Quality of Life of Older People with Dementia

Abstract

As a result of an aging population and an increase in life expectancy, de-mentia is now a serious problem in public health. In elderly populations, this is a syndrome often caused by neurodegenerative diseases that currently lack curative treatment. Dementia has an enormous impact on patients, their families, and society. In a disease management model with no curative treatments, only a care program can be provided to fully treat people with dementia, considering improvement or, at least, maintenance of their quality of life (QoL) a priority of care. Therefore, determining the standard of QoL in a patient and monitoring this over time requires the use of instruments to measure this construct. In line with the biopsychosocial models of medicine and patient-centered care, there is a theoretical and practical interest in including patient-reported outcomes, such as QoL, into patient care. In dementia, QoL has intrinsic importance due to the type of information it provides, the complexity of progression in dementia, and the difficulty of evaluating aspects closely related to neuropsychological changes in patients. The concept of QoL is complex, multidimensional, and includes both objective and subjective aspects. The theoretical models of QoL in dementia include components that are different from those of the general population, requiring specific instruments to measure and monitoring this construct in subjects who experience problems of under-standing, communication, insight, and interpretation. The objective of this chapter is to revise the concept, determinants and instruments of QoL in dementia. A narrative review was performed. This chapter summarizes the theoretical evidence concerning QoL of patients with dementia and attempts to identify its significant predictors. A search of the literature was conducted using electronic databases (Medline, EMBASE, Web of Science) using the search terms “quality of life”, “dementia” and “older people”. Different conceptual models of quality of life in dementia, determinants and instruments of QoL were found by severity level of dementia.