Philadelphia Geriatric Center Research Articles

The Potential of Informal Care for Self-Perceptions of Aging Among Older Community-Dwelling Adults: Longitudinal Findings From the Health and Retirement Study.

This is the first study to analyze, whether receipt of (informal) care with (instrumental) activities of daily living (IADL/ADL) is associated with (positive and negative) self-perceptions of aging among community-dwelling older adults; and whether chronological age moderates these associations, using a longitudinal design. Longitudinal data of the Health and Retirement Study in the United States was used. The sample was composed of up to 9,198 observations of community-dwelling adults aged ≥50 years pooled over 6 waves (2008-2018). Receiving care at all and the amount of care received with (I)ADL were analyzed in association with positive and negative attitudes towards own aging (ATOA; 8-item modified Philadelphia Geriatric Center Morale Scale, positive and negative subscore). Adjusted fixed effects regression analyses with robust standard errors were calculated. Transitioning into receipt of care with any (I)ADL was associated with lower positive ATOA but not with any change in negative ATOA. Chronological age moderated the association between receipt of informal care, primarily with IADL, and negative ATOA. More negative ATOA was found among care recipients between 50 and 64 years but less among care recipients aged ≥80 years. Receiving any form of informal care was associated with an increase in internalized ageism, in particular among adults aged 50 to 64 years, but a decrease among those aged ≥80 years. Psycho-educative measures are recommended for adults with care needs to prevent a loss of positive self-perceptions of aging, and reduce the danger to their healthy aging, with the receipt of care.

The Relationship between Subjective Aging and Cognition in Elderly People: A Systematic Review.

There is a growing body of evidence on the effects of subjective aging on health, well-being and quality of life. This review aims to synthesize findings about the link between subjective aging and cognition and cognitive decline. Furthermore, it provides an examination of variation sources such as subjective aging construct, cognitive domains, measures employed, age and moderator variables. A systematic search was performed in PubMed, PsychInfo and Web of Science, as well as grey literature searches in Google Scholar, OpenGrey, WorldCat and NDLTD, which resulted in 59 reports being included. Subjective aging is a relevant construct in the explanation and prediction of cognitive aging and cognitive decline in elderly adults. More positive views about own aging and self-perceptions of aging, as well as a younger subjective age, were consistently related to better cognition and lower risk of cognitive decline. However, there were differences due to subjective aging subdimensions and cognitive domains, as well as an effect of age. Additionally, there were concerns about the content validity of some measures employed, such as the Philadelphia Geriatric Center Morale Scale for subjective aging and the Mini Mental State Examination for global cognition. Further studies should employ longitudinal designs with a process-based approach to cognition and precise subjective aging measures.

Self Perceptions of Stress in Caregiving Moderate Associations of Within and Between Caregivers’ Physical Health Symptoms

AbstractBackgroundThe success of dementia care requires the full support from the caregivers with the goal of delaying the disease’s progress. Studies over decades have reinforced that the knowledge, attitude, and skills of caregivers are crucial parameters of the success of in‐community care for dementia. Nevertheless, studies have identified that many caregivers, across different culture and ethicity, are not well prepared emotionally or practically to be the caregivers and this will result in stress, particularly when their stress are ignored by medical professionals during this long journey of care.MethodThis is a mixed‐method research to examine how self‐perceptions of aging (SPA) moderated within‐ and between‐caregivers Self‐perceived stress (SPS) associations with physiological health symptoms (PHS) and daily physical health symptoms (DPHS). SPA was measured by the Philadelphia Geriatric Centre Morale scale. SPS was measured by Zarit Burden Interview Scale and Revised Memory and Behaviour Problem Checklist. DPHS was measured daily through an adapted symptom checklist.ResultA pilot study of 20 caregivers reported significantly more physical health symptoms compared to individuals with lower perceived stress on average (p < .05). SPA significantly moderated associations between both within‐ and between‐persons perceived stress (SPS) and physiological health symptoms (PHS) (ps < .05).ConclusionMore positive SPA significantly dampened the impact of perceived stress, suggesting the importance of SPA as an individual characteristic within stress processes. Future work should examine how daily changes in SPA may exacerbate or mitigate the impacts of daily stress processes and health outcomes.

