Dementia Quality Of Life Questionnaire Research Articles

The effect of scalp electroacupuncture combined with Memantine in patients with vascular dementia: A retrospective study.

Currently there is no effective treatment for vascular dementia (VaD). Pharmacological treatment often lead to severe complications and require drug dosage adjustment. This study investigated the effect of scalp electroacupuncture combined with Memantine in VaD. The safety and antioxidative effect of scalp electroacupuncture were also explored.A retrospective study was conducted and data of inpatients of Linyi Central Hospital with VaD between June 2017 and May 2018 were collected and sorted. The patients were divided into scalp electroacupuncture-medication (A), scalp electroacupuncture (B) and medication (control) (C) groups, in which Memantine was prescribed as medication. Cognitive function, activities of daily living and quality of life assessed by Montreal Cognitive Assessment (MoCA), Barthel index and dementia quality of life questionnaire; the contents of superoxide dismutase, lipid peroxide and nitric oxide in blood samples; and adverse reaction were compared.Data from a total of 150 patients were collected (Group A, n = 55; Group B, n = 50; Group C, n = 45). The post-treatment/follow-up Montreal Cognitive Assessment, Barthel index and dementia quality of life questionnaire scores were significantly improved in all groups compared to pre-treatment (groups A and B, P<.01; group C, P<.05). The improvements were significant for groups A vs C, B vs C (P<0.01, both), and group A vs B (P<.05). The post-treatment/follow-up levels of lipid peroxide and nitric oxide decreased significantly while superoxide dismutase increased significantly in groups A and B compared to pre-treatment (P<.01, both). The differences were significant for groups A vs C, and B vs C (P < .01, both), but not significant between groups A and B (P > .05). There were no significant adverse events occurred during the study and follow-up.In combined treatment, scalp electroacupuncture works in parallel with Memantine and significantly increase the therapeutic effect in VaD with no significant adverse events. Scalp electroacupuncture may have the potential to serve as an option or alternative treatment for VaD. Scalp electroacupuncture may alleviate VaD symptoms through its antioxidative mechanism.

154 Specialised Memory and Attention Rehabilitation Therapy (SMART) Programme

Abstract Background The population of Ireland is ageing and the number of people with dementia in the coming years will be significant and could be as high as 132,000 people by 2041 (Pierce et al 2014). This estimated prediction highlighted the importance and value of developing and implementing interventions that will meet the needs of individuals with dementia and their carers in the community. We identified the need for a cognitive rehabilitation programme in an acute hospital and developed the “Specialised Memory and Attention Rehabilitation Therapy (SMART) Programme”. The aim of the programme is to improve quality of life, cognitive ability and performance of meaningful occupations for individuals with dementia in the community. Methods The SMART programme uses an evidence based approach of education, process training, strategy training and function for delivery to individuals with dementia and their carers. It is a seven week programme with a three month follow up appointment. Weeks one, seven and three month follow up are 1:1 assessments where outcome measures are completed. There is a group intervention programme for five weeks which includes a patient booklet with education sheets, strategy, work and homework sheets as well as functional tasks. Results There was statistically significant results pre and post intervention in the Rivermead Behavioural Memory test, Canadian Occupational Performance Measure, Functional Independence Measure and the DEMQoL – Dementia quality of life questionnaire. Overall, the results showed statistically significant improvements in memory function, clinically significant gains in terms of perceived functional performance &amp; satisfaction and objective and significant improvements in functional performance. Conclusion The findings have demonstrated potential to significantly improve participants’ cognitive function and have shown functional significant gains as a result both objectively and subjectively. The findings have also demonstrated the feasibility of successfully implementing a cognitive rehabilitation programme on an outpatient basis in an acute hospital setting.

Psychotropic medications in older people in residential care facilities and associations with quality of life: a cross-sectional study

