Quality of Life among Elderly Patients with Dementia in Institutions

• Published in: Dementia and geriatric cognitive disorders Vol. 31; no. 6; pp. 435 - 442
• Main Authors: Barca, Maria L., Engedal, Knut, Laks, Jerson, Selbæk, Geir
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland Karger 01.01.2011; S. Karger AG
• Subjects: Aged; Biological and medical sciences; Cognition; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Dementia; Dementia - complications; Dementia - psychology; Depressive Disorder - complications; Depressive Disorder - psychology; Depressive Disorder, Major - complications; Depressive Disorder, Major - psychology; Diagnostic and Statistical Manual of Mental Disorders; Factor Analysis, Statistical; Female; Hospitalization; Humans; International Classification of Diseases; Linear Models; Male; Medical sciences; Middle Aged; Neurology; Neuropsychological Tests; Norway; Nursing Homes; Original Research Article; Quality of Life - psychology; Vascular diseases and vascular malformations of the nervous system; Norway; Depression; Factor analysis; Correlates; Dementia; Quality of life; Human; Mood disorder; Nervous system diseases; Cognitive disorder; Degenerative disease; Factor analysts; Elderly
• ISSN: 1420-8008; 1421-9824
• DOI: 10.1159/000328969

Aim: To study quality of life among the elderly with dementia in institutions. Methods: Patients above 60 years with dementia, 82 in nursing home and 74 in departments of geriatric psychiatry, were included. They were assessed with the Quality of Life in Late-Stage Dementia (QUALID); the Self-Maintenance scale, Mini Mental State Examination (MMSE) and Clinical Dementia Rating scale. Patient’s age, gender, previous medical and psychiatric history were recorded. Dementia was diagnosed according to ICD-10 criteria for research. Based on information in an interview with the patient and a carer and information in the patient’s record, a geriatric psychiatrist made a diagnosis of major depression according to DSM-IV, if present. Results: The patients’ mean (± SD) age was 82.9 ± 7.7 years, 103 (66%) were women. A factor analysis of the QUALID scale resulted in two factors: ‘discomfort’ and ‘comfort’. Three linear regression analyses were performed. Variables associated with lower quality of life (total QUALID score) were: a diagnosis of major depression (p < 0.001), lower score on MMSE (p = 0.032), impaired function in activities of daily living (p = 0.007) and female gender (p = 0.046). Variables associated with the ‘discomfort’ subscale score were: major depression (p < 0.001), lower score on MMSE (p = 0.006) and living in a department of geriatric psychiatry (p = 0.041). The ‘comfort’ subscale score was associated with impaired function in activities of daily living (p < 0.001). Explained variance for the three models was 34, 33 and 23%, respectively. Conclusion: Quality of life is diminished among elderly patients in institutions and the most marked correlates were a diagnosis of major depression, worse performance in activities of daily living and worse cognitive function.