Abstract
ObjectivesTo identify factors associated with QOL in carers of persons with young-onset Alzheimer’s (AD) and frontotemporal dementia (FTD) and explore development in QOL over a two-year period.MethodsEighty-eight family carers of community-dwelling people with young-onset AD (n = 50) and FTD (n = 38) recruited from Nordic memory clinics. Carer QOL was assessed using the Quality of Life–Alzheimer’s Disease questionnaire. Carer burden was assessed by the Relatives’ Stress scale and depressive symptoms by the Montgomery-Åsberg Depression Rating Scale. Factors associated with QOL in YOD and development in QOL over time were explored with growth mixture model trajectories and mixed model analyses.ResultsWe identified two carer groups of persons with YOD following trajectories with better (n = 53) versus poorer (n = 30) QOL. Carers who reported more burden at baseline had greater odds of belonging to the poorer QOL group (OR 1.1 (1.0–1.2), p = 0.004). Analyses of the development in QOL showed a significant decline in QOL–AD scores among the AD-carers from baseline to two-year follow-up (p = 0.044), while the score remained stable among the FTD-carers. The FTD-carer group had significantly higher mean QOL–AD scores at one- and two-year follow-up (p = 0.022 and 0.045, respectively). However, the difference between the two groups regarding time trend was non-significant. Poorer QOL was associated with increased carer burden (p = 0.01), more depressive symptoms (p = 0.024), and being male carer (p = 0.038).ConclusionHigher care burden, more depressive symptoms, and being a male carer was associated with poorer QOL in family carers for persons with YOD. Carers of persons with AD may experience greater challenges in preserving QOL compared to carers of persons with FTD.
Highlights
The symptom presentation in dementia is primarily determined by the affected brain areas, which causes the characteristic symptom profiles in two common dementia subtypes, Alzheimer’s (AD) and frontotemporal dementia (FTD)
Analyses of the development in quality of life (QOL) showed a significant decline in Quality of Life—Alzheimer’s Disease (QOL–AD) scores among the AD-carers from baseline to two-year follow-up (p = 0.044), while the score remained stable among the FTD-carers
Poorer QOL was associated with increased carer burden (p = 0.01), more depressive symptoms (p = 0.024), and being male carer (p = 0.038)
Summary
The symptom presentation in dementia is primarily determined by the affected brain areas, which causes the characteristic symptom profiles in two common dementia subtypes, Alzheimer’s (AD) and frontotemporal dementia (FTD). Different symptom profiles are likely to have different impact on family carers and possibly affect quality of life (QOL) [1,2,3,4] As both AD and FTD lead to progressive impairment of various brain functions family carers find themselves dedicating increasingly more time and effort to informal care at the expense of other tasks. The repercussions to the individual and their families are greater [7] as care responsibilities may be combined with a working career, childcare, social obligations, and hobbies and interests Balancing these competing tasks whilst maintaining good physical and mental health, and QOL, can be a challenge [8,9,10,11], and failure to do so may result in a sense of entrapment in the caring role
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