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Proxy-rated quality of life in Alzheimer's disease: a three-year longitudinal study

Published online by Cambridge University Press:  28 June 2011

Asmus Vogel*
Affiliation:
Memory Disorders Research Group, Department of Neurology, Neuroscience Centre, Copenhagen University Hospital, Rigshospitalet, Denmark
Suvosree Bhattacharya
Affiliation:
Memory Disorders Research Group, Department of Neurology, Neuroscience Centre, Copenhagen University Hospital, Rigshospitalet, Denmark
Frans B. Waldorff
Affiliation:
Research Unit and Department of General Practice, Institute of Public Health, University of Copenhagen, Denmark
Gunhild Waldemar
Affiliation:
Memory Disorders Research Group, Department of Neurology, Neuroscience Centre, Copenhagen University Hospital, Rigshospitalet, Denmark
*
Correspondence should be addressed to: Asmus Vogel, Memory Disorders Research Group, Department of Neurology, Rigshospitalet, N6702, 9 Blegdamsvej, 2100 Copenhagen, Denmark. Phone: +45 3545 2982; Fax: + 45 3545 2446. Email: asmus.vogel@rh.regionh.dk.

Abstract

Background: The study investigated the change in proxy rated quality of life (QoL) of a large cohort of home living patients with Alzheimer's disease (AD) over a period of 36 months.

Methods: The sample consisted of 102 patients with mild AD and their primary caregivers from the Danish Alzheimer's Disease Intervention Study. QoL was assessed with the proxy-rated (primary caregivers) Quality of Life in Alzheimer Disease scale (QOL-AD) and the EuroQuol Visual Analogue Scale (EQ-VAS) scale. The Cornell Scale for Depression in Dementia (CSDD), Alzheimer's Disease Cooperative Study, Activities of Daily living Inventory (ADCS-ADL), Mini-Mental State Examination (MMSE) and Neuropsychiatric Inventory (NPI-Q) were also applied. Evaluations were conducted at baseline and at 12 and 36 months follow-up.

Results: There was a significant decline in mean QoL assessed by both the QOL-AD and the EQ-VAS (p < 0.001). There were vast individual differences in the QoL scores on both scales at 12 and 36 months’ follow-up. Mean change from baseline in QOL-AD was significantly associated with change in CSDD, ADCS-ADL and MMSE scores at 12 months and with ADCS-ADL score at 36 months.

Conclusion: QoL is a subjective concept and may not be influenced by the degree of cognitive dysfunction. Future studies should investigate the factors for individual variations in order to understand the nature of change of QoL in AD and the wide variation in QoL scores over time.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2011

