Factors associated with quality of life of people with dementia in long-term care facilities: A systematic review
Section snippets
Background
Dementia affects an increasing number of people each year. It is estimated that in Europe the number of people with dementia will increase to reach 13 million in 2040. This is important because these people are heavy consumers of health care (Ferri et al., 2005). As there is no sign yet of a cure for the syndrome, dementia care should focus on contributing to maximizing quality of life (QoL). Therefore, over the last decade QoL has become a highly important outcome measure in dementia research (
Search strategy
A literature search was performed. Relevant articles published between January 2000 and May 2012 were obtained by searching in five electronic databases: Cochrane, Pubmed, CINAHL, Web of Science, and PsycINFO. Additional articles were searched by exploring references from retrieved publications.
The main outcome measure ‘quality of life’ was used as a search term and combined with the Boolean operator ‘AND’ with other search terms with respect to the disease (dementia OR Alzheimer), the place of
Search results
The electronic database search yielded 2178 publications. After removal of duplicates, 1505 articles remained. Stepwise screening resulted in the inclusion of ten cross-sectional articles and three longitudinal articles, which were all written in English. No additional articles could be obtained via reference tracking. Fig. 1 gives an overview of the selection process from initial search to final retrieved articles.
Methodological quality
Assessments of the publications are shown in Table 1. Eight cross-sectional
Discussion
From the findings of this systematic review it can be concluded that mood, and especially depressive symptoms, is a consistent factor which is negatively related to self-rated QoL of people with dementia living in long-term care facilities, indicating that more depressive symptoms are related to lower QoL. The association between proxy-rated QoL and depressive symptoms is less clear. There are also reasonable indications that behavioural disturbances, and especially agitation, are negatively
Conclusion
This review provides evidence for nurses and other caregivers working in long-term care facilities who aim to improve QoL of people with dementia and shows that attention to depressive symptoms and agitated behaviour should have priority. This could for example be realized in the development and execution of psychosocial interventions, but it is recommended that associations of QoL be further explored. In particular, longitudinal studies are needed in order to determine which factors are
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