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

Bosboom, Pascalle R.; Alfonso, Helman; Eaton, Joanna; Almeida, Osvaldo P.

doi:10.1017/s1041610211002493

Cited by 72 publications

(144 citation statements)

References 56 publications

(123 reference statements)

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“…No clear or consistent associations between QOL and socio-demographic variables including age, education and gender were found (Banerjee et al, 2009). A consistent pattern is found in the literature for lower QOL and high levels of depressive symptoms (Bosboom, Alfonso, Eaton & Almeida, 2012;Logsdon, Gibbons, McCurry, & Teri, 2002) and more dependence in activities of daily living (Black et al, 2012;Conde-Sala, GarreÀOlmo, Turr oÀGarriga, L opezÀPousa, & VilaltaÀFranch, 2009). In general, high levels of behavioral problems are associated with decreased QOL (Banerjee et al, 2009).…”

Section: Difficulties In These Areasmentioning

confidence: 75%

Determinants of quality of life in young onset dementia – results from a European multicenter assessment

Millenaar

Hvidsten

Vugt

et al. 2016

Aging & Mental Health

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Background: Promoting adaptation, improving well-being and maintaining an optimal quality of life (QOL) is an important aspect in dementia care. The purpose of this study was to identify determinants of QOL in young onset dementia, and to assess differences in QoL domains between people with Alzheimer's disease (AD) and frontotemporal dementia (FTD). Methods: In total 135 persons with AD and 58 persons with FTD were included from two prospective cohort studies. QOL was assessed with the proxy reported quality of life in Alzheimer's disease questionnaire (QoL-AD). Possible determinants were explored using multiple linear regression and included sociodemographic variables, diagnosis, dementia severity, disease awareness, neuropsychiatric symptoms, met and unmet needs and hours of personal and instrumental care. Differences between QOL domains in people with AD and FTD were calculated using Mann-Whitney U tests. Results: Lower QOL was associated with more depressive symptoms, lower disease awareness, and a higher amount of needs, both met and unmet. People with AD scored lower on the memory and higher on the friends' subscale. No differences were found for the other items. Conclusion: This study demonstrates a unique set of determinants of QOL in AD and FTD. Interventions directed towards these specific factors may improve QOL.

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Section: Difficulties In These Areasmentioning

confidence: 75%

Determinants of quality of life in young onset dementia – results from a European multicenter assessment

Millenaar

Hvidsten

Vugt

et al. 2016

Aging & Mental Health

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“…The severity of depressive symptoms has shown a strong reverse association both with self-assessed and for proxy-rated QoL in all stages of dementia [Barca et al 2011;Bosboom et al 2012;Hoe et al 2006;Hoe et al 2007;Karttunen et al 2011], although the observation is less consistent in more severe cases [Banerjee et al 2009].…”

Section: Clinical Determinants Of Quality Of Life In Dementiamentioning

confidence: 98%

“…Of note, none of the studies had adopted assessment instruments which are validated in patients with AD; therefore, no clear conclusion can be drawn from them [Takeda et al 2006]. Conversely, some observational studies have reported an independent association between patient-rated QoL, measured with appropriate instruments, and treatment with antidementia agents [Bosboom et al 2012], especially CIs [Hoe et al 2007].…”

Section: Direct Assessmentmentioning

confidence: 99%

Management of patients with Alzheimer’s disease: pharmacological treatment and quality of life

Mossello¹,

Ballini

2012

Therapeutic Advances in Chronic Disease

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Abstract:A methodological approach to quality of life (QoL) assessment in Alzheimer's disease (AD) is challenging and few clinical trials have included it among outcomes, with conflicting results. In this review an indirect appraisal of evidence has been performed, searching the literature for the effect of drug treatments on determinants of QoL in AD. Among clinical factors associated with QoL, possible targets of drugs include cognition, which seems to be associated with QoL in early disease and can be positively affected by cholinesterase inhibitors (CIs) in this stage; functional decline, the risk of which can be decreased by CIs and memantine (MEM); behavioral and psychological symptoms, which can be reduced by MEM and atypical antipsychotics. Long-term observational studies have associated CIs and MEM treatment with a reduced institutionalization risk. According to the evidence, drug treatment of depression associated with AD should not be first choice from a QoL perspective, while treatment of pain can have beneficial effects on wellbeing indicators also in the late stages of the disease. Possible drug-related adverse events can affect QoL and should always be weighed against expected benefits from the patient's perspective. For this reason antipsychotic treatment is often problematic in AD and should be limited to severe psychosis and aggression, using the lowest effective doses for the shortest possible period. Conversely titration of CIs is necessary to reach the most effective dosages, although dose-related risk of adverse events has to be taken into account. Finally, CIs and MEM have been shown to reduce caregiver burden in randomized trials, possibly affecting caregivers' QoL.

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“…2 There is evidence that people with mild to moderate dementia can reliably rate their own QoL. 3 However, there is substantive literature on the differences between selfreported and caregiver-reported QoL in people with dementia (PwD). [4][5][6] These differences have been interpreted as indicative of low level of agreement, 7 disagreement, 8 moderately low correlation, 9 and even high correlation.…”

Section: Introductionmentioning

confidence: 99%

Quality of life in mild dementia: patterns of change in self and caregiver ratings over time

Dourado

Sousa

Santos

et al. 2016

Rev. Bras. Psiquiatr.

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Objectives: To determine changes over time in self and caregiver ratings of quality of life (QoL) in people with dementia (PwD) and to identify factors associated with changes in QoL ratings. Methods: In this longitudinal study, 69 people with mild Alzheimer's disease and their caregivers were assessed at baseline and after 1 year. We examined the association of QoL ratings with the following variables at the two time points: awareness of disease, cognitive status, mood, functionality, neuropsychiatric symptoms, and caregiver burden. Multivariate regression analyses were conducted to examine the contribution of co-factors. Results: At baseline, PwD self-ratings of QoL were associated with caregiver ratings of PwD QoL (p = 0.001). Caregiver ratings were associated with PwD mood (p = 0.001) and self-rated QoL (p = 0.001). After 1 year, caregiver ratings of PwD QoL changed significantly (p = 0.049, d = -0.27), whereas PwD selfratings did not (p = 0.89, d = 0.09). PwD awareness of disease changed significantly (p = 0.001) at 1 year, having declined in 25.4% and improved in 12.3% of participants. PwD QoL self-ratings were associated with caregiver ratings (p = 0.001). Caregiver ratings of PwD QoL after 1 year were associated with PwD mood (p = 0.029), self-reported QoL (p = 0.001), and awareness of disease (p = 0.033). Conclusions:The association between self and caregiver ratings of PwD QoL was maintained over 1 year. The primary factors accounting for the change in caregiver ratings were PwD mood and awareness of disease. QoL and cognitive impairment seem to be relatively independent in mild dementia.

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

Cited by 72 publications

References 56 publications

Determinants of quality of life in young onset dementia – results from a European multicenter assessment

Determinants of quality of life in young onset dementia – results from a European multicenter assessment

Management of patients with Alzheimer’s disease: pharmacological treatment and quality of life

Quality of life in mild dementia: patterns of change in self and caregiver ratings over time

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