A comprehensive model of predictors of quality of life in older adults with schizophrenia: results from the CSA study

Soc Psychiatry Psychiatr Epidemiol. 2021 Aug;56(8):1411-1425. doi: 10.1007/s00127-020-01880-2. Epub 2020 May 15.


Background: Numerous factors are known to influence quality of life of adults with schizophrenia. However, little is known regarding the potential predictors of quality of life in the increasing population of older adults with schizophrenia. The main objective of the present study was to propose a comprehensive model of quality of life in this specific population.

Methods: Data were derived from the Cohort of individuals with Schizophrenia Aged 55 years or more (CSA) study, a large (N = 353) multicenter sample of older adults with schizophrenia or schizoaffective disorder recruited from French community mental-health teams. We used structural equation modeling to simultaneously examine the effects of six broad groups of clinical factors previously identified as potential predictors of quality of life in this population, including (1) severity of general psychopathology, (2) severity of depression, (3) severity of cognitive impairment, (4) psychotropic medications, (5) general medical conditions and (6) sociodemographic characteristics.

Results: General psychopathology symptoms, and in particular negative and depressive symptoms, cognitive impairment, reduced overall functioning and low education were significantly and independently associated with diminished quality of life (all p < 0.05). Greater number of medical conditions and greater number of antipsychotics were also independently and negatively associated with quality of life, although these associations did not reach statistical significance in sensitivity analyses, possibly due to limited statistical power.

Conclusion: Several domains are implicated in quality of life among older adults with schizophrenia. Interventions targeting these factors may help improve importantly quality of life of this vulnerable population.

Keywords: Antipsychotics; Cognition; Comprehensive model; Depression; Elderly; Late-life; Older; Quality of life; Schizophrenia; Structural equation modeling; Symptoms.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Antipsychotic Agents* / therapeutic use
  • Cognitive Dysfunction*
  • Humans
  • Psychotic Disorders* / drug therapy
  • Quality of Life
  • Schizophrenia* / drug therapy
  • Schizophrenia* / epidemiology


  • Antipsychotic Agents