16 Does Cognitive Test Performance Upon Admission to Nursing Homes Predict Long Term Care Residents’ Psychological Functioning?

Objective:The current study investigated whether older adults’ cognitive test scores at the time of long-term care nursing home admission are associated with psychological well-being over the first six months. We analyzed the link between Mattis Dementia Rating Scale (DRS-2) subscale scores and anxiety, depression, quality of life, and positive/negative affect.Participants and Methods:Participants were recently admitted long-term care residents from 13 nursing homes in the Louisville, KY area. Sixty-two older adults were administered the DRS-2 shortly after nursing home admission. Using a cutoff of less than 6 scaled score on the DRS-2, 52% of participants scored as cognitively impaired. Self-report measures of anxiety (RAID), depression (PHQ9), quality of life (QoL-AD), and positive/negative affect (Philadelphia Geriatric Center Affect Rating Scale) were collected at time of admission, and 3 and 6 months later.Results:The DRS-2 attention subscale significantly correlated with baseline depression symptoms. No other DRS-2 subscale or the DRS-2 total score correlated with anxiety, depression, quality of life, or affect ratings at admission. Baseline DRS-2 attention, initiation/perseveration, and memory had significant correlations with self-report measures at 3 and 6 months; these DRS-2 scores were selected for further analysis. Mixed ANOVAs found a significant main effect of group (impaired vs. not-impaired) for the initiation/perseveration subscale, memory subscale, and DRS-2 total score on negative affect; impairment in any of these domains was associated with lower reported negative affect at all three time points. There was no significant effect of cognitive scores on any other self-report measure. There was a significant, positive linear trend in quality of life over time. There was a significant quadratic trend in depression symptoms, with decreased depression reported at 3 months and increase at 6 months.Conclusions:Impaired performance on the DRS-2 was associated with lower negative affect over time. Cognitive impairment was not associated with anxiety, depression, quality of life, or positive affect. There appear to be reliable trends in some psychological factors regardless of cognitive scores, with an increase in quality of life over time and a temporary decrease in reported depression captured at 3 months. The relationship between cognitive impairment and negative affect should be interpreted with caution, as only 22 residents completed the affect self-report at all three time points. Overall, we found limited evidence of an association between cognitive scores at time of admission and self-reported psychological factors at 3 and 6 months.

Association between serum oxytocin levels and depressive state in community-dwelling older adults: A cross-sectional study.

Identifying peripheral biomarkers related to the prevention or modification of unhealthy mental conditions in older adults would be extremely beneficial. This study aimed to evaluate serum oxytocin levels in older adults living in a rural community and their association with cognitive function, anxiety, depressive state, and well-being. This survey was conducted between November 2016 and September 2017 in Kurokawa-cho, Imari, Saga Prefecture, Japan, among people aged ≥65 years. Blood samples were collected from the participants for serum oxytocin level analysis, which was performed using peptide enzyme immunoassay. Participants underwent neuropsychological assessments, including the Mini-Mental State Examination, Clinical Dementia Rating, Frontal Assessment Battery, State-Trait Anxiety Inventory, 15-item Geriatric Depression Scale, and 17-item Philadelphia Geriatric Center Morale Scale. We examined the association between serum oxytocin levels and neuropsychological assessment results. Out of 94 participants, 25 were men and 69 were women, with mean ages of 78.24 ± 3.85 years and 78.10 ± 5.43 years, respectively. Serum oxytocin levels were negatively associated with 15-item Geriatric Depression Scale scores. Additionally, nondepressive state/depressive state was classified by the 15-item Geriatric Depression Scale (cut-off 5/6). Logistic regression analysis showed that higher serum oxytocin levels tended to be associated with a less depressive state at that time. Serum oxytocin levels may be associated with depressive state in adults aged ≥65 years.

