A national survey on health-related quality of life for people with dementia in residential long-term care institutions

• Published in: Journal of the Formosan Medical Association Vol. 123; no. 7; pp. 764 - 772
• Main Authors: Huang, Mao-Hsuan, Tsai, Chia-Fen, Lin, Yung-Shuan, Kuo, Yu-Shan, Hsu, Chih-Cheng, Fuh, Jong-Ling
• Format: Journal Article
• Language: English
• Published: Singapore Elsevier B.V 01.07.2024; Elsevier
• Subjects: Activities of Daily Living; Aged; Aged, 80 and over; Cross-Sectional Studies; Dementia; Dementia - psychology; Dependency; Female; Humans; Institution; Long-Term Care; Male; Mental Status and Dementia Tests; Middle Aged; Nursing Homes; Quality of Life; Surveys and Questionnaires; Taiwan; Taiwan; Dependency; Institution; Long-term care; Dementia; Quality of life
• ISSN: 0929-6646; 1876-0821
• DOI: 10.1016/j.jfma.2023.11.012

Health-related quality of life (HRQoL) is an essential outcome parameter in geriatric research; however, the available evidence is mixed regarding the factors associated with HRQoL among people with dementia. We aimed to identify factors that contribute to HRQoL among people with dementia in residential long-term care (LTC) institutions. We randomly selected 299 of 1607 registered residential LTC institutions in Taiwan. A cross-sectional survey was conducted between 2019 and 2020, including items on demographic characteristics, comorbidities, the EuroQol-5 dimensions-5 levels (EQ-5D-5L; utility and visual analog scale [VAS] scores), the Mini-Mental State Examination (MMSE), the Clinical Dementia Rating (CDR), behavioral and psychological symptoms of dementia, activities of daily living (ADL), and instrumental ADL (IADL). In total, 1313 people with dementia from 267 institutions were enrolled (mean age, 76.4 ± 12.7 years). The mean EQ-5D-5L utility and VAS scores were 0.10 (standard deviation [SD] = 0.48) and 66.57 (SD = 20.67), respectively. In multivariate linear regression analysis, higher scores for ADL, IADL, and CDR sum of boxes were associated with higher utility scores. Higher VAS scores were associated with higher ADL and MMSE scores. Lower utility scores and VAS scores were associated with more frequent depressive symptoms. ADL, dementia severity, cognitive function, and depressive symptoms influenced the HRQoL of people with dementia in residential LTC institutions. Longitudinal studies should be conducted to better understand how HRQoL changes over time among people with disabilities. •Activities of daily living, dementia severity, cognitive function, and depressive symptoms influence health-related quality of life (in people with dementia in residential long-term care institutions.•The determinants of two HRQoL measures, the EQ-5D-5L utility and visual analog scale systems, were different.•The findings provide evidence for policymakers to accurately target individuals who are at risk of reduced HRQoL and offer patient-centered care.