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Predictors of quality of life ratings for persons with dementia simultaneously reported by patients and their caregivers: the Cache County (Utah) Study

Published online by Cambridge University Press:  14 March 2012

Trevor Buckley
Affiliation:
Center for Epidemiologic Studies, Utah State University, Logan, Utah, USA
Elizabeth B. Fauth
Affiliation:
Center for Epidemiologic Studies, Utah State University, Logan, Utah, USA Department of Family, Consumer and Human Development, Utah State University, Logan, Utah, USA
Ann Morrison
Affiliation:
Department of Psychiatry, Johns Hopkins Bayview and School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
JoAnn Tschanz
Affiliation:
Center for Epidemiologic Studies, Utah State University, Logan, Utah, USA Department of Psychology, Utah State University, Logan, Utah, USA
Peter V. Rabins
Affiliation:
Department of Psychiatry, Johns Hopkins Bayview and School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
Kathleen W. Piercy
Affiliation:
Center for Epidemiologic Studies, Utah State University, Logan, Utah, USA Department of Family, Consumer and Human Development, Utah State University, Logan, Utah, USA
Maria Norton
Affiliation:
Center for Epidemiologic Studies, Utah State University, Logan, Utah, USA Department of Family, Consumer and Human Development, Utah State University, Logan, Utah, USA Department of Psychology, Utah State University, Logan, Utah, USA
Constantine G. Lyketsos
Affiliation:
Department of Psychiatry, Johns Hopkins Bayview and School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
Corresponding
E-mail address:

Abstract

Background: Quality of life (QOL) is frequently assessed in persons with dementia (PWD) through self- and/or proxy-report. Determinants of QOL ratings are multidimensional and may differ between patients and caregiver proxies. This study compared self- and proxy-reported QOL ratings in a population-based study of PWD and their caregivers, and examined the extent to which discrepancies in reports were associated with characteristics of the PWD.

Methods: The sample consisted of 246 patient/caregiver dyads from the initial visit of the Cache County Dementia Progression Study, with both members of the dyad rating PWD QOL. PWD age, gender, cognitive impairment (Mini-Mental State Examination), neuropsychiatric symptoms (Neuropsychiatric Inventory; NPI), dementia severity (Clinical Dementia Rating), medical comorbidities (General Medical Health Rating), and functional impairment (Dementia Severity Rating Scale) were examined as correlates of self- and proxy-reported QOL ratings and the differences between the QOL reports.

Results: Self- and proxy-reported PWD QOL ratings were only modestly correlated. Medical comorbidity was associated with self-report whereas NPI was associated with proxy-report. Dementia severity was associated with discrepancies in self- and proxy-report, with worse patient cognition associated with poorer proxy-reported QOL ratings.

Conclusions: PWD self- and proxy-reported QOL ratings are associated with different variables. Discrepancies between PWD and caregiver perceptions of PWD QOL should be recognized, particularly in cases of more severe dementia.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2012

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