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References

Alexopoulos, G. S., Abrams, R. C., Young, R. C. and Shamoian, C. A. (1988). Cornell Scale for Depression in Dementia. Biological Psychiatry, 23, 271284.CrossRefGoogle ScholarPubMed
Ankri, J., Beaufils, B., Novella, J.-L., Morrone, I., Guillemin, F., Jolly, D., Ploton, L. and Blanchard, F. (2003). Use of the EQ-5D among patients suffering from dementia. Journal of Clinical Epidemiology, 56, 10551063.CrossRefGoogle ScholarPubMed
Andrieu, S. et al. (2009). Methodological issues in primary prevention trials for neurodegenerative dementia. Journal of Alzheimer's Disease, 16, 235270.CrossRefGoogle ScholarPubMed
Bhattacharya, S., Vogel, A., Hansen, M. L., Waldorff, F. B. and Waldemar, G. (2010). Generic and disease-specific measures of quality of life in patients with mild Alzheimer's disease. Dementia and Geriatric Cognitive Disorders, 30, 327333.CrossRefGoogle ScholarPubMed
Coucill, W., Bryan, S., Bentham, P., Buckley, M. B. and Laight, A. (2001). EQ-5D in Patients With Dementia. Medical Care, 39, 760771.CrossRefGoogle ScholarPubMed
Ettema, T. P., Droes, R. M., de, L. J., Ooms, M. E., Mellenbergh, G. J. and Ribbe, M. W. (2005). The concept of quality of life in dementia in the different stages of the disease. International Psychogeriatrics, 17, 353370.CrossRefGoogle ScholarPubMed
EuroQol (1990). EuroQol: a new facility for the measurement of health-related quality of life. Health Policy, 16, 199208.CrossRefGoogle Scholar
Evans, S. and Huxley, P. (2005). Adaptation, response-shift and quality of life ratings in mentally well and unwell groups. Quality of Life Research, 14, 17191732.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.CrossRefGoogle ScholarPubMed
Galasko, D. et al. (1997). An inventory to assess activities of daily living for clinical trials in Alzheimer's disease. The Alzheimer's Disease Cooperative Study. Alzheimer Disease and Associated Disorders, 11 (Suppl. 2), S33S39.CrossRefGoogle ScholarPubMed
Hoe, J., Hancock, G., Livingston, G., Woods, B., Challis, D. and Orrell, M. (2009). Changes in the quality of life of people with dementia living in care homes. Alzheimer Disease & Associated Disorders, 23, 285290.CrossRefGoogle ScholarPubMed
Jonsson, L. et al. (2006). Patient- and proxy-reported utility in Alzheimer disease using the EuroQoL. Alzheimer Disease and Associated Disorders, 20, 4955.CrossRefGoogle ScholarPubMed
Katona, C., Livingston, G., Cooper, C., Ames, D., Brodaty, H. and Chiu, E. (2007). International Psychogeriatric Association consensus statement on defining and measuring treatment benefits in dementia. International Psychogeriatrics, 19, 345354.CrossRefGoogle ScholarPubMed
Kaufer, D. I. et al. (2000). Validation of the NPI-Q, a brief clinical form of the Neuropsychiatric Inventory. Journal of Neuropsychiatry and Clinical Neuroscience, 12, 233239.CrossRefGoogle ScholarPubMed
Logsdon, R. G., Gibbons, L. E., McCurry, S. M. and Teri, L. (1999). Quality of life in Alzheimer's disease: patients’ and caregiver's reports. Journal of Mental Health and Aging, 5, 2132.Google Scholar
Logsdon, R. G., Gibbons, L. E., McCurry, S. M. and Teri, L. (2002). Assessing quality of life in older adults with cognitive impairment. Psychosomatic Medicine, 64, 510519.CrossRefGoogle ScholarPubMed
Lyketsos, C. G., Gonzales-Salvador, T., Chin, J. J., Baker, A., Black, B. and Rabins, P. (2003). A follow-up study of change in quality of life among persons with dementia residing in a long-term care facility. International Journal of Geriatric Psychiatry, 18, 275281.CrossRefGoogle ScholarPubMed
McKeith, I. G. et al. (1996). Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB): report of the consortium on DLB international workshop. Neurology, 47, 11131124.CrossRefGoogle Scholar
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D. and Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology, 34, 939944.CrossRefGoogle ScholarPubMed
Missotten, P. et al. (2008). Relationship between quality of life and cognitive decline in dementia. Dementia and Geriatric Cognitive Disorders, 25, 564572.CrossRefGoogle ScholarPubMed
Selwood, A., Thorgrimsen, L. and Orrell, M. (2005). Quality of life in dementia–a one-year follow-up study. International Journal of Geriatric Psychiatry, 20, 232237.CrossRefGoogle ScholarPubMed
Spector, A., Woods, B. and Orrell, M. (2008). Cognitive stimulation for the treatment of Alzheimer's disease. Expert Review of Neurotherapeutics, 8, 751757.CrossRefGoogle ScholarPubMed
Waldemar, G. et al. (2011). The Danish Alzheimer intervention study: rationale, study design and baseline characteristics of the cohort. Neuroepidemiology, 36, 5261.CrossRefGoogle ScholarPubMed
World Health Organization (1993). The ICD-10 Classification of Mental and Behavioral Disorders: Diagnostic Criteria for Research. Geneva: World Health Organization.Google Scholar