Abstract
BackgroundIt is not well established how psychosocial factors like social support and depression affect health-related quality of life in multimorbid and elderly patients. We investigated whether depressive mood mediates the influence of social support on health-related quality of life.MethodsCross-sectional data of 3,189 multimorbid patients from the baseline assessment of the German MultiCare cohort study were used. Mediation was tested using the approach described by Baron and Kenny based on multiple linear regression, and controlling for socioeconomic variables and burden of multimorbidity.ResultsMediation analyses confirmed that depressive mood mediates the influence of social support on health-related quality of life (Sobel’s p < 0.001). Multiple linear regression showed that the influence of depressive mood (β = −0.341, p < 0.01) on health-related quality of life is greater than the influence of multimorbidity (β = −0.234, p < 0.01).ConclusionSocial support influences health-related quality of life, but this association is strongly mediated by depressive mood. Depression should be taken into consideration in research on multimorbidity, and clinicians should be aware of its importance when caring for multimorbid patients.Trial registrationISRCTN89818205
Highlights
It is not well established how psychosocial factors like social support and depression affect health-related quality of life in multimorbid and elderly patients
Health-related quality of life is a measure of subjective health that complements disease-specific outcomes in multimorbid patients, because good quality of life is of value in itself and it is an independent predictor of mortality [1,2]
To clarify the direct and indirect effects of social support and depressive mood on health-related quality of life in multimorbid patients, we investigated the hypothesis that depressive mood mediates the influence of social support on health-related quality of life in these patients
Summary
It is not well established how psychosocial factors like social support and depression affect health-related quality of life in multimorbid and elderly patients. All relevant factors that might affect healthrelated quality of life in multimorbid patients need to be looked at in order to gain a more detailed biopsychosocial understanding [3] of multimorbidity. These include biological factors such as the extent of multimorbidity, as well as psychosocial factors such as social support. Previous research has attempted to increase our understanding of multimorbidity by identifying patterns of disease combinations [7,8,9]. Based on factor-analysis, Schäfer et al [9] identified three multimorbidity patterns: cardiovascular/metabolic disorders (CMD), anxiety/depression/somatoform disorders and pain (ADS/P) and neuropsychiatric disorders (NPS)
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