Trajectories of quality of life in early-stage dementia: individual variations and predictors of change
Trajectories of quality of life in early-stage dementia: individual variations and predictors of change
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DOI：
10.1002/gps.4044
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发表时间：
2014-06-01
影响因子：
4
通讯作者：
Morris, Robin G.
中科院分区：
文献类型：
--
作者：
Clare, Linda;Woods, Robert T.;Morris, Robin G.
BackgroundLittle evidence is available about how quality of life（QoL）changes as dementia progresses.ObjectivesWe explored QoL trajectories over a 20 month period and examined what predicted change in QoL.Method51 individuals with a diagnosis of Alzheimer's，血管性或混合性痴呆参与记忆障碍和痴呆意识研究的痴呆症患者（PwD）使用QoL-基线和20个月随访时的阿尔茨海默病量表。普华永道还评估了他们的情绪和与照顾者的关系质量。在每种情况下，照顾者评定他或她的压力水平和感知质量的关系与PwD.ResultsThere平均生活质量评分没有变化。近三分之一的PwD在20个月随访时对生活质量的评价更积极，近三分之一的PwD对生活质量的评价更消极。在四分之一的样本中，这些变化可以被视为可靠。基线时服用乙酰胆碱酯酶抑制药物的参与者更有可能显示QoL评分下降。在任何人口统计学或疾病相关变量、情绪或与照顾者关系的感知质量方面，得分增加、减少或保持不变的人之间没有其他显著差异。而基线生活质量评分是最强的预测生活质量在20个月，与照顾者的关系的质量感知的PwD也是独立的显着predictor.ConclusionsThere是一个程度的生活质量轨迹的个体差异。使用乙酰胆碱酯酶抑制药物似乎与生活质量评分下降有关，而与照顾者的积极关系在维持早期痴呆患者的生活质量方面起着重要作用。版权所有（c）2013约翰威利父子有限公司
BackgroundLittle evidence is available about how quality of life (QoL) changes as dementia progresses.ObjectivesWe explored QoL trajectories over a 20-month period and examined what predicted change in QoL.MethodFifty-one individuals with a diagnosis of Alzheimer's, vascular or mixed dementia (people with dementia (PwD)) participating in the Memory Impairment and Dementia Awareness Study rated their QoL using the QoL-Alzheimer's Disease Scale at baseline and at 20-month follow-up. PwD also rated their mood and quality of relationship with the carer. In each case, the carer rated his or her level of stress and perceived quality of relationship with the PwD.ResultsThere was no change in mean QoL score. Nearly one-third of PwD rated QoL more positively at 20-month follow-up and nearly one-third rated QoL more negatively. These changes could be regarded as reliable in one-quarter of the sample. Participants taking acetylcholinesterase-inhibiting medication at baseline were more likely to show a decline in QoL score. There were no other significant differences between those whose scores increased, decreased or stayed the same on any demographic or disease-related variables, or in mood or perceived quality of relationship with the carer. Whereas baseline QoL score was the strongest predictor of QoL at 20 months, the quality of relationship with the carer as perceived by the PwD was also independently a significant predictor.ConclusionsThere is a degree of individual variation in QoL trajectories. Use of acetylcholinesterase-inhibiting medication appears linked to decline in QoL score, whereas positive relationships with carers play an important role in maintaining QoL in early-stage dementia. Copyright (c) 2013 John Wiley & Sons, Ltd.