ABSTRACT
Background
Quality of life (QOL) in elderly individuals with severe mental illness (SMI) is understudied, despite the growing size of this vulnerable population. While psychiatric symptomatology has been frequently examined, the role of treatment adherence and treatment characteristics in determining QOL remains unclear.
Aim
This study aimed to examine the association between QOL and treatment adherence, treatment characteristics and psychiatric symptomatology in the elderly with SMI living in the community.
Method
Sixty-eight community-dwelling patients aged 60 and over with schizophrenia spectrum disorder or bipolar disorder were recruited from a community mental health centre. QOL was assessed using the World Health Organization Quality of Life Scale Brief Form (WHOQOL-BREF), and treatment adherence was assessed using the Medication Adherence Rating Scale (MARS). Psychiatric symptomatology and cognitive status of the patients were examined with standardised scales.
Results
Our results indicated that treatment adherence was positively correlated with QOL in the physical health (r = 0.245) and environment (r = 0.303) subdomains of QOL. The association between treatment adherence and environmental QOL was also significant in the multivariable regression models (β = 0.253). While depressive symptoms were consistently associated with poorer QOL across all domains, negative symptoms predicted QOL in physical health (β = −0.552) and environmental (β = −0.297), and positive symptoms with physical health domains (β = −0.345). Although antipsychotic dosage initially correlated with physical QOL (r = −0.360), this association lost significance in the multivariable model.
Conclusion
In the community-dwelling elderly individuals with SMI, treatment adherence and symptom burden, particularly depressive and negative symptoms, emerge as key correlates of QOL. These findings highlight the importance of addressing treatment adherence and symptom management through integrated community-based mental health services to improve the QOL of individuals with SMI.