Association Between Higher-Level Functional Capacity and Subjective Well-Being in Older Adults with Chronic Conditions: A Cross-Sectional Study

Aims The aim of the present study was to examine the associations between higher-level functional capacity and subjective well-being (SWB) in older adults with chronic conditions. Materials We used data from a self-administered questionnaire survey conducted in two day-service facilities and one home-visit nursing station. We performed multiple linear regression analyses with SWB measured by the revised Philadelphia Geriatric Center Morale Scale and higher-level functional capacity including instrumental self-maintenance, intellectual activity, and social role. Results 140 persons were included in the analyses. We did not find an association between instrumental self-maintenance and SWB (B = 0.30, 95% confidence interval [CI]: −0.15, 0.75). On the other hand, intellectual activity (B = 0.77, 95%CI: 0.19, 1.34) and social role (B = 0.88, 95% CI: 0.34, 1.43) were associated with SWB. Conclusions Being intellectually active and performing social role may be important to increase SWB in older adults with chronic conditions.

Age images of older patients with psychiatric diseases -The importance of attachment and mentalization

Objectives: The emergence and effects of self-perception of ageing (SPA) are central gerontological research topics. SPA has an influence on numerous psychological, cognitive and physical parameters.The question of its significance for mental illness in old age, which was investigated in the present study, has so far remained in the background. Of particular interest was the connection to attachment and mentalization. Method: A clinical sample (N = 150) was compared with a non-clinical sample (N = 153). Both were divided into three age groups (40-54, 55-69 and over 70 years).The survey instruments used were the Attitude to Own Ageing subscale of the Philadelphia Geriatric Center Moral Scale (PGCMS) and a mentalizing and an attachment questionnaire (MZQ and ECR). Results:The clinical sample showed significantly lower scores in all age groups (more negative SWA), but only the non-clinical sample showed a decrease in age across the three age groups, thus the SPA became more negative. In the regression analytic evaluation, a more negative SPA was associated with an avoidant attachment orientation as well as reduced mentalizing skills. Conclusions: The results highlight the importance of SWA as a clinically and therapeutically significant variable. Finally, therapeutic implications are discussed.

Impact of skin care on body image of aging people: A quasi-randomized pilot trial

AimSupport for various activities of daily living is essential for maintaining the health of residents in nursing homes. Although aging people who move to nursing homes often change their skin care habits, how these changes impact aging adults’ social and mental well-being remains unclear. This study aimed to evaluate the effects of facial skin care on aging residents’ self-body image, self-esteem, well-being, depressive symptoms and social cognitive function by a quasi-randomized controlled pilot trial in Japanese nursing homes. MethodThirty-seven older adult women living in nursing homes took part in this quasi-randomized controlled pilot trial. Eighteen participants applied a skincare gel-cream to the face twice a day for three months, while 19 participants used no skincare products. Self-body image and psychological measures such as the Cutaneous Body Image Scale (CBIS), the Rosenberg Self-esteem Scale (RSES), Philadelphia Geriatric Center Morale Scale (PGCMS) and Geriatric Depression Scale (GDS) were used in each nursing home to evaluate the pre- and post-treatment scores. In addition, cognitive items of the Functional Independence Measure (FIM) were evaluated as social cognitive function at pre- and post-treatment. ResultsThere was a significant different change of the Cutaneous Body Image Scale scores (p = 0.045, r = 0.34) after three months between skin care group and control group. Although there were no clear significant differences in other psychological assessments, there was a higher number of them with positive changes in the skin care group compared to the control group. ConclusionSkin care may help improve cutaneous self-body image and positive emotion in aging female residents of Japanese nursing homes.

