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Predictors of self- and caregiver-rated quality of life for people with dementia living in the community and in nursing homes in northern Taiwan

Published online by Cambridge University Press:  03 December 2014

Hsiu-Li Huang ,
Li-Chueh Weng ,
Yu-Hsia Tsai ,
Yi-Chen (Yulanda) Chiu ,
Kang-Hua Chen ,
Chin-Chang Huang ,
John Sai-Hung Tang  and
Woan-Shyuan Wang
Hsiu-Li Huang*
Affiliation:
School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan Healthy Aging Research Center, Chang Gung University, Tao-Yuan, Taiwan
Li-Chueh Weng
Affiliation:
School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
Yu-Hsia Tsai
Affiliation:
School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
Yi-Chen (Yulanda) Chiu
Affiliation:
School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan Healthy Aging Research Center, Chang Gung University, Tao-Yuan, Taiwan
Kang-Hua Chen
Affiliation:
School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
Chin-Chang Huang
Affiliation:
Department of Neurology, Chang Gung Memorial Hospital, No. 199, Tun-Hwa North Road, Taipei, 10547Taiwan School of Medicine, Chang Gung University, Tao-Yuan, Taiwan
John Sai-Hung Tang
Affiliation:
Cardinal Tien Hospital, No.362, Chung Cheng Rd., Hsintien Taipei Hsien 23137, Taiwan
Woan-Shyuan Wang
Affiliation:
School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
*
Correspondence should be addressed to: Hsiu-Li Huang, No. 259, Wen-Hwa 1st Road, Kwei-Shen, Taoyuan 33302, Taiwan. Phone: +886-3-2118800; ext. 5183; Fax: +886-3-2118800-5326. Email: hsiuli@mail.cgu.edu.tw.
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Abstract

Background:

Factors affecting quality of life (QOL) ratings for people with dementia (PWD) have been well studied, but few studies have examined the effect of residence on PWD- and caregiver-rated QOL for PWDs. We designed this study to determine the factors related to PWD- and caregiver-rated QOL in dementia as well as factors related to the discrepancy in these ratings.

Methods:

For this cross-sectional study, we analyzed data from a convenience sample of 106 PWD-family caregiver dyads (58 community-dwelling dyads and 48 nursing-home dyads). PWDs’ data included socio-demographic variables, QOL (assessed by the Quality of Life-Alzheimer's Disease [QOL-AD] scale), cognition, dementia severity, depression, comorbidities, and quality of the dyadic relationship. Caregivers’ data included socio-demographic variables, depressive symptoms, and mutuality of the dyadic relationship.

Results:

QOL-AD scores were lower when rated by caregivers than by PWDs. The key factors positively related to both PWD- and caregiver-rated QOL for PWDs were fewer PWD depressive symptoms and higher quality of the PWD-caregiver relationship. The key factors related to the discrepancy in PWD- and caregiver-rated QOL in dementia were PWD residence in a nursing home and lower dementia severity, as well as higher caregiver depression, being an adult child caregiver, and lower caregiver-PWD mutuality.

Conclusion:

Caregiver-rated QOL for PWDs and the discrepancy in rated QOL were significantly associated with PWD residence. If caregiver-rated QOL is needed, the effect of residence of PWD should be taken into consideration. Caregivers’ depressive status and mutuality with PWD must be also carefully assessed.

Keywords

dementiacarersquality of lifedepression
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Issue 5 , May 2015 , pp. 825 - 836
Copyright
Copyright © International Psychogeriatric Association 2014 

