Dementia subtypes and quality of life in people with mild‐to‐moderate dementia: longitudinal findings from the IDEAL and IDEAL‐2 cohorts over 6 years

Abstract

AbstractBackgroundThe heterogeneity of symptoms across dementia subtypes may influence the capability of people with dementia to ‘live well’. We investigated how quality of life varies across dementia subtypes and over time.MethodWe assessed 1749 individuals with mild‐to‐moderate dementia on entry to the IDEAL or IDEAL‐2 studies and followed them up at 12, 24, 48, 72 and 96 months. We used mixed effects models to examine whether quality of life varied by dementia subtype at the time of diagnosis and how quality of life trajectories changed over time.Result52.4% of participants had a diagnosis of Alzheimer’s disease, 10.2% vascular dementia, and 19.8% mixed Alzheimer’s and vascular dementia. Of the rarer subtypes, 5.7% had frontotemporal dementia, 4.2% had Parkinson’s disease dementia and 5.3% had dementia with Lewy bodies, with 2.4% having other/mixed dementias. The strongest associations between dementia subtype and quality of life were seen at the time of diagnosis. Compared to individuals with Alzheimer’s disease, people with Parkinson’s disease dementia (‐4.89, 95% CI ‐6.60 ‐ ‐3.17) and dementia with Lewy bodies (‐4.90, 95% CI ‐6.38 ‐ ‐3.42) had relatively poor quality of life. People with vascular dementia (‐2.45, 95% CI ‐3.55 ‐ ‐1.35) and mixed Alzheimer’s and vascular dementia (‐1.70, 95% CI ‐2.47 ‐ ‐0.92) had somewhat poorer quality of life, but the difference was less marked. There was no difference between people with Alzheimer’s disease and people with frontotemporal dementia (‐0.39, 95% CI ‐1.73 – 0.95). There was little change in quality of life over time and we found no differences in quality of life trajectories according to dementia subtype.ConclusionAt the time of diagnosis, quality of life already differs according to dementia subtype, and this pattern is maintained over time. People with Parkinsonian dementias in particular may need extra support with the challenges they face.