1
|
Gopalakrishnan P, Tiwari S, Nagaraja R, Krishnan G. Quality of life in persons with mild cognitive impairment: a systematic review and meta-analysis. Dement Neuropsychol 2024; 18:e20230093. [PMID: 39193465 PMCID: PMC11348882 DOI: 10.1590/1980-5764-dn-2023-0093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/06/2024] [Accepted: 01/21/2024] [Indexed: 08/29/2024] Open
Abstract
The global increase in the aging population has raised concerns over various age-related conditions like dementia and mild cognitive impairment (MCI) and their consequences on the affected persons. People with MCI exhibit cognitive deficits more significantly than expected for their age and literacy level. Though the nature of this condition is considered "mild", studies have reported that even more subtle deficits can influence the quality of life (QOL). Objective The present work aimed at exploring and comparing QOL in older adults with and without MCI through a systematic review and meta-analysis. Methods After a detailed search of articles till May 2021 in the relevant electronic databases (PubMed Central, PubMed, Scopus, CINAHL Plus, Web of Science, ProQuest, and Cochrane) using the keywords "mild cognitive impairment", "quality of life", "old", "old aged", "aged", "older adult", "geriatrics", "healthy controls", "healthy participants", and "normal controls", we included 23 articles in the systematic review and 12 in the meta-analysis. Results The quality of all the included articles were assessed using the Modified Downs and Black tool. Most of the studies in the systematic review demonstrated differences in QOL scores in older adults with MCI compared to healthy older adults. However, meta-analysis findings suggest that older adults with MCI had statistically non-significant yet lower differences in QOL compared to their healthy counterparts. Conclusion Future research should focus on developing QOL assessment tools specifically for older adults with MCI and follow-up studies that could provide better knowledge of their changing cognitive profile and life quality.
Collapse
Affiliation(s)
- Priya Gopalakrishnan
- Manipal Academy of Higher Education, Manipal College of Health Professions, Department of Speech and Hearing, Manipal, Karnataka, India
| | - Shivani Tiwari
- Manipal Academy of Higher Education, Manipal College of Health Professions, Department of Speech and Hearing, Manipal, Karnataka, India
| | - Ravishankar Nagaraja
- University of Delhi, Vallabhbhai Patel Chest Institute, Department of Biostatistics, Delhi, India
| | - Gopee Krishnan
- Manipal Academy of Higher Education, Manipal College of Health Professions, Department of Speech and Hearing, Manipal, Karnataka, India
| |
Collapse
|
2
|
Gonçalves-Pereira M, Marques MJ, F Alves R, Verdelho A, Balsinha C, Alves L, Alves Reis T, Woods B, De Vugt M, Verhey F. Needs for Care, Service Use and Quality of Life in Dementia: 12-Month Follow-Up of the Actifcare Study in Portugal. ACTA MEDICA PORT 2024; 37:355-367. [PMID: 38457746 DOI: 10.20344/amp.20427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 11/02/2023] [Indexed: 03/10/2024]
Abstract
INTRODUCTION The intermediate stages of dementia are relatively under-researched, including in Portugal. The Actifcare (ACcess to TImely Formal Care) EU-JPND project studied people with mild-moderate dementia, namely their needs, access to and use of community services (e.g., day centers, home support). In our baseline assessment of the Portuguese Actifcare cohort, the unmet needs of some participants would call for formal support, which was not always accessible or used. We now report the main results of the 12-month follow-up, analyzing changes in needs, service (non)use, quality of life and related variables. METHODS This was a longitudinal, observational study using a convenience sample of 54 dyads of people with dementia and their family carers. Our main outcomes were the Camberwell Assessment of Need for the Elderly (CANE) and the Resources Utilization in Dementia. Clinical-functional, quality of life, psychological distress and caregiving-related assessments were also used. RESULTS At follow-up, the cognitive and functional status of people with dementia declined (p < 0.001), and their neuropsychiatric symptoms increased (p = 0.033). Considering CANE interviewers' ratings, the total needs of people with dementia increased at follow-up (p < 0.001) but not the unmet needs. Quality of life was overall stable. The use of formal care did not increase significantly, but informal care did in some domains. Carers' depressive symptoms increased (p = 0.030) and perseverance time decreased (p = 0.045). However, carers' psychological distress unmet needs were lower (p = 0.007), and their stress and quality of life remained stable. CONCLUSION People with dementia displayed complex biopsychosocial unmet needs. Their cognitive-functional decline over one year was not accompanied by a corresponding increase in any pattern of unmet need, nor of service use. Reliance on informal care (namely supervision) may have contributed to this. Caregiving-related outcomes evolved according to different trends, although stability was almost the rule. Primary carers were even more present at follow-up, without an apparently heavier toll on their own needs, burden, and quality of life. Overall, this longitudinal study comprehensively assessed Portuguese community-dwelling people with dementia. Despite the lack of generalizability, participants' needs remained overall stable and partly unmet over one year. Longer follow-up periods are needed to understand such complex processes.
Collapse
Affiliation(s)
- Manuel Gonçalves-Pereira
- Faculdade de Ciências Médicas | NOVA Medical School. Universidade NOVA de Lisboa. Lisbon; Comprehensive Health Research Center (CHRC). Laboratório Associado REAL. Universidade NOVA de Lisboa. Lisbon. Portugal
| | - Maria J Marques
- Comprehensive Health Research Center (CHRC). Laboratório Associado REAL. Universidade NOVA de Lisboa. Lisbon; NOVA School of Public Health. Universidade NOVA de Lisboa. Lisbon. Portugal
| | - Regina F Alves
- NOVA School of Public Health. Universidade NOVA de Lisboa. Lisbon. Portugal
| | - Ana Verdelho
- Faculdade de Medicina da Universidade de Lisboa. Centro Hospitalar Universitário Lisboa Norte. Instituto de Saúde Ambiental. Lisbon. Portugal
| | - Conceição Balsinha
- Faculdade de Ciências Médