CORE--QUALITY OF LIFE

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While the Quality of Life/Health Services Research (QOL) Laboratory shares the overall CRC's concern with associations among physical health problems, their functional manifestations, and depression, the QOL Lab is unique in examining these associations within the larger psychosocial context in which they are embedded. The laboratory focuses largely on "everyday" affective, social and behavioral processes in terms of how they affect and are affected by chronic medical and psychiatric disorders. The QOL Lab seeks to elucidate the dynamic of these relationships by examining their temporal variability, over both the longer durations of most longitudinal research and also shorter (weekly, daily, and even within- day) time periods. The overarching goals of the QOL Laboratory are: (I) to stimulate research on interrelationships among physical and mental health, functional disability, and affective and psychosocial processes in late life; (2) to investigate the manifestations of mental and physical health problems and their effects upon the daily lives of older adults; (3) to examine how transactions with the health care delivery system affect and are affected by mental health and quality of life of frail elderly persons, and (4) to develop and refine methods and models that are best suited to the study of these issues. These broad aims will be pursued in a series of activities examining quality of life among diverse groups of elderly medical patients. These activities address several specific, short-term objectives: (1) to differentiate events and environmental contexts of chronically ill elders' lives that are associated with several manifestations of positive emotions and negative emotions; (2) to examine intrapersonal and environmental sources of quality of everyday life of chronically ill elders and to determine how these facets of quality of life affect judgments of the worth of continued living; (3) to clarify the roles of illness symptoms and functional disability in the general association between medical illness and depression in diverse elderly medical populations; (4) to develop methods for studying daily and within- day variability in pain, depression and other effects of medical illness as a function of personal and social activities and events, and (5) to examine effects of depression and perceived quality of life upon frail older persons' utilization of health services and consequent medical cost consumption.