Livskvalitet, depressive symptomer og funksjonssvikt hos personer med demens

Abstract

English summary sammEndrag Quality of life, depressive symptoms and impairment in people with dementiaBackground: It is uncertain whether the association between quality of life, the symptoms of depression and impairment of daily living activities is as strong in people with dementia, as in those without dementia.Objective: To investigate the association between quality of life, the symptoms of depression, impairment of daily living activities and dementia.Methods: Information about 223 nursing home patients with dementia was collected through interviews with the primary caregivers. Quality of life was examined using the Quality of Life in Late Stage Dementia (QUA-LID) scale; symptoms of depression were examined using the Cornell scale; impairment of daily living activities was examined using Lawton's Physical Self-Maintenance Scale (PSMS); and the degree of dementia was examined using the Clinical Dementia Rating scale. Results: Correlation analysisshowed that reduce quality of life was significantly associated with depressive symptoms, functional impairment and dementia. A stepwise linear regression analysis showed that four of Cornell's five sub scales: the mood, behavioural, retardation and cyclic subscales were significantly associated with QUALID. The physical sub scale was not associated with quality of life in the regression analysis because retardation and physical sub scales correlated highly. Impairment of activities of daily living and degree of dementia are significantly associated to reduced quality of life. Conclusion:Quality of life in people with dementia is associated with symptoms of depression, especially the core symptoms of depression and level of impairment of activities of daily living.Key words: quality of life, symptoms of depression, impairment of activities in daily living, dementia.Bakgrunn: Det er usikkert om sammenhengen mellom livskvalitet, depressive symptomer og funksjonssvikt er like sterk hos personer med demens som hos dem uten demens.Hensikt: Å undersøke sammenhengen mellom livskvalitet, depressive symptomer, funksjonssvikt og grad av demens. Metode:Opplysninger om 223 pasienter med demens i sykehjem ble innhentet gjennom intervju av pasientenes primaerpleiere. Livskvalitet ble kartlagt med Quality of life in late stage dementia scale (QUALID), symptomer på depresjon med Cornell skala, funksjonsevne med Lawtons ADL skala og grad av demens med Klinisk demensvurdering.Resultater: Korrelasjonsanalyser viste at livskvalitet var signifikant assosiert til depressive symptomer, grad av demens og tap av funksjonsevne. Spearman's korrelasjon varierte mellom 0,37 og 0,53. En trinnvis lineaer regresjonsanalyse viste at fire av fem subskalaer i Cornell skalaen, affekt-, adferds-, retardasjon -og syklisk subskala var signifikant assosiert med QUALID-skåren. Den fysiske sub skalaen var det ikke fordi sub skalaene retardasjon og fysisk korrelerte sterkt. Tap av funksjonsevne og grad av demens var også signifikant relatert til redusert livskvalitet.Konklusjon: Livskvalitet hos personer med ...

Associations between physical function and depression in nursing home residents with mild and moderate dementia: a cross-sectional study

“…We found no significant associations between ADL function and depression, which is in line with the study of Barca and colleagues 9 and in contrast to other studies. 8 29 However, BI is a proxy-reported measurement and may not be sensitive enough to identify the true abilities of an individual. 30 The readiness of the nursing home staff to assist as well as the institutionalisation of the residents may influence the scores on BI.…”

“…Even though the importance of physical activity for the preservation of function in elderly is well documented, 21–28 the relationship between physical function and depression in nursing home residents with dementia is unclear, and results from studies are ambiguous. Some studies indicate that nursing home residents with good physical function are less depressed than those with low level of physical function, 8 29 while others do not find any significant associations between the two factors. 9 …”

“… 6 The prevalence of depressive disorders among nursing home residents is 10%, while the prevalence of depressive symptoms is 29% on an international level. 2 Depression is frequently occurring in nursing home residents with dementia (43%) 7 and is associated with reduced quality of life, 8 poor medical health and more severe cognitive impairment. 9 WHO defines depression as ‘a mental disorder, characterised by sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, feelings of tiredness and poor concentration.’ 10 Reduced physical function and dependency in old age as well as somatic disorders are the main risk factors for developing depression.…”