BackgroundPsychotropic medications have been associated with many adverse outcomes in older people living in residential care. Home-like models of residential care may be preferable to traditional models of care and we hypothesized that this model may impact on the prevalence of psychotropic medications. The objectives were to: 1) examine associations between psychotropic medications and quality of life in older adults living in residential care facilities with a high prevalence of cognitive impairment and dementia and 2) determine if there was a difference in prevalence of psychotropic medications in facilities which provide a small group home-like model of residential care compared to a ‘standard model’ of care.MethodsParticipants included 541 residents from 17 residential aged care facilities in the Investigating Services Provided in the Residential Environment for Dementia (INSPIRED) study. Cross-sectional analyses were completed to examine the above objectives. Quality of life was measured with the dementia quality of life questionnaire (DEMQOL) and the EQ-5D-5L completed by the resident or a proxy.ResultsOverall, 70.8% (n = 380) of the population had been prescribed/dispensed at least one psychotropic medication in the 100 days prior to recruitment. An increased number of psychotropic medications was associated with lower quality of life according to DEMQOL-Proxy-Utility scores (β (SE): − 0.012 (0.006), p = 0.04) and EQ-5D-5L scores (− 0.024 (0.011), p = 0.03) after adjustment for resident-level and facility-level characteristics. Analysis of the individual classes of psychotropic medications showed antipsychotics were associated with lower DEMQOL-Proxy-Utility scores (− 0.030 (0.014), p = 0.03) and benzodiazepines were associated with lower EQ-5D-5L scores (− 0.059 (0.024), p = 0.01). Participants residing in facilities which had a home-like model of residential care were less likely to be prescribed psychotropic medications (OR (95% CI): 0.24 (0.12, 0.46), p < 0.001).ConclusionsAn increased number of psychotropic medications were associated with lower quality of life scores. These medications have many associated adverse effects and the use of these medications should be re-examined when investigating approaches to improve quality of life for older people in residential care. Home-like models of residential care may help to reduce the need for psychotropic medications, but further research is needed to validate these findings.

Associations between the Drug Burden Index, Potentially Inappropriate Medications and Quality of Life in Residential Aged Care.

Inappropriate polypharmacy may negatively impact the quality of life of residents in aged care facilities, but it remains unclear which medications may influence this reduced quality of life. The objective of this study was to examine whether the Drug Burden Index and potentially inappropriate medications were associated with quality of life in older adults living in residential care with a high prevalence of cognitive impairment and dementia. We conducted cross-sectional analyses of 541 individuals recruited from 17 residential aged care facilities in Australia in the Investigating Services Provided in the Residential Environment for Dementia (INSPIRED) study. Quality of life was measured using the EuroQol Five Dimensions Questionnaire (a measure of generic quality of life) and the Dementia Quality of Life Questionnaire completed by the participant or a proxy. In the 100days prior to recruitment, 83.1% of the participants received at least one anticholinergic or sedative medication included in the Drug Burden Index and 73.0% received at least one potentially inappropriate medication according to the Beers Criteria. Multi-level linear models showed there was a significant association between a higher Drug Burden Index and lower quality of life according to the EuroQol Five Dimensions Questionnaire [β (standard error): -0.034 (0.012), p=0.006] after adjustment for potential confounding factors. Increasing numbers of potentially inappropriate medications were also associated with lower EuroQol Five Dimensions Questionnaire scores [-0.030 (0.010), p=0.003] and Dementia Quality of Life Questionnaire-Self-Report-Utility scores [-0.020 (0.009), p=0.029]. Exposure to both Drug Burden Index-associated medications and potentially inappropriate medications was associated with lower Dementia Quality of Life Questionnaire-Self-Report-Utility scores [-0.034 (0.017), p=0.049]. Exposure to anticholinergic and sedative medications and potentially inappropriate medications occurred in over three-quarters of a population of older adults in residential care and was associated with a lower quality of life.

Measurement tools of resource use and quality of life in clinical trials for dementia or cognitive impairment interventions: A systematically conducted narrative review.

Knowledge is limited about the standardised instruments used to collect resource use and quality of life data alongside trials of dementia interventions. This review aimed to identify the trials using such instruments in order to guide the design of future trial-based cost-effectiveness studies. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement, this review examined all original, peer-reviewed research in major databases and general searches published until June 2017, including randomised clinical trials, pilot studies, or feasibility studies about interventions for older adults with dementia or cognitive impairment. Forty-one studies were identified. Only 8 collected the resource use data using adapted Client Service Receipt Inventory (CSRI), Resource Use Inventory (RUI), cost diary, or study-specific questionnaire. Quality of life was assessed using a wide range of instruments. The most frequently used dementia-specific instrument was Quality of Life in Alzheimer's Disease (QOL-AD) and Dementia Quality of Life questionnaire (DEMQOL). Among the generic measures, EuroQol 5-dimentison (EQ-5D) was mostly used to collect health utility data, and Short Form surveys (SF-36 or SF-12) were widely to measure general health. Several useful resource use and quality of life measurement instruments have been identified by this review. For resource use, CSRI was mostly used, but no studies have used Resource Utilisation in Dementia (RUD); for quality of life, we recommend the inclusion of dementia-specific DEMQOL, generic SF-12, and health utility EQ-5D-5L, based on both self-report and proxy-report.