Can Informal Caregiving be Perceived as Rejuvenating? Changes in Perceptions of Ageing at Onset and End of Informal Caregiving during Different Stages of Life

Introduction: Perceptions of ageing are a central predictor of health, wellbeing, and longevity. This study analyses the association between the onset and end of informal caregiving and perceptions of ageing in different stages of life. Methods: Data from the German Aging Survey (2014, 2017) were used; a longitudinal dataset that is representative of community-dwelling individuals aged ≥40 years in Germany. Adjusted asymmetric fixed effects regression analyses were conducted to analyse the associations in three age groups (40 to <60, 60 to <80, and ≥80). Perceptions of ageing were measured in terms of attitude towards one’s own ageing (Philadelphia Geriatric Centre Morale Scale), subjective age (felt age), and onset of old age (when someone is considered to be old). Results: Significant changes in the perceptions of ageing were found only among individuals aged ≥80 years. In this group, the onset of informal caregiving was significantly associated with improved attitude towards one’s own ageing and the end of informal caregiving was significantly associated with increased subjective age and earlier onset of old age. Conclusion: The perceptions of ageing improved with the onset and worsened with end of caregiving – but only among oldest old individuals. Thus, informal caregiving seems to be a significant predictor for perceptions of ageing in old age.

Associations between everyday physical activity and morale in older adults

Studies that objectively investigate patterns of everyday physical activity in relation to well-being and that use measures specific to older adults are scarce. This study aimed to explore objectively measured everyday physical activity and sedentary behavior in relation to a morale measure specifically constructed for older adults. A total of 77 persons (42 women, 35 men) aged 80 years or older (84.3 ± 3.8) wore an accelerometer device for at least 5 days. Morale was measured with the Philadelphia Geriatric Center Morale Scale (PGCMS). PGCMS scores were significantly positively associated with number of steps, time spent stepping, and time spent stepping at >75 steps per minute. Sedentary behavior did not associate with PGCMS. Promoting PA in the form of walking at any intensity–or even spending time in an upright position—and in any quantity may be important for morale, or vice versa, or the influence may be bidirectional.

Reliability and Validation of the Japanese Version of the Patient Empowerment Scale.

Empowerment scales for inpatients have been developed worldwide, but their validity and reliability have not been adequately tested and applied to the health promotion and care among older adults during hospitalization. In this study, the Patient Empowerment Scale developed by Faulkner was translated into Japanese, and Japanese patients were surveyed to test its clinical applicability. To test its applicability, 151 patients in rehabilitation wards were surveyed in four municipalities. After considering ceiling/floor effects and validating the structure, the Patient Empowerment Scale—Japanese comprised 37 items and six factors: subject–staff interaction, environmental adjustment through collaboration, necessary information gathering and problem awareness, proactive behavioral practices, self-disclosure, and self-management of activities. Criteria-related validity assessment confirmed the scale’s correlation with the Health Locus of Control Scale, General Self-Efficacy Scale, 13-item Sense of Coherence Scale, Rosenberg Self-Esteem Scale, and Philadelphia Geriatric Center Morale Scale. Regarding internal consistency, the Cronbach’s alpha was 0.93 for all 37 items. The Cronbach’s alphas for the six factors were 0.93, 0.91, 0.92, 0.92, 0.91, and 0.75, respectively. In our test/re-test of reliability, Spearman’s rank correlation coefficient between the first and second total scores was ρ = 0.96, p < 0.01. These results confirm the scale’s validity and reliability, and its applicability to older hospitalized patients.

