Assessing quality of life of nursing home residents with dementia: feasibility and limitations in patients with severe cognitive impairment

Crespo, María; Hornillos, Carlos; Gómez, M. Mar

doi:10.1017/s1041610213000823

Cited by 20 publications

(15 citation statements)

References 26 publications

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“…The differences in the rating of QOL between self-report and proxy report generally depend on variables such as depressive symptoms and severity of dementia and should be recognized [55,61,62,63,64]. The QUALIDEM was developed to measure QOL in persons with dementia; however, observational instruments always have the possibility of observer bias [65].…”

Section: Discussionmentioning

confidence: 99%

Characteristics Associated with Quality of Life in Long-Term Care Residents with Dementia: A Cross-Sectional Study

Klapwijk

Caljouw

Pieper

et al. 2016

Dement Geriatr Cogn Disord

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Background: To determine which characteristics are associated with quality of life (QOL) in residents with moderate to very severe dementia in long-term care facilities (LTCFs). Material and Methods: This was a cross-sectional analysis of a cluster randomized controlled study in 12 Dutch LTCFs that enrolled 288 residents, with moderate to severe dementia assessed with the Reisberg Global Deterioration Scale (Reisberg GDS) and QOL with the QUALIDEM. Characteristics that were hypothesized to be associated with the six domains of QOL (applicable to very severe dementia) included demographic variables, activities of daily living (Katz ADL), cognitive performance (Cognitive Performance Scale; CPS), pain (Pain Assessment Checklist for Seniors with Limited Ability to Communicate; PACSLAC-D), neuropsychiatric symptoms (Neuropsychiatric Inventory-Nursing Home Version; NPI-NH) and comorbidities. Results: Multivariate logistic regression modelling showed associations with age in the domain Social isolation [odds ratio, OR, 0.95 (95% confidence interval, CI, 0.91-0.99)], ADL level in the domain Positive affect [OR 0.89 (95% CI 0.83-0.95)] and the domain Social relations [OR 0.87 (95% CI 0.81-0.93)], severity of dementia in the domain Social relations [OR 0.28 (95% CI 0.12-0.62)] and in the domain Social isolation [OR 2.10 (95% CI 1.17-3.78)], psychiatric disorders in the domain Positive affect [OR 0.39 (95% CI 0.17-0.87)] and pulmonary diseases in the domain Negative affect [OR 0.14 (95% CI 0.03-0.61)] of the QUALIDEM. Neuropsychiatric symptoms were independently associated with all six domains of the QUALIDEM [OR 0.93 (95% CI 0.90-0.96) to OR 0.97 (95% CI 0.95-0.99)]. Pain was associated with the domains Care relationship [OR 0.92 (95% CI 0.84-1.00)] and Negative affect [OR 0.92 (95% CI 0.85-1.00)]. Conclusion: QOL in dementia is independently associated with age, ADL, dementia severity, pain, psychiatric disorders, pulmonary diseases and neuropsychiatric symptoms. It is possible to detect persons with dementia at risk for a lower QOL. This information is important for developing personalized interventions to improve QOL in persons with dementia in LTCFs.

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Section: Discussionmentioning

confidence: 99%

Characteristics Associated with Quality of Life in Long-Term Care Residents with Dementia: A Cross-Sectional Study

Klapwijk

Caljouw

Pieper

et al. 2016

Dement Geriatr Cogn Disord

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“…Sin embargo, no contar con los datos de este grupo haría que se perdiera información muy importante, especialmente de las personas con demencia más avanzada. Esto hace aún más trascendental la información que puede aportar el cuidador en relación a la persona con demencia 41,42 .…”

Section: Discussionunclassified

Calidad de vida y estado de salud en personas mayores de 60 años con demencia institucionalizadas

Rodríguez‐Blázquez

Martín-García²,

Frades-Payo

et al. 2015

Rev. Esp. Salud Publica

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“…Due to cognitive impairment, many persons with AD may be unable to complete HRQoL scales, especially as the disease progresses and cognitive function worsens [ 6 , 7 ]. Although some persons with AD might be capable of answering the question “How do you feel now?” [ 8 ], the verbal or non-verbal responses to this question cannot be converted into health utility scores or QALYs.…”

Section: Introductionmentioning

confidence: 99%

Can the general public use vignettes to discriminate between Alzheimer’s disease health states?

et al. 2016

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BackgroundValid estimates of health-related quality-of-life (HRQoL) are often difficult to obtain from persons with Alzheimer’s disease (AD) and family caregiver proxies. To help assess whether the general public can serve as an alternate source of proxy HRQoL estimates in AD, we examined whether the general public can use vignettes to discriminate between AD health states.MethodsWe administered a telephone survey to randomly recruited participants from the general public who were aged 18 years or older. Interviewers read vignettes describing the mild, moderate, and severe AD health states to the participants, who answered the EQ-5D-5L and Quality of Life-Alzheimer’s Disease (QoL-AD) scales as if they had AD based on the vignette descriptions. Participants also answered the EQ-5D-5L for their current health states. We converted EQ-5D-5L responses into health utility scores using Canadian preference weights. We employed the Wilcoxon signed rank test to examine whether mean health utility scores and mean QoL-AD scores differed between health states. We used Pearson’s r to assess correlations between health utility and QoL-AD scores.ResultsForty-eight participants (median age = 53 years; 25 female) completed the telephone interview; health utility and QoL-AD scores decreased as AD severity increased (p <0.0001). Mean health utility scores were 0.65 (mild), 0.51 (moderate), and 0.25 (severe). Mean QoL-AD scores were 26.7 (mild), 23.0 (moderate), and 17.4 (severe). The correlations between health utility and QoL-AD scores were moderate to strong (r ≥ 0.62).ConclusionsUsing the vignettes, the general public provided HRQoL estimates that discriminated between the three AD health states. This finding suggests the general public may be a promising source of proxy HRQoL estimates in place of persons with AD.Electronic supplementary materialThe online version of this article (doi:10.1186/s12877-016-0207-4) contains supplementary material, which is available to authorized users.

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Assessing quality of life of nursing home residents with dementia: feasibility and limitations in patients with severe cognitive impairment

Cited by 20 publications

References 26 publications

Characteristics Associated with Quality of Life in Long-Term Care Residents with Dementia: A Cross-Sectional Study

Characteristics Associated with Quality of Life in Long-Term Care Residents with Dementia: A Cross-Sectional Study

Calidad de vida y estado de salud en personas mayores de 60 años con demencia institucionalizadas

Can the general public use vignettes to discriminate between Alzheimer’s disease health states?

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