Positive affect and regional cerebral blood flow in Alzheimer's disease

Quality of life (QOL) has been recently recognized as the central purpose of healthcare, and positive affect is one of the core dimension of QOL. However, positive affect among patients with dementia or Alzheimer's disease (AD) has not received much attention in the medical research field. One hundred sixteen consecutive patients with AD were recruited from the outpatient units of the Memory Clinic of Okayama University Hospital. The positive affect score was evaluated using the positive affect domain of the Quality of Life questionnaire for Dementia (QOL-D). Patients underwent brain SPECT with 99mTc-ethylcysteinate dimer. Positive affect scores were inversely related to apathy scores, subjective depressive scores, and delusion scores. After removing the effects of age, sex, duration of education, and cognitive function, positive affect scores showed a significant correlation with regional cerebral blood flow in the left premotor and superior frontal gyri. The left premotor and superior frontal area is significantly involved in the pathogenesis of the decrease of positive affect in AD. Apathy and depression are closely related to the prefrontal area in AD, and they may affect the relationship between positive affect and the left prefrontal area.

Acupuncture for Vascular Dementia: A Pragmatic Randomized Clinical Trial.

In this trial, patients who agreed to random assignment were allocated to a randomized acupuncture group (R-acupuncture group) or control group. Those who declined randomization were assigned to a nonrandomized acupuncture group (NR-acupuncture group). Patients in the R-acupuncture group and NR-acupuncture group received up to 21 acupuncture sessions during a period of 6 weeks plus routine care, while the control group received routine care alone. Cognitive function, activities of daily living, and quality of life were assessed by mini-mental state examination (MMSE), Activities of Daily Living Scale (ADL), and dementia quality of life questionnaire (DEMQOL), respectively. All the data were collected at baseline, after 6-week treatment, and after 4-week follow-up. No significant differences of MMSE scores were observed among the three groups but pooled-acupuncture group had significant higher score than control group. Compared to control group, ADL score significantly decreased in NR-acupuncture group and pooled-acupuncture group. For DEMQOL scores, no significant differences were observed among the three groups, as well as between pooled-acupuncture group and control group. Additional acupuncture to routine care may have beneficial effects on the improvements of cognitive status and activities of daily living but have limited efficacy on health-related quality of life in VaD patients.

Person-centered care and quality of life of patients with dementia in long-term care facilities

Good quality of life (QOL) is an important goal of dementia care. However, there have been few studies on the relationship of care characteristics to QOL of dementia patients in long-term care facilities. We developed a questionnaire evaluating person-centered care and used it to assess person-centered care and QOL of elderly patients with dementia in both geriatric health service facilities (GHSF) and hospitals. In GHSF, person-centered care scores were not correlated with cognitive or activities of daily living (ADL) functions, but were significantly correlated with four subscale scores on a quality of life questionnaire for dementia (QOL-D) after controlling the effect of age, cognitive function, and ADL scores. In contrast, in hospitals, person-centered care scores were significantly correlated with cognitive and ADL function. We found quite different patterns in the relationship of person-centered care scores to clinical characteristics. Dementia care characteristics and QOL of dementia patients are significantly interrelated, especially in GHSF. Improvement of dementia care standards might affect the QOL of dementia patients. We should pay more attention to the quality of dementia care and QOL of dementia patients.

Psychometric properties of a German short version of the patient-rated Dementia Quality of Life Questionnaire (DEMQOL-K)

Psychometric properties of a German short version of the patient-rated Dementia Quality of Life Questionnaire (DEMQOL-K)

Influence of acupuncture on cognitive function and markers of oxidative DNA damage in patients with vascular dementia