Relationship between morality, happiness, and social support among elderly people

BackgroundVarious factors influence the lives of elders, such as social support, which is critical in preventing physical, psychological, and social difficulties. This study aimed to investigate the relationship between morality, happiness, and social support among elderly people. A descriptive correlational design was used in carrying out this study. This study was conducted at the Geriatric Social Club in El-Qawmia; Zagzig City, Alsharkia Governorate. A purposeful sample of 235 elders was recruited for this study. Four tools were used to collect data: A structured interview questionnaire, Philadelphia Geriatric Center Morale Scale (interview version), Multidimensional Scale of Perceived Social Support, and Oxford Happiness Questionnaire.ResultsResults denoted that less than half of studied elders had moderate score as regards morale scale and perceived social support. As well, less than three-fifths of them had moderate score regards total happiness. There were statistically significant relations between morality and both of age, income, chronic diseases, and taking medication. Perceived social support was positively statistically significantly related with elders’ gender, marital status, chronic diseases, medication, and income. There were statistical significant relations between elderly happiness level and working condition, income, and with whom they live. Elders’ perceived social support was highly positively statistically correlated with happiness and morality.ConclusionsIt was concluded that these variables were positively correlated with each one, where increasing perceived social support and feeling of happiness associated with enhancing feeling of morality among elders. The perceived social support and happiness were the key co-existences of elders’ morality. Therefore, it is recommended to implement caring and training programs focusing on enhancing social support in order to develop morale among elders. The country should provide various kinds of assistance to the elderly, such as counseling services.

Does grandchild care affect ageing satisfaction? Findings based on a nationally representative longitudinal study.

ObjectiveThis study seeks to explore the association between grandchild care and Attitudes Towards Own Ageing, assessing whether the commencement of, or ceasing, grandchild care is associated with changes in grandparents’ perspectives on ageing.MethodsLongitudinal data were drawn from a population-based sample of community-dwelling individuals aged ≥40 years in Germany. The Attitudes Toward Own Ageing subscale of the Philadelphia Geriatric Center Moral Scale (PGCMS) was used to measure Attitudes Towards Own Ageing. To determine whether respondents provided grandchild care, respondents were asked “I’d now like to go on to learn more about your activities and pastimes. Do you supervise other people’s children privately, e.g. your grandchildren, or the children of siblings, neighbors, friends or acquaintances?” Symmetric and asymmetric linear fixed effects regressions were used to assess within-person changes longitudinally.ResultsNo statistically significant association between providing care for grandchildren and Attitudes Towards Own Ageing was found. Significant associations were found between Attitudes Towards Own Ageing and employment status. Namely, retirement was associated with more positive Attitudes Towards Own Ageing (β = 0.57, p < .001), as was not being employed (β = 0.57, p < .001). A significant association between self-rated health and Attitudes Towards Own Ageing was also found (β = -0.06, p < .001), with poorer self-rated health associated with more negative Attitudes Towards Own Ageing.ConclusionOur findings suggest that undertaking grandchild care does not shape Attitudes Towards Own Ageing. As our findings did not align with existing evidence on the associations between grandchild caregiving and measures of subjective ageing, further research is required.

Subjective Wellbeing and Related Factors of Older Adults Nine and a Half Years after the Great East Japan Earthquake: A Cross-Sectional Study in the Coastal Area of Soma City.

This study examined older adults’ subjective wellbeing and related factors in the coastal area of Soma City nine and a half years after the Great East Japan Earthquake (GEJE). Data were collected from 65- to 84-year-old residents and 1297 participants via a questionnaire from October to November 2020. The participants were divided into two groups: housing complexes and non-housing complexes. The dependent variable was subjective wellbeing assessed via Lawton’s Philadelphia Geriatric Center Morale Scale (PGCMS). Using multivariate regression analysis, the factors most strongly related to a low PGCMS score for both groups were poor health conditions, difficulties resting while asleep, poor financial wellbeing, inability to chew certain foods, and fear of solitary death. The GEJE experience was further distinguished in the housing complex group by the loss of an important non-family individual; for the other group, important factors were female gender, junior high school education level or lower, limited social networks, and deterioration of a family member’s health. Older adults’ subjective wellbeing in Soma City was low after nine and a half years following the GEJE. For disaster victims and their families in both groups, it is crucial to implement measures such as long-term, continuous physical and mental health support.

Effect of life-space mobility on subjective well-being in aged home-based rehabilitation users with different levels of independence in activities of daily living.

