Health-Related Quality of Life in Older Persons with Medically Unexplained Symptoms.
Research on health-related quality of life (HRQoL) in older persons with medically unexplained symptoms (MUS) is scarce, and, in contrast with younger patients, interactions with chronic somatic diseases are more complex.



In the current study we compared HRQoL between older persons with MUS and older persons with medically explained symptoms (MES). Our study sample consisted of 118 older MUS-patients and 154 older MES-patients.



The diagnosis of MUS was ascertained by the general practitioner and confirmed by a geriatrician within a multidisciplinary diagnostic assessment. Additional characteristics, including the HRQoL (Short Form-36), were assessed during a home visit. MES-patients received two home visits to assess all measures. Multiple linear regression analyses, adjusted for age, sex, education, cognitive functioning, and psychiatric diagnoses, were performed to assess the relationship between group (MUS/MES) and HRQoL. Analyses were repeated with additional adjustments for somatization and hypochondriacal cognitions.



Older patients with MUS had a significantly lower level of HRQoL compared with older patients with MES. Even after adjustments, the presence of MUS was still associated with both a lower physical and mental HRQoL. These associations disappeared, however, after additional adjustments for somatization and hypochondriacal cognitions. Within the subgroup of MUS-patients, higher levels of hypochondriac anxiety and of somatization were significantly associated with both lower physical and mental HRQoL.



Associations between HRQoL and late-life MUS disappear when corrected for somatization and hypochondriacal cognitions, which is in line with the DSM-5 classification of somatic symptom disorder. Appropriate psychological treatment seems needed to improve HRQoL in older MUS-patients.
Department of Psychiatry, Radboud Institute for Health Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. Electronic address: D.Hanssen@psy.umcn.nl.
Denise J C
DJC
Hanssen
Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Peter L B J
PLBJ
Lucassen
SeniorBeter, Practice for Old Age Psychiatry, Gendt, The Netherlands.
Peter H
PH
Hilderink
Department of Old-Age Psychiatry, GGNet, Apeldoorn, The Netherlands.
Paul
P
Naarding
University Center for Psychiatry and the Interdisciplinary Center for Psychopathology and Emotion Regulation, University Medical Center Groningen, Groningen, The Netherlands.
Richard C Oude
RCO
Voshaar
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006304:Health Status; D006801:Humans; D016014:Linear Models; D008297:Male; D000071896:Medically Unexplained Symptoms; D008875:Middle Aged; D011788:Quality of Life; D013001:Somatoform Disorders / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy
aged; medically unexplained symptoms; quality of life; somatization