Background and aims: to investigate possible clinical determinants of quality of life (QoL) in mild dementia
Methods: 200 dementia outpatients assessed with the Quality of Life-AD (QoL-AD) scale administered to patients and their caregivers and combined into a QoL-AD composite score (QoL-AD CS). Patients were divided into tertiles according to high, intermediate and low QoL levels. Cognitive status was assessed with the Mini Mental State Examination (MMSE) and depressive symptoms with the Geriatric Depression Scale (GDS). Basic (BADL) and instrumental (IADL) activities of daily living scales were used to assess functional domain. The Neuropsychiatric Inventory (NPI) measured neuropsychiatric symptoms.
Results: a strong correlation was found between patient-rated QoL-AD scores and caregiver-rated QoL-AD scores (Pearson correlation coefficient: .353; p = .000). High QoL group patients displayed better functional status in BADL and IADL, had lower comorbidity and number of medications. Insight level and cognition were comparable among the three groups. The group with higher QoL had significantly lower depressive and neuropsychiatric symptoms compared to the intermediate and low QoL groups. On linear regression analysis using the QoL-AD CS as the depended variable, the model including GDS, IADL, number of medications and NPI explains nearly 50% of QoL-CS variance (R2 = .495; adjusted R2 = .485).
Conclusions: QoL in mild dementia is a broad dominion that goes beyond the cognitive impairment itself and is determined by for the presence of depression, impairment in instrumental activities of daily living, behavioural disturbances and number of medications.