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References

Abrahamson, K., Lewis, T., Perkins, A., Clark, D., Nazir, A. and Arling, G. (2013). The Influence of cognitive impairment, special care unit placement, and nursing facility characteristics on resident quality of life. Journal of Aging & Health, 25, 574–588. doi: 10.1177/0898264313480240.Google Scholar
Albert, S. M. (2004). The special care unit as a quality-of-life intervention for people with dementia. [comment]. Journal of the American Geriatrics Society, 52, 1214–1215.Google Scholar
Albert, S. M. et al. (1996). Quality of life in patients with Alzheimer's disease as reported by patient proxies. Journal of the American Geriatrics Society, 44, 1342–1347.Google Scholar
Alexopoulos, G. A., Abrams, R. C., Young, R. C. and Shamoian, C. A. (1988). Cornell scale for depression in dementia. Biological Psychiatry, 23, 271–284.Google Scholar
Alzheimer's Disease International (2013). Policy Brief for Heads of Government: the Global Impact of Dementia 2013–2050. Available at: http://www.alz.co.uk/research/GlobalImpactDementia2013.pdf; last accessed 1 October 2014.Google Scholar
Archbold, P. G., Stewart, B. J., Greenlick, M. R. and Harvath, T. A. (1990). Mutuality and preparedness as predictors of caregiver role strain. Research in Nursing & Health, 12, 375–384.CrossRefGoogle Scholar
Arlt, S., Hornung, J., Eichenlaub, M., Jahn, H., Bullinger, M. and Petersen, C. (2008). The patient with dementia, the caregiver and the doctor: cognition, depression and quality of life from three perspectives. International Journal of Geriatric Psychiatry, 23, 604–610.CrossRefGoogle ScholarPubMed
Ball, V. et al. (2010). Quality of relationships as a predictor of psychosocial functioning in patients with dementia. Journal of Geriatric Psychiatry and Neurology, 23, 109–114. DOI:10.1177/0891988710363709.Google Scholar
Beerens, H. C. et al. (2014). Quality of life and quality of care for people with dementia receiving long term institutional care or professional home care: the European RightTimePlaceCare Study. Journal of the American Medical Directors Association, 15, 54–61.Google Scholar
Behuniak, S. M. (2011). The living dead? The construction of people with Alzheimer's disease as zombies. Ageing & Society, 31, 70–92.Google Scholar
Black, B. S., Johnston, D., Morrison, A., Rabins, P. V., Lyketsos, C. G. and Samus, Q. M. (2012). Quality of life of community-residing persons with dementia based on self-rated and caregiver-rated measures. Quality of Life Research, 21, 1379–1389. doi: 10.1007 /s11136-011-0044-z.CrossRefGoogle ScholarPubMed
Bosboom, P. R., Alfonso, H., Eaton, J. and Almeida, O. P. (2012). Quality of life in Alzheimer's disease: different factors associated with complementary ratings by patients and family carers. International Psychogeriatrics, 24, 708–721.Google Scholar
Bruvik, F. K., Ulstein, I. D., Ranhoff, A. H. and Engedal, K. (2012). The quality of life of people with dementia and their family carers. Dementia and Geriatric Cognitive Disorders, 34, 7–14. doi: 10.1159/000341584.Google Scholar
Buckley, T. et al. (2012). Predictors of quality of life ratings for persons with dementia simultaneously reported by patients and their caregivers: the cache county (Utah) study. International Psychogeriatrics, 24, 1094–1102.Google Scholar
Conde-Sala, J. L., Garre-Olmo, J., Turró-Garriga, O., Vilalta-Franch, J. and López-Pousa, S. (2010). Quality of life of patients with Alzheimer's disease: differential perceptions between spouse and adult child caregivers. Dementia and Geriatric Cognitive Disorders, 29, 97–108. doi: 10.1159/000272423.Google Scholar
Conde-Sala, J. L. et al. (2014). Severity of dementia, anosognosia, and in relation to the quality of life of patients with Alzheimer disease: discrepancies between patients and caregivers. American Journal of Geriatric Psychiatry, 22, 138–147. doi: 10.1016/j.jagp.2012.07.001.Google Scholar
Crespo, M., de Quirós, M., Gómez, M. M. and Hornillos, C. (2012). Quality of life of nursing home residents with dementia: a comparison of perspectives of residents, family, and staff. Gerontologist, 52, 56–65.Google Scholar
