The influence of neuropsychiatric and functional changes on quality of life in Alzheimer's disease.

Marcia M.P.C Novelli,Paulo Caramelli

doi:10.1590/s1980-57642010dn40100008

Abstract

To investigate the influence of neuropsychiatric manifestations and functional performance on quality of life (QOL) of AD patients and their caregivers/family members.MethodsThe QOL-AD scale, Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Cornell and Beck Scales for Depression, Physical and Instrumental-Self Maintenance scales (AIDL and ADL) and the Neuropsychiatric Inventory (NPI) were applied to 60 patients with probable AD, mild (n=30) or moderate (n=30) dementia, according to NINCDS-ADRDA and DSM-III-R criteria, respectively, and to their caregivers/family members. The total scores on the three QOL-AD versions were correlated with the measures previously mentioned.ResultsThe QOL-AD patients' version displayed significant correlations with GDS (–0.76 p<0.01), Cornell (–0.53 p<0.01) and NPI (–0.46 p<0.05) in the mild dementia subgroup. The caregivers' version about patients' QOL correlated with GDS (–0.48 p<0.01), Cornell (–0.57 p<0.01), NPI (–0.46 p<0.01) and AIDL (–0.36 p<0.05), while the caregivers' version about their own QOL was significantly correlated with NPI (–0.43 p<0.01), AIDL (–0.35 p<0.05) and Beck Depression (–0.67 p<0.01). In the moderate dementia subgroup, significant correlations were observed with GDS (–0.45 p<0.05) and Cornell (–0.46 p<0.01). For the caregivers' version about patients' QOL, significant correlations emerged with Cornell (–0.68 p<0.01), NPI (–0.67 p<0.01), AIDL (–0.41 p<0.05), ADL (–0.49, p<0.01) and Beck Depression (–0.33 p<0.05). For the caregivers' version about their own QOL, significant correlations with Beck Depression (–0.54 p<0.01) and ADL (–0.38, p<0.05) were found.ConclusionThe symptoms presented in AD affected the QOL in patients and caregivers/family members in both mild and moderate dementia.

Highlights

One way to minimize the influence of anosognosia on quality of life (QOL) in evaluations is to consider the proxy report as an additional source of information
Family members who had a minimum of 24 hours weekly contact time with the patient in order to ensure reliability of collected information
In the current study we examined the association between QOL evaluations and different clinical measures, including cognitive functions, IADL and ADL performance, behavioral disturbances and depressive symptoms in both patients and their caregivers

Summary

Introduction

One way to minimize the influence of anosognosia on QOL in evaluations is to consider the proxy report as an additional source of information. Our aim in this study was to evaluate the influence of AD symptoms (mild and moderate dementia) on QOL of patients and their caregivers.

Results

Conclusion