Quality of life of people with dementia in residential care homes

Hoe, Juanita; Hancock, G; Livingston, Gill; Orrell, Martin

doi:10.1192/bjp.bp.104.007658

Cited by 242 publications

(273 citation statements)

References 26 publications

(29 reference statements)

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“…(37;38) In our examination of mediators of the patient depression-caregiver depression relationship both impact on patient’s functioning and burden to caregiver were important. While caregiver burden has been previously shown to mediate the relationship between patient objective behavior and caregiver outcomes,(15;17;39) the role of impact on patient functioning in the causal pathway has not been previously explored.…”

Section: Discussionmentioning

confidence: 99%

The Differential Impact of Unique Behavioral and Psychological Symptoms for the Dementia Caregiver: How and Why Do Patients' Individual Symptom Clusters Impact Caregiver Depressive Symptoms?

Ornstein

Gaugler

Devanand

et al. 2013

The American Journal of Geriatric Psychiatry

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Objectives The behavioral and psychological symptoms associated with dementia (BPSD) are highly burdensome to caregivers. While BPSD consist of a wide variety of patient behaviors including depression, physical aggression and paranoid delusions, it remains unclear whether specific symptoms have a differential impact on caregivers. The aims of this study were (1) to assess how individual BPSD symptoms, categorized based on how they may affect caregivers, impact depressive symptoms for dementia patient caregivers and (2) to test the pathways by which BPSD symptom clusters impact caregiver depressive symptoms. Design Cross-sectional analysis of data from a longitudinal study of patients with Alzheimer’s disease and Dementia with Lewy Bodies. Setting Multiple U.S. dementia clinics. Participants 160 patient-caregiver dyads. Methods Using multivariate GEE logistic models, we analyzed the relationship between four BPSD symptom clusters (patient depressive symptoms, accusatory/aggressive behaviors, non-threatening psychotic symptoms, and difficult to manage behaviors) and caregiver depressive symptoms and assessed mediators of these relationships. Results Only the presence of patient depressive symptoms was associated with caregiver depression (OR=1.55; 95% CI=1.14–2.1). This relationship was mediated by both caregiver report of the symptom’s impact on the patient and perceived burden to caregivers. Conclusions Patient depressive symptoms may be the most important driver of the relationship between BPSD and caregiver depression. Research in this field should further test the effects of individual BPSD symptoms and should also consider how symptoms may negatively impact caregivers by increasing burden and evoking empathy for the patient.

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Section: Discussionmentioning

confidence: 99%

The Differential Impact of Unique Behavioral and Psychological Symptoms for the Dementia Caregiver: How and Why Do Patients' Individual Symptom Clusters Impact Caregiver Depressive Symptoms?

Ornstein

Gaugler

Devanand

et al. 2013

The American Journal of Geriatric Psychiatry

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“…Older people, particularly those who have been diagnosed with dementia, have a high prevalence of depressive symptoms (Hoe et al, 2006). Programmes to increase physical activity are a potential intervention that might address this problem.…”

Section: Introductionmentioning

confidence: 99%

A systematic review of the effects of physical activity on physical functioning, quality of life and depression in older people with dementia

Potter

Ellard

Rees

et al. 2011

Int J Geriat Psychiatry

172

131

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Background: Depression is common in older people with dementia. Physical activity is effective in reducing depression in adults but there is limited evidence about its effectiveness in people with dementia. Design and Methods: A systematic review and partial meta-analysis of physical activity interventions in people with dementia is reported. We searched eight databases for English language papers and reference lists of relevant papers. Included studies reported a physical activity intervention lasting at least 12 weeks in which participants were older and had a diagnosis of dementia. Studies compared the intervention with a non-active or a no-intervention control and reported at least one outcome related to physical function, quality of life or depression. At least two authors independently assessed each paper for inclusion and for study quality and extracted data. Results: We included 13 randomised controlled trials with 896 participants. Three of six trials that reported walking as an outcome found an improvement, as did four of the five trials reporting timed get up and go tests. Only one of the four trials that reported depression as an outcome found a positive effect. Both trials that reported quality of life found an improvement. Conclusions: There is some evidence that physical activity interventions improve physical function in older people with dementia. Evidence for an effect on depression and quality of life is limited.

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“…Dette kan blant annet skyldes at pasienter med demens, saerlig av moderat til alvorlig grad, har problemer med abstrakt tenkning, hukommelse og språkforståelse. På grunn av disse problemene er det også vanskelig å vurdere livskvalitet hos denne gruppen (9,26 blant personer med demens (10,16,27), mens andre studier finner at det er en sammenheng (6,11,28). I de ulike studiene ser man en tendens til at det oftere er sammenheng mellom funksjonsnivå og livskvalitet hos personer med demens når en annen enn pasienten gir informasjon.…”

Section: Introduksjonunclassified

Livskvalitet, depressive symptomer og funksjonssvikt hos personer med demens

Mjørud¹,

Engedal²,

Barca³

et al. 2011

Sykepleien

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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 ...

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Quality of life of people with dementia in residential care homes

Cited by 242 publications

References 26 publications

The Differential Impact of Unique Behavioral and Psychological Symptoms for the Dementia Caregiver: How and Why Do Patients' Individual Symptom Clusters Impact Caregiver Depressive Symptoms?

The Differential Impact of Unique Behavioral and Psychological Symptoms for the Dementia Caregiver: How and Why Do Patients' Individual Symptom Clusters Impact Caregiver Depressive Symptoms?

A systematic review of the effects of physical activity on physical functioning, quality of life and depression in older people with dementia

Livskvalitet, depressive symptomer og funksjonssvikt hos personer med demens

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