[Purpose] The relationship between quality of life and life-space mobility in community-dwelling older adults has recently been reported. The present study aimed to elucidate this relationship in home-based rehabilitation users with limited life-space mobility and loss of independence in activities of daily living. [Participants and Methods] The study population comprised 33 home-based rehabilitation users. The participants were expected to have a wide range of the level of independence in activities of daily living; therefore, they were categorized into three groups according to the Barthel Index score: independent (95–100 points), moderately disabled (90–65 points), and severely disabled (60–0 points) groups. We examined the relationships among the Philadelphia Geriatric Center Morale Scale, Life-Space Assessment, and Barthel Index scores and age. [Results] We detected a strong positive correlation between the Philadelphia Geriatric Center Morale Scale and Life-Space Assessment scores in the independent group; however, no significant correlations were observed in the moderately and severely disabled groups. [Conclusion] Our findings suggest a relationship between subjective well-being and life-space mobility in home-based rehabilitation users who are mostly independent in activities of daily living. However, owing to the small sample size and characteristics of the scales used in this study, further studies are warranted to verify these results.

MORAL AND SOCIAL SUPPORT STATUSES AND DEPRESSIVE SYMPTOMS OF PATIENTS AGED 65 AND OVER WHO HAVE CHRONIC OBSTRUCTIVE LUNG DISEASE

The current study was undertaken to determine status of morale, social support and depressive symptoms among patients aged ≥ 65 years old with chronic obstructive pulmonary disease. This study conducted in a descriptive and correlational design. The data were collected using patient descriptive forms developed by the researchers, a personal information form about the disease, Philadelphia Geriatric Center Morale Scale, the Multidimensional Scale of Perceived Social Support and Geriatric Depression Scale through face to face interview method. For the analyses of the data; percentages, means, Mann Whitney U, Kruskall Wallis and Correlation Analyses tests were employed.The rate of patients currently smoking was 6.2% whereas the rate of patients previously smoking was 60.6%. It was found that 50.9% of the elderly COPD patients had severe depression and their average depression score was 13.76±5.02, their average morale score was 5.78±2.11 and their average social support score was 54.71±16.80. It was found that there was a negative and significant correlation between morale and social support status of the elders whereas there was no correlation between morale and depression symptoms. It was identified that elderly COPD patients had lower morale status, moderate social support status and more than half of them demonstrated depressive symptoms. While morale levels of the patients decreased, their social support status increased. It is recommended that sufficient support systems should be provided to the elders in order to reduce their depression symptoms and to elevate their morale levels.

Positive Self-Perceptions of Aging Play a Significant Role in Predicting Physical Performance among Community-Dwelling Older Adults.

Self-perceptions of aging (SPA) is associated with various health-related outcomes, including physical performance. No previous study has investigated the potential predictive influence of SPA on physical performance among Swedish community-dwelling older adults. This was a cross-sectional study using a random sample of 153 Swedish community-dwelling individuals aged 70 and older. Multiple logistic regression analysis was performed, using the subscale “Attitude Towards Own Aging” of the Philadelphia Geriatric Center Morale Scale, as a measure of SPA. The Short Physical Performance Battery (SPPB) was dichotomized and used as the outcome variable. SPA was a significant predictor (OR = 1.546, CI = 1.066–2.243) of physical performance, adjusted for age, cognitive function, and life-space mobility. Further analyses revealed significant sex differences, with SPA not being included in the model for the men whilst it was still a significant predictor (OR = 1.689, CI = 1.031–2.765) of physical performance in the group of women. SPA plays a significant role in predicting physical performance among Swedish community-dwelling older adults. To further clarify this relationship and its consequences, future longitudinal research should focus on the relationship between SPA, physical performance, and fall risk.

