Factors Affecting Quality of Life in a Multiracial Sample of Older Persons With Schizophrenia

Abstract

There have been few studies of quality of life (QOL) among older persons with schizophrenia. The authors used an adaptation of Lehman's QOL model to examine factors that impact QOL in a multiracial urban sample of older persons with schizophrenia. The schizophrenia group consisted of 198 community-dwelling persons aged 55 years and older who developed schizophrenia before age 45 years. A community comparison group (N = 113) was recruited using randomly selected block-groups. The QOL model consisted of four variable sets (demographic, objective, clinical, and subjective) comprising 19 independent variables. The dependent variable was the Quality of Life Index (QLI). The schizophrenia group had a significantly lower QLI score than the comparison group (21.7 versus 24.2; t = -5.36, df = 362, p = 0.001). Within the schizophrenia group, in bivariate analyses, 11 of 19 variables were significantly related to QLI. In regression analysis, six variables were significantly associated with the QLI: fewer depressive symptoms, more cognitive deficits, fewer acute life stressors, fewer medication side effects, lower financial strain, and better self-rated health. The model explained 55% of the variance in QLI, with the demographic, objective, psychiatric illness, and subjective variable sets accounting for 6%, 35%, 9%, and 5% of the variance, respectively. With the exception of the demographic set, each of the variable sets added significant variance. Our data confirmed earlier reports that older persons with schizophrenia have lower self-reported quality of life than their age-matched peers. Our findings suggest that the factors impacting on QOL are potentially ameliorable and therefore provide an opportunity to enhance the well-being of this population.