Correlates of Quality of Life of Older Adults with Dementia, Alexandria, Egypt

Abstract

Objective(s) : To determine factors associated with quality of life (QoL) of older adults with dementia in Alexandria, Egypt. Methods : A total of 102 dementia patient-caregiver participated in a cross-sectional study at the psychogeriatric outpatient clinic in Almaamora Psychiatric Hospital in Alexandria (2013). Community dwelling older adults (≥ 60 years), and having scores of 10-20 on the Mini Mental State Examination (MMSE), were recruited. They were assessed using Quality of Life-Alzheimer’s Disease (QoL-AD)-combined report, Patient Health Questionnaire-9 (PHQ-9) for depression, and Katz Index for Activities of Daily Living (ADL). Results : The higher scores on the QoL-AD correlated significantly with younger ages of patients (r = –0.270, p < 0.001) and caregivers (r = –0.254, p = 0.01), higher scores on the MMSE (r = 0.208, p = 0.03) and ADL (r = 0.551, p < 0.001), and lower PHQ-9 scores (r = –0.506, p < 0.001). Better QoL associated significantly with adequate monthly income (p = 0.04), AD type of dementia (p = 0.002), absence of co-morbid physical diseases (p < 0.001), and caregivers not living with the patient in same residence (p = 0.02). Regression analysis revealed only two predictors of QoL namely the person's level of independence in ADL, and lower depressive symptoms ( B = 0.644, B = –0.303, respectively, p < 0.001). Conclusion: QoL of patients with moderate dementia was significantly predicted by the severity of depressive symptoms and level of functional dependence. Dementia care plans should include regular screening and early management of depression, as well as patient and caregiver psycho-education to increase patients' functional independency. Keywords: ADL, community dwelling older adults, dementia, depression, QoL-AD.