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Quality of life in Alzheimer's disease: different factors associated with complementary ratings by patients and family carers

Published online by Cambridge University Press:  16 January 2012

Pascalle R. Bosboom ,
Helman Alfonso ,
Joanna Eaton  and
Osvaldo P. Almeida
Pascalle R. Bosboom*
Affiliation:
WA Centre for Health and Ageing, Centre for Medical Research, University of Western Australia, Perth, Australia School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia
Helman Alfonso
Affiliation:
WA Centre for Health and Ageing, Centre for Medical Research, University of Western Australia, Perth, Australia School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia
Joanna Eaton
Affiliation:
WA Centre for Health and Ageing, Centre for Medical Research, University of Western Australia, Perth, Australia School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia
Osvaldo P. Almeida
Affiliation:
WA Centre for Health and Ageing, Centre for Medical Research, University of Western Australia, Perth, Australia School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia Department of Psychiatry, Royal Perth Hospital, Perth, Australia
*
Correspondence should be addressed to: Pascalle R. Bosboom, MA, MAPS, WA Centre for Health and Ageing (M573), University of Western Australia, 35 Stirling Highway, Crawley, Perth, WA 6009, Australia. Phone: +61-8-9224 2855; Fax: +61-8-9224 8009. Email: bosboomp@meddent.uwa.edu.au.
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Abstract

Background: Quality of life (QoL) in dementia is a complex construct and factors that predict QoL ratings are unclear. We designed this study to determine: (1) the agreement in QoL ratings between community-dwelling patients with mild to moderate dementia and family carers; and (2) the factors associated with self-reported and two types of carer-reported QoL ratings: carer–carer perspective and carer–patient perspective.

Methods: A cross-sectional study was carried out of 80 community-dwelling patients with the diagnosis of probable Alzheimer's disease (AD) of mild or moderate severity according to NINCDS-ADRD criteria, and their 80 family carers. The QoL-AD was the primary outcome measure. We collected patients’ self-reported QoL ratings and two types of carer-reported QoL ratings: carer–patient and carer–carer perspectives. Explanatory variables included demographics, lifestyle, and clinical information from patients and carers, along with cognition, awareness, psychopathology, burden-of-care, and functionality in daily life. Bland-Altman plots guided the interpretation of agreement by visualizing the distribution of all the ratings. Univariate and multivariate regression analyses were conducted to examine the contribution of candidate explanatory factors.

Results: Patients and their carers showed good agreement in their QoL ratings, although the total scores of carers (regardless of perspective) were lower than the scores of patients. Depression, insight and use of anti-dementia agents were associated with QoL self-ratings, whereas cognitive function was directly associated and depression inversely associated with carers’ QoL ratings.

Conclusion: Mild to moderate community-dwelling AD patients and their carers (with different perspectives) agree within an acceptable range in QoL ratings but the ratings are driven by different factors, and consequently are not interchangeable but complementary. They provide valuable information when used separately, not in a composite score.

Keywords

Health Related Quality of Life (HR-QoL)Quality of Life-AD (QoL-AD)depressioncognitive functionbehavioral and psychological symptoms of dementiainsightcholinesterase inhibitorsmemantine
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 5 , May 2012 , pp. 708 - 721
Copyright
Copyright © International Psychogeriatric Association 2012

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