Purposes of Going out and Subjective Well-Being in Older Adults with Impairments

Aims To examine the association between diverse purposes of going out and the participant’s subjective well-being and their orientation toward going out. Methods We conducted a self-administered questionnaire survey to assess the association between orientation toward going out, purposes of going out, and the Philadelphia Geriatric Center Morale Scale (PGCMS) score in adults > 65 years. Results A regression analysis of 138 responses using a multistage adjustment approach showed no significant association, only with diverse purposes of going out (b: −1.74; 95%CI: −4.17, 0.69). In contrast, the interaction term was significantly associated with the PGCMS score (b: 3.28; 95%CI: 0.38 6.17). Conclusions Having diverse purposes of going out was associated with a higher level of subjective well-being in individuals with an orientation toward going out, suggesting the importance of increasing the variety of purposes of going out.

Psychometric Properties of the Persian Version of the 11-Item de Jong Gierveld Loneliness Scale in Iranian Older Adults.

Loneliness is usually a chronic condition which may lead to physical and psychological undesirable consequences, and requires measurement and intervention. This study was conducted with the aim of preparing a Persian version of the 11-item de Jong Gierveld Loneliness Scale and evaluating its psychometric properties among the Iranian older adults. After applying the translation-back translation method, the prepared script was subjected to the face and content validity evaluations and a Persian version of the scale was prepared. Factor analysis, concurrent validity, internal consistency, and test-retest methods were used to validate the scale. The Persian version of the 11-item de Jong Gierveld Loneliness Scale showed acceptable content validity. The negative and significant correlations between the loneliness scores and the Philadelphia Geriatric Center Morale Scale indicated that the questionnaire had acceptable concurrent validity. The results of confirmatory factor analysis confirmed two factors for the scale. Also, the results of the intra-class correlation coefficient and Cronbach's alpha coefficient demonstrated that the scale had acceptable reliability. The Persian version of the 11-item de Jong Gierveld Loneliness Scale is an appropriate tool for measuring loneliness in the Iranian older adults.

Health-Related Quality of Life With Trastuzumab Monotherapy Versus Trastuzumab Plus Standard Chemotherapy as Adjuvant Therapy in Older Patients With HER2-Positive Breast Cancer.

We report findings on quality of life (QoL) in the RESPECT trial, which compared adjuvant trastuzumab monotherapy with trastuzumab plus chemotherapy in older patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC). Patients age 70-80 years with human epidermal growth factor receptor 2-positive surgically treated breast cancer were randomly assigned to receive trastuzumab (T) or trastuzumab plus chemotherapy (T + C). QoL was assessed using the Functional Assessment of Cancer Therapy-General (FACT-G), Philadelphia Geriatric Center Morale Scale, Hospital Anxiety and Depression Scale, Patient Neurotoxicity Questionnaire, and Tokyo Metropolitan Institute of Gerontology Index of Competence at baseline and after 2, 12, and 36 months. Comparisons were based on individual changes from baseline and were performed by Fisher's test or mixed-model repeated-measures. Among 275 patients in the parent study, 231 (84%) (average age: 74 years) were included in the analysis. At 2, 12, and 36 months, 198, 177, and 178 patients completed surveys, and the mean FACT-G scores at each survey point were 78.9, 80.4, 82.7, and 79.1 in group T and 79.5, 74.5, 78.4, and 78.5 in group T + C. Compared with group T + C, the proportion of patients showing QoL deterioration (≥ 5 points decrease from baseline in FACT-G) was significantly lower at 2 months (31% v 48%; P = .016) and 12 months (19% v 38%; P = .009). In group T, the Hospital Anxiety and Depression Scale score (P = .003) and the proportion of severe sensory peripheral neuropathy (P = .001) were significantly lower at 2 months, and Philadelphia Geriatric Center Morale Scale and Tokyo Metropolitan Institute of Gerontology Index of Competence scores were significantly higher (P = .024, .042) at 12 months. At 36 months, there were no significant differences in any QoL items. Detrimental effects of adjuvant chemotherapy on global QoL, morale, and activity capacity lasted for at least 12 months but were not observed at 36 months.