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Martyr A, Gamble LD, Hunt A, Quinn C, Morris RG, Henderson C, Allan L, Opdebeeck C, Charlwood C, Jones RW, Pentecost C, Kopelman MD, Thom JM, Matthews FE, Clare L. Differences in trajectories of quality of life according to type of dementia: 6-year longitudinal findings from the IDEAL programme. BMC Med 2024; 22:265. [PMID: 38915081 PMCID: PMC11197262 DOI: 10.1186/s12916-024-03492-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 06/17/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND People with different types of dementia may have distinct symptoms and experiences that affect their quality of life. This study investigated whether quality of life varied across types of dementia and over time. METHODS The participants were 1555 people with mild-to-moderate dementia and 1327 carers from the IDEAL longitudinal cohort study, recruited from clinical services. As many as possible were followed for up to 6 years. Diagnoses included were Alzheimer's disease, vascular dementia, mixed Alzheimer's and vascular dementia, Parkinson's disease dementia, dementia with Lewy bodies, and frontotemporal dementia. Self- and informant-rated versions of the Quality of Life in Alzheimer's Disease scale were used. A joint model, incorporating a mixed effects model with random effects and a survival model to account for dropout, was used to examine whether quality of life varied by dementia type at the time of diagnosis and how trajectories changed over time. RESULTS The strongest associations between dementia type and quality of life were seen around the time of diagnosis. For both self-ratings and informant ratings, people with Parkinson's disease dementia or dementia with Lewy bodies had lower quality of life scores. Over time there was little change in self-rated scores across all dementia types (- 0.15 points per year). Informant-rated scores declined over time (- 1.63 points per year), with the greatest decline seen in ratings by informants for people with dementia with Lewy bodies (- 2.18 points per year). CONCLUSIONS Self-rated quality of life scores were relatively stable over time whilst informant ratings showed a steeper decline. People with Parkinson's disease dementia or dementia with Lewy bodies report particularly low levels of quality of life, indicating the importance of greater attention to the needs of these groups.
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Affiliation(s)
- Anthony Martyr
- Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK
| | - Laura D Gamble
- Population Health Sciences Institute, Newcastle University, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle Upon Tyne, UK.
| | - Anna Hunt
- Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK
| | - Catherine Quinn
- Centre for Applied Dementia Studies, Bradford University, Bradford, UK
- Wolfson Centre for Applied Health Research, Bradford, UK
| | - Robin G Morris
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Catherine Henderson
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Louise Allan
- Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK
- NIHR Applied Research Collaboration South-West Peninsula, Exeter, UK
| | - Carol Opdebeeck
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | - Catherine Charlwood
- Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK
- NIHR Applied Research Collaboration South-West Peninsula, Exeter, UK
| | - Roy W Jones
- Research Institute for the Care of Older People (RICE), Bath, UK
| | - Claire Pentecost
- Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK
| | - Michael D Kopelman
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jeanette M Thom
- School of Health Sciences, The University of Sydney, Sydney, Australia
| | - Fiona E Matthews
- Population Health Sciences Institute, Newcastle University, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle Upon Tyne, UK
- Institute for Clinical and Applied Health Research, Hull York Medical School, University of Hull, Hull, UK
| | - Linda Clare
- Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, Exeter, UK
- NIHR Applied Research Collaboration South-West Peninsula, Exeter, UK
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Martyr A, Rusted JM, Quinn C, Gamble LD, Collins R, Morris RG, Clare L. Resilience in caregivers of people with mild-to-moderate dementia: findings from the IDEAL cohort. BMC Geriatr 2023; 23:804. [PMID: 38053063 PMCID: PMC10696882 DOI: 10.1186/s12877-023-04549-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 11/30/2023] [Indexed: 12/07/2023] Open
Abstract
OBJECTIVES A novel model of resilience was tested in caregivers of people with mild-to-moderate dementia and was extended to explore whether including self-efficacy, optimism, and self-esteem improved its predictive value. DESIGN Cross-sectional. SETTING Data from the IDEAL cohort were used. PARTICIPANTS The study comprised 1222 caregivers of people with dementia. MEASUREMENTS A composite resilience score was calculated from five measures. Multivariable regressions were used to investigate factors associated with resilience. RESULTS Greater resilience was associated with being older, being male, and caregiving for older people with dementia. Greater resilience was also observed when people with dementia had fewer functional difficulties and/or fewer neuropsychiatric symptoms, there was a stronger dyadic relationship, and the caregiver had fewer social restrictions, less neuroticism, and greater perceived competence. Surprisingly, caregiver self-efficacy, optimism, and self-esteem were unrelated to resilience. CONCLUSION Caregivers of people with mild-to-moderate dementia generally scored well for resilience. Resilience was associated with both the personal characteristics of caregivers and level of care need among people with dementia. Future work is needed to determine whether the caregivers in this cohort appeared resilient because the care recipients had relatively low care needs and consequently placed fewer demands on caregiver well-being than would be the case where dementia is more advanced.
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Affiliation(s)
- Anthony Martyr
- Centre for Research in Ageing and Cognitive Health, Faculty of Health and Life Sciences, University of Exeter, St Luke's Campus, Exeter, UK.
| | | | - Catherine Quinn
- Centre for Applied Dementia Studies, University of Bradford, Bradford, UK
- Wolfson Centre for Applied Health Research, Bradford, UK
| | - Laura D Gamble
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Rachel Collins
- Centre for Research in Ageing and Cognitive Health, Faculty of Health and Life Sciences, University of Exeter, St Luke's Campus, Exeter, UK
| | - Robin G Morris
- Department of Psychology, King's College London Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Linda Clare
- Centre for Research in Ageing and Cognitive Health, Faculty of Health and Life Sciences, University of Exeter, St Luke's Campus, Exeter, UK
- NIHR Applied Research Collaboration South-West Peninsula, Exeter, UK
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