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What contributes to a good quality of life in early dementia? awareness and the QoL-AD: a cross-sectional study

BACKGROUND: Self-report quality of life (QoL) measures for people with dementia are widely used as outcome measures in trials of dementia care interventions. Depressed mood, relationship quality and neuropsychiatric symptoms predict scores on these measures, whereas cognitive impairment and function...

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Autores principales: Woods, Robert T, Nelis, Sharon M, Martyr, Anthony, Roberts, Judith, Whitaker, Christopher J, Markova, Ivana, Roth, Ilona, Morris, Robin, Clare, Linda
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4061777/
https://www.ncbi.nlm.nih.gov/pubmed/24919416
http://dx.doi.org/10.1186/1477-7525-12-94
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author Woods, Robert T
Nelis, Sharon M
Martyr, Anthony
Roberts, Judith
Whitaker, Christopher J
Markova, Ivana
Roth, Ilona
Morris, Robin
Clare, Linda
author_facet Woods, Robert T
Nelis, Sharon M
Martyr, Anthony
Roberts, Judith
Whitaker, Christopher J
Markova, Ivana
Roth, Ilona
Morris, Robin
Clare, Linda
author_sort Woods, Robert T
collection PubMed
description BACKGROUND: Self-report quality of life (QoL) measures for people with dementia are widely used as outcome measures in trials of dementia care interventions. Depressed mood, relationship quality and neuropsychiatric symptoms predict scores on these measures, whereas cognitive impairment and functional abilities typically do not. This study examines whether these self-reports are influenced by personality and by the person’s awareness of his/her impairments. A strong negative association between QoL and awareness of deficits would have implications for the validity of self-report in this context and for therapeutic interventions aiming to increase adjustment and coping. METHODS: Participants were 101 individuals with early‒stage dementia and their family carers participating in the Memory Impairment and Dementia Awareness (MIDAS) Study. QoL was assessed using the QoL-AD scale, and awareness was assessed in relation to memory, activities of daily living and social functioning. Self-concept, conscientiousness, quality of relationship and mood were assessed and a brief neuropsychological battery administered. Carers rated their own stress and well-being and reported on neuropsychiatric symptoms. A series of regression analyses predicting QoL-AD were carried out, identifying key variables in each domain of assessment to take forward to an overall model. RESULTS: Cognitive impairment was not related to QoL. The final model accounted for 57% of the variance in QoL-AD scores, with significant contributions from depressed mood, severity of irritability shown by the person with dementia, self-concept, quality of relationship (rated by the person with dementia) and male gender. The bivariate relationships of QoL-AD with awareness of memory function, awareness of functional abilities and conscientiousness were mediated by both depressed mood and self-concept. CONCLUSIONS: This study reports the most comprehensive approach to evaluation of awareness to date. Most of the indices of awareness used are not related to self-reported QoL. Discrepancies in evaluative judgements of memory function and functional abilities between people with dementia and carers are related to QoL, but this relationship is mediated by both depressed mood and self-concept, which have a much stronger relationship with QoL. The validity of self-report measures of QoL in people with early stage dementia is supported by these results.
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spelling pubmed-40617772014-06-19 What contributes to a good quality of life in early dementia? awareness and the QoL-AD: a cross-sectional study Woods, Robert T Nelis, Sharon M Martyr, Anthony Roberts, Judith Whitaker, Christopher J Markova, Ivana Roth, Ilona Morris, Robin Clare, Linda Health Qual Life Outcomes Research BACKGROUND: Self-report quality of life (QoL) measures for people with dementia are widely used as outcome measures in trials of dementia care interventions. Depressed mood, relationship quality and neuropsychiatric symptoms predict scores on these measures, whereas cognitive impairment and functional abilities typically do not. This study examines whether these self-reports are influenced by personality and by the person’s awareness of his/her impairments. A strong negative association between QoL and awareness of deficits would have implications for the validity of self-report in this context and for therapeutic interventions aiming to increase adjustment and coping. METHODS: Participants were 101 individuals with early‒stage dementia and their family carers participating in the Memory Impairment and Dementia Awareness (MIDAS) Study. QoL was assessed using the QoL-AD scale, and awareness was assessed in relation to memory, activities of daily living and social functioning. Self-concept, conscientiousness, quality of relationship and mood were assessed and a brief neuropsychological battery administered. Carers rated their own stress and well-being and reported on neuropsychiatric symptoms. A series of regression analyses predicting QoL-AD were carried out, identifying key variables in each domain of assessment to take forward to an overall model. RESULTS: Cognitive impairment was not related to QoL. The final model accounted for 57% of the variance in QoL-AD scores, with significant contributions from depressed mood, severity of irritability shown by the person with dementia, self-concept, quality of relationship (rated by the person with dementia) and male gender. The bivariate relationships of QoL-AD with awareness of memory function, awareness of functional abilities and conscientiousness were mediated by both depressed mood and self-concept. CONCLUSIONS: This study reports the most comprehensive approach to evaluation of awareness to date. Most of the indices of awareness used are not related to self-reported QoL. Discrepancies in evaluative judgements of memory function and functional abilities between people with dementia and carers are related to QoL, but this relationship is mediated by both depressed mood and self-concept, which have a much stronger relationship with QoL. The validity of self-report measures of QoL in people with early stage dementia is supported by these results. BioMed Central 2014-06-11 /pmc/articles/PMC4061777/ /pubmed/24919416 http://dx.doi.org/10.1186/1477-7525-12-94 Text en Copyright © 2014 Woods et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Woods, Robert T
Nelis, Sharon M
Martyr, Anthony
Roberts, Judith
Whitaker, Christopher J
Markova, Ivana
Roth, Ilona
Morris, Robin
Clare, Linda
What contributes to a good quality of life in early dementia? awareness and the QoL-AD: a cross-sectional study
title What contributes to a good quality of life in early dementia? awareness and the QoL-AD: a cross-sectional study
title_full What contributes to a good quality of life in early dementia? awareness and the QoL-AD: a cross-sectional study
title_fullStr What contributes to a good quality of life in early dementia? awareness and the QoL-AD: a cross-sectional study
title_full_unstemmed What contributes to a good quality of life in early dementia? awareness and the QoL-AD: a cross-sectional study
title_short What contributes to a good quality of life in early dementia? awareness and the QoL-AD: a cross-sectional study
title_sort what contributes to a good quality of life in early dementia? awareness and the qol-ad: a cross-sectional study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4061777/
https://www.ncbi.nlm.nih.gov/pubmed/24919416
http://dx.doi.org/10.1186/1477-7525-12-94
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