Quality of life in patients with Alzheimer's disease as reported by patient proxies.
Quality of life in patients with Alzheimer's disease as reported by patient proxies.
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DOI：
10.1111/j.1532-5415.1996.tb01405.x
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发表时间：
1996-11-01
影响因子：
6.3
通讯作者：
Stern, Y
中科院分区：
文献类型：
--
作者：
Albert, SM;DelCastilloCastaneda, C;Stern, Y
目的：测量阿尔茨海默病患者的生活质量(QOL)行为，并检验患者QOL的相关性。设计：横断面调查。设置：多中心研究。配对：130名确诊患者的样本。主要结果测量：(1)15项可能在痴呆患者能力范围内的非ADL活动的频率、机会和享受，以及(2)一系列积极和负面影响的频率，明显地表现在面部和身体表情上。结果：QOL评分可靠。家庭照顾者和机构照顾者的不同之处只在于患者活动机会的报告。活动频率随着痴呆症严重程度的增加而下降。随着痴呆症严重程度的增加，负性情绪出现频率增加，积极情绪出现频率下降，但相关性较弱。高生活质量，由频繁的活动和积极的情感定义，在四分之一的样本中很明显。在多变量模型中，功能和认知状态独立预测社区居民老年人的生活质量；只有在养老院的老年人中，缺乏抗精神病药物与生活质量有关。患者教育作为病前状态的标志，可独立预测某些活动模式。结论：虽然痴呆患者的主观世界不能直接接触到，但容易观察到的行为为评估生活质量提供了依据。
OBJECTIVE: To measure behaviors indicative of quality of life (QOL) in patients with Alzheimer's disease and to examine correlates of patient QOL.DESIGN: Cross-sectional investigation.SETTING: Multi-center study.PARTICIPANTS: Sample of 130 diagnosed patients.PRINCIPAL OUTCOME MEASURES: Proxy ratings of (1) the frequency, opportunity, and enjoyment of 15 non-ADL activities potentially within the capacity of a demented person, and (2) the frequency of a series of positive and negative affects, evident in clearly demarcated facial and bodily expressions.RESULTS: QOL ratings were reliably elicited. Family and institutional caregivers differed only in reports of opportunity for patient activity. Frequency of activities declined with increasing severity of dementia. The frequency of negative affects increased and positive affects declined with increasing severity of dementia, but correlations were weak. High QOL, defined by frequent activity and positive affect, was evident in a quarter of the sample. In multivariate models, functional and cognitive status independently predicted QOL among community-resident older adults; only absence of antipsychotics was related to QOL among older people in nursing homes. Patient education, a marker of premorbid state, independently predicted some activity patterns.CONCLUSIONS: Although the subjective world of the demented patient is not directly accessible, readily observable behaviors offer a basis for assessing QOL.