Quality of life of older adult patients with heart failure with different somatic symptom profiles: The mediating role of depressive symptoms.

Aim: With an increasingly aging population, the management of heart failure (HF) in older adult patients warrants greater attention. This study aimed to identify somatic symptom profiles by using the person-oriented approach, explore the association between somatic symptom profiles and quality of life (QoL) and examine the mediating effect of depressive symptoms on this association among older adult patients with HF.

Methods: This cross-sectional study involved a convenience sample of 445 older adult patients with HF from two tertiary hospitals in China. Patients' somatic symptoms, depressive symptoms and QoL were measured using self-reported questionnaires. Latent profile analysis, linear regression analysis and mediation analysis were used to analyze the data.

Results: Among the 445 patients (71.84 ± 7.61 years, 49.7% women), four somatic symptom profiles were identified: mild symptoms, high dyspnea symptoms, high difficulty sleeping symptoms and severe symptoms. Considering the mild symptoms profile as a reference, the high difficulty sleeping symptoms and severe symptoms profiles were associated with reduced physical and mental QoL (β = -0.277 to -0.179, all P < 0.001), whereas the high dyspnea symptoms profile was associated with reduced mental QoL (β = -0.105, P = 0.041). Furthermore, both the high difficulty sleeping symptoms and severe symptoms profiles had significantly indirect effects on physical and mental QoL through depressive symptoms.

Conclusions: Our findings showed that older adult patients with different HF somatic symptom profiles experience varying levels of QoL. Tailored interventions that facilitate somatic symptom management and alleviate depressive symptoms might improve older adult patients' physical and mental QoL. Geriatr Gerontol Int 2025; ••: ••-••.