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Title: Gender differences in quality of life and depression among older people with coronary heart disease
Author: Zaninotto, P.
Awarding Body: University College London (University of London)
Current Institution: University College London (University of London)
Date of Award: 2012
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This study explored gender differences in quality of life and depressive symptoms over time among people with coronary heart disease (CHD) and compared them with a healthy population. Using three waves of the English Longitudinal Study of Ageing (2002-03, 2004-05 and 2006-07) methodological problems such as missing data and sources of error and uncertainty which may arise from reliance on a self-reported measure of CHD were addressed. A simulation study was set up to compare three techniques for dealing with missing data: full information maximum likelihood, multivariate normal imputation and a two-fold fully conditional specification. Results supported the use of the latter technique which outperformed the other two techniques in recovering the targeted parameters, especially with a binary outcome. Results based on imputed data showed that compared to people from the healthy population, men and women with CHD had on average lower levels of quality of life. Men with CHD were also at higher risk of having depressive symptoms than men from the healthy population. Women with CHD were as likely as women from the healthy population to have depressive symptoms. Trajectories over time of quality of life had a different shape from trajectories of depressive symptoms after the onset of CHD. Men’s quality of life declined over time and no changes in depressive symptoms were found. Women’s quality of life declined only between baseline and four year follow-up, while in the same period their risk of having depressive symptoms reduced. A sensitivity analysis based on an external validation study and a deterministic sensitivity analysis helped understand the impact that misclassification of the self-reported CHD measure could have on the results of this thesis. It was found that the reliability of the results presented could be affected by false positive and false negative cases of CHD.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available