation: Department of Psychiatry,Changhua Christian Hospital & Changhua Christian Healthcare System,Changhua,Taiwan.
authors.forename: Wen-Chen
authors.initials: WC
authors.lastname: Ouyang
authors.affiliation: Department of Community Health,Chia-Yi Christian Hospital,Chia-Yi,Taiwan.
authors.forename: Mei-Chun
authors.initials: MC
authors.lastname: Lu
authors.affiliation: Department of Public Health,College of Medicine,National Cheng Kung University,Tainan,Taiwan.
authors.forename: Jung-Der
authors.initials: JD
authors.lastname: Wang
authors.affiliation: Department of Public Health,College of Medicine,National Cheng Kung University,Tainan,Taiwan.
authors.forename: Susan C
authors.initials: SC
authors.lastname: Hu
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D057187:Independent Living; D008297:Male; D009483:Neuropsychological Tests; D011594:Psychometrics / Q000295:instrumentation* / Q000706:statistics & numerical data; D011788:Quality of Life / Q000523:psychology*; D012044:Regression Analysis; D015203:Reproducibility of Results; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013624:Taiwan; D014944:World Health Organization
keywords: depressive symptoms; gender difference; lower level of depressive symptoms; older adults; quality of life