Faul, F., Erdfelder, E, Lang, A. G. and Buchner, A. (2007). G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39, 175–191.CrossRefGoogle ScholarPubMed
Fleiss, J. L. (1986). Reliability of Measurement: The Design and Analysis of Clinical Experiments. New York, NJ: Wiley.Google Scholar
Giebel, C. M. et al. (2014). Deterioration of basic activities of daily living and their impact on quality of life across different cognitive stages of dementia: a European study. International Psychogeriatrics, 26, 1283–1293.Google Scholar
Hoe, J., Katona, C., Orrell, M. and Livingston, G. (2007). Quality of life in dementia: care recipient and caregiver perceptions of quality of life in dementia: the LASER-AD study. International Journal of Geriatric Psychiatry, 22, 1031–1036.Google Scholar
Hsu, H. C., Lew-Ting, C. Y. and Wu, S. C. (2001). Age, period, and cohort effects on the attitude toward supporting parents in Taiwan. Gerontologist, 41, 742–750.Google Scholar
Huang, H., Yeh, C. M., Tang, J. S., Chiu, Y. and Weng, L. (2009). Determinants of the discrepancy in patient-rated and caregiver-rated quality of life for persons with dementia. Journal of Clinical Nursing, 18, 3107–3117.Google Scholar
Lee, H. C. B. et al. (1993). Chinese elderly and the GDS short form: a preliminary study. Clinical Gerontologist: The Journal of Aging and Mental Health, 14, 37–42.Google Scholar
Lin, J. N. and Wang, J. J. (2008). Psychometric evaluation of the Chinese version of the Cornell Scale for Depression in Dementia. Journal of Nursing Research, 16, 202–210.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, 510–519.Google Scholar
Morris, J. C. (1997). Clinical Dementia Rating: a reliable and valid diagnostic and staging measure for dementia of the Alzheimer type. International Psychogeriatrics, 9, 173–176. doi:10.1017/S1041610297004870.Google Scholar
Moyle, W., Murfield, J. E., Griffiths, S. G. and Venturato, L. (2012). Assessing quality of life of older people with dementia: a comparison of quantitative self-report and proxy accounts. Journal of Advanced Nursing, 68, 2237–2246. doi: 10.1111/j.1365–2648.2011.05912.x.Google Scholar
Ready, R. E., Ott, B. R. and Grace, J. (2006). Insight and cognitive impairment: effects on quality-of-life reports from mild cognitive impairment and Alzheimer's disease patients. American Journal of Alzheimers Disease Other Dementias, 21, 242 –248.Google Scholar
Schiffczyk, C., Romero, B., Jonas, C., Lahmeyer, C., Muller, F. and Riepe, M. W. (2010). Generic quality of life assessment in dementia patients: a prospective cohort study. BMC Neurology, 10, 1–8.Google Scholar
Sheikh, J. I. and Yesavage, J. A. (1986). Geriatric depression scale (GDS): recent evidence and development of a shorter version. Clinical Gerontologist, 5, 165–173.Google Scholar
Shyu, Y. I. and Yip, P. K. (2001). Factor structure and explanatory variables of the Mini-Mental State Examination (MMSE) for elderly persons in Taiwan. Journal of the Formosan Medical Association, 100, 676–683.Google Scholar
Shyu, Y. L., Yang, C., Huang, C., Kuo, H., Chen, S. and Hsu, W. (2010). Influences of mutuality, preparedness, and balance on caregivers of patients with dementia. Journal of Nursing Research, 18, 155–163.Google Scholar
Trigg, R., Watts, S., Jones, R. and Tod, A. (2011). Predictors of quality of life ratings from persons with dementia: the role of insight. International Journal of Geriatric Psychiatry, 26, 83–91.Google Scholar
Vogel, A., Mortensen, E. L., Hasselbalch, S. G., Andersen, B. B. and Waldemar, G. (2006). Patient versus informant reported quality of life in the earliest phases of Alzheimer's disease. International Journal of Geriatric Psychiatry, 21, 1132–1138.Google Scholar
Weintraub, D., Saboe, K. and Stern, M. B. (2007). Effect of age on geriatric depression scale performance in Parkinson's disease. Movement Disorders, 22, 1331–1335.Google Scholar
World Health Organization QOL Group (1995). World Health Organization Quality of Life-100. Geneva, Switzerland: World Health Organization Division of Mental Health.Google Scholar