ObjectiveTo test the influence of acupuncture on cognitive function and a marker of oxidative DNA damage in patients with vascular dementia (VD). MethodsSixteen VD patients were evaluated before and after acupuncture, using the Folstein Mini-Mental State Examination-Revised (MMSE-R) to assess cognitive function, and the ADL-R scale to assess independence in activities of daily living (ADL). Life quality was evaluated using the DEMQOL (Dementia quality of life questionnaire) questionnaire, and syndromes and expression of vascular dementia were evaluated with the Scale for the Differentiation of Syndromes of Vascular Dementia (SDSVD). In addition, the urine concentration of 8-hydroxy-2′-deoxyguanosine (8-OHdG) —a marker of oxidative damage—was quantified with enzyme-linked immunosorbent assay. ResultsThe MMSE-R and DEMQOL scores were higher after acupuncture than before (P<0.05), while there were no obvious differences in the ADL-R or SDSVD scores (P>0.05). The 8-OHdG content in urine significantly decreased after acupuncture (P<0.05). ConclusionAcupuncture reduces the levels of 8-OHdG and improves cognitive function and quality of life in VD patients, suggesting that acupuncture is beneficial at least in part by preventing oxidative damage.

Assessing quality of life of older people with dementia in long‐term care: a comparison of two self‐report measures

This study sought to compare two well-known and well-used self-report quality of life questionnaires in terms of completion rates, reliability and assessment of quality of life. People with dementia have a meaningful experience of quality of life and several disease-specific instruments have been designed to capture self-report assessments. A quantitative survey design, with a convenience sample of older people with dementia from four long-term care facilities. Sixty-one participants were recruited for survey on the Dementia Quality of Life questionnaire and the Quality of Life in Alzheimer's Disease questionnaire. The Quality of Life in Alzheimer's Disease questionnaire had a higher rate of completion (98·4%) than the Dementia Quality of Life questionnaire (68·9%). Those unable to complete the latter measure had significantly greater cognitive impairment (F(1,59) = 30·35, p < 0·001) than those completing the measure. Internal reliability was good for the Quality of Life in Alzheimer's Disease questionnaire (0·86), but there were varying levels found for the five Dementia Quality of Life questionnaire subscales (0·79-0·48). The Quality of Life in Alzheimer's Disease questionnaire was significantly correlated with all the Dementia Quality of Life questionnaire subscales and overall item. Although it is recognised that there is no superior instrument in assessing quality of life, this study found both the Quality of Life in Alzheimer's Disease questionnaire and Dementia Quality of Life questionnaire to be useful self-report instruments. Assessment of quality of life should include the perspective of the person with dementia. The Quality of Life in Alzheimer's Disease questionnaire and Dementia Quality of Life questionnaire appear to measure similar aspects of quality of life. Where assessments are sought from participants with more advanced cognitive and functional impairment, it may be favourable to employ the Quality of Life in Alzheimer's Disease questionnaire.

The Spanish version of the dementia quality of life questionnaire: A validation study

Background: The aim of the study was to adapt and validate culturally the dementia-specific health-related quality of life instrument (HRQoL) into Spanish for patients with mild to moderate dementia. Methods: Two forward translations, a reconciled version, and then a back translation were completed and subjected to expert review. A total of 112 patients with dementia, diagnosed according to DSM-IV criteria, from six centres providing care for persons with dementia in Spain participated in the study. The following patient-reported information was obtained by interview: demographics, subjective perception of health, depressive symptoms (Geriatric Depression Scale-15; GDS-15), functional ability (Barthel Index), and both generic (World Health Organization Quality of Life; WHOQOL-BREF) and dementia-specific quality of life (DQoL). Results: The Spanish version of the DQoL showed acceptable psychometric properties. Internal consistency (Cronbach's alpha) was acceptable for most of the DQoL scales. As expected, associations were found between DQoL scales and the WHOQOL-BREF psychological domain and the GDS-15, indicating good validity. Neither functional status nor severity of dementia was associated with QoL; but depressive symptoms and self-reported feeling ill had a negative association on QoL. Conclusions: The results showed that the Spanish version of the DQoL has comparable psychometric properties to the US version. The DQoL appears to be a reliable and valid instrument intended to be administered to patients with mild/moderate dementia who are living at home.

Is the Screening Test of the French Version of the Dementia Quality of Life Questionnaire Indispensable

The aim of this study was to evaluate the usefulness of the screening questions in the French version of the Dementia Quality of Life (DQoL) questionnaire. To assess the psychometric properties of the French DQoL, 155 patients with mild-to-moderate dementia were recruited. Here, we compared the psychometric properties of the instrument between patients who passed the screening test (n = 109) and the whole study population (n = 155). The French DQoL version showed a good test-retest reliability at a 2-week interval (0.95 ≤ intraclass correlation coefficients ≤ 1.0), and an average internal consistency (0.58 ≤ Cronbach’s α ≤ 0.87) for the 2 study groups. Significant differences were observed in the 2 groups for 4 dimensions of the DQoL regarding dementia severity (Cornell scale), and for 3 dimensions evaluating depression (MMSE). Convergent validity with the Duke Health Profile revealed many significant correlations between dimensions not only in the 109 patients, but also in the whole study population. Our study demonstrated that patients who failed the screening procedure nonetheless seemed to be able to answer the DQoL questionnaire, the whole study group showing acceptable psychometric properties.

Pain and Quality of Life Among Residents of Norwegian Nursing Homes

Pain is a major problem in the nursing home population, with a prevalence range of 27% to 84%. Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage ( International Association for the Study of Pain, 2008). It has an impact on many aspects of a person's emotional, social, and physical functioning, and on quality of life (QoL) The purpose of this study was to describe pain and QoL in a nursing home population that could self-report pain and to examine the association between QoL and pain in these patients. Pain was measured by a verbal rating scale from “no pain” to “severe pain.” Quality of life was measured by the Dementia Quality of Life Questionnaire (DQoL) consisting of five domains: self-esteem, positive affect/humor, feeling of belonging, and sense of esthetics and negative affect. Totally, 106 patients, with a mean age of 86 years (SD 6.5, range 65-102) with a Mini Mental State Examination (MMSE) score >11 were included, and 87% had mild or moderate reduced cognitive function. In total, 55% reported pain, and out of those, 55% reported mild, 29% moderate, and 16% severe pain. A significant association was found between scores on the negative affect domain and reported pain ( t = 3.17; p < .01) and pain intensity ( r = 0.40; p < .01). No significant associations were found between the other domains and pain. This study shows that pain has a negative effect on mood. Examining the relationship between pain and negative feelings in persons with reduced cognitive function may suggest new areas of intervention for reducing pain and negative feelings in this patient population.

Association Between Quality of Life of Demented Patients and Professional Knowledge of Care Workers

Professional knowledge about dementia and care methods is necessary for the appropriate care of demented people. In this study, the quality of life of 91 demented people staying at 12 care institutions was evaluated with the Quality of Life Questionnaire for Dementia (QOL-D). The amount of professional knowledge was evaluated in 140 staff members who took care of the patients using the professional knowledge test (PKT), and the mean PKT score was calculated for each institution (professional knowledge of institution). A positive significant correlation was observed between the QOL-D score and the professional knowledge of institution. The correlation remained significant when age, sex, and severity of dementia of demented patients were partialled out. This result indicated that the quality of life of demented people was better at institutions with staff members having more professional knowledge, indicating the importance of education of staff members and the possibility that such education improves the quality of life of the demented people.

Study on factors associated with changes in quality of life of demented elderly persons in group homes

The purpose of the present study was to attempt to identify changes in quality of life (QOL) and factors associated with them shortly after demented elderly residents entered a group home. The subjects were 25 demented elderly persons who had entered a group home within the previous 3 months. Their QOL and factors associated with it were evaluated on two occasions, at baseline and 3 months later. An objective scale for dementia, the Quality of Life Questionnaire for Dementia (QOL-D), was used to evaluate their QOL. The results showed a significant change between the QOL-D scores at baseline and 3 months later, and changes in housekeeping item scores were extracted as factors associated with changes in QOL-D. These findings suggest that the QOL score rises soon after entering a group home, and that the acquisition of roles within the group home may influence the increase in QOL.

Development and evaluation of a health-related quality of life questionnaire for the elderly with dementia in Japan.

The purpose of this study was the development of the quality of life (QOL) questionnaire for dementia (QOL-D) in Japan. We performed a questionnaire survey of QOL assessment in elderly patients with dementia in Japan, and developed QOL-D. The final version consists of only 31 items grouped into six response sets, each with its own scale. Reliability is good to excellent, and validity is, to some extent, established. The six domains of health-related QOL are divided into two groups. One is the positive and the other is the negative aspects of health-related QOL. The positive aspects have been shown to correlate positively with cognitive function and activities of daily living (ADL) score, whereas the negative aspects have not. The concept of QOL for elderly patients with dementia in Japan is similar to that in Western countries. We demonstrated that QOL-D is a reliable and valid instrument for QOL assessment in elderly patients with dementia in Japan.