Anxiety, depression, and health-related quality of life in aging people living with HIV compared to diabetes patients and patients with minor health conditions: a longitudinal study

Abstract

HIV infection has evolved from a fatal to a treatable condition, leading to an increase in the rate of elderly People Living with HIV (PLWH). However, little is known about the psychosocial burden of elderly PLWH. Thus, the aim of this longitudinal multi-center cohort study was to investigate whether elderly PLWH experience more anxiety and depression and reduced health related quality of life (HRQOL) compared to elderly patients with other chronic conditions. PLWH were compared to diabetes patients (DM) and patients with minor health conditions (MHC), e.g. patients with hypertension or allergic conditions. All patients were over 50 years old. Anxiety and depression (HADS) as well as HRQOL (SF-36) were assessed at baseline and after 12 months. 218 PLWH, 249 DM and 254 MHC were included. At baseline, the study groups did not differ in anxiety, depression, and physical HRQOL. However, PLWH indicated lower mental HRQOL than DM and MHC patients (p = 0.001). We did not obtain any moderating effects showing a differential effect of patient characteristics on anxiety, depression, and HRQOL in the three patient groups. At follow-up, the level of anxiety, depression, and HRQOL did not change significantly. The prevalence of anxiety ranged between 27 and 35%, and that of depression between 17 and 28%. Thus, the results of our investigation tentatively suggest that the psychosocial adaptation to HIV among elderly PLWH resembles those of other chronic diseases. There may be some subtle impairments, though, as PLWH experienced lower mental HRQOL.

Keywords:

• HIV
• chronic disease
• aging
• anxiety
• depression
• quality of life

Acknowledgements

The study has been initiated and conducted by the German Association of Physicians Specialized in HIV Care (Deutsche Arbeitsgemeinschaft Niedergelassener Ärzte für die Versorgung HIV-Infizierter, ‘dagnae e.V.’, Berlin). The following centers and medical practices in Germany participated in the recruiting process: Dr Robert Baumann, Neuss; Dr Axel Baumgarten, Berlin; Dr Jürgen Brust, Mannheim; Dr Heiner Busch & Dr Stefan Christensen, Münster; Dr Ralf Denger, Friedrichsthal; Dr Albrecht Dix, Konstanz; Dr Georg Friese, Giessen; Dr Peter Hartmann & Dr Rüdiger Gippert, Münster; Dr Beatrice Gospodinov, Saarbrücken; Dr Annette Haberl, Frankfurt/Main; Dr Volker Hanhoff, Geilenkirchen; Dr Gerd Klausen & Dr Bettina Hintsche, Berlin; PD Dr Christian Hoffmann, Hamburg; Dr Hans Jaeger, Munich; Dr Martin Karwat, Munich; Dr Gaby Knecht, Frankfurt/Main; Dr Siegfried Köppe, Berlin; Dr Birger Kuhlmann, Hannover; Dr Elke Lauenroth-Mai, Berlin; Dr Sabine Mauruschat, Wuppertal; Dr Christoph Mayr & Dr Wolfgang Schmid, Berlin; Dr Anja Meurer, Munich; Dr Franz A. Mosthaf, Karlsruhe; Dr Ramona Pauli, Munich; Prof. Dr Andreas Plettenberg, Hamburg; Dr Michael Rausch & Dr Matthias Freiwald, Berlin; Dr Martin Reith, Duesseldorf; Dr Burkhard Schappert, Mainz; Dr Frank Schlote, Berlin; Dr Stefan Schölzel, Troisdorf; Dr Dietmar Schranz, Berlin; Dr Christoph Schuler, Berlin; Dr Manfred Stündel, Berlin; Dr Albrecht Ulmer, Stuttgart; Dr Susanne Usadel, Freiburg; Dr Thomas Wünsche, Berlin; Dr Reinhard Zebhauser, Munich. We would like to thank the doctoral students Franzika Häusler, Thomas Kohl and Miriam Lindner for their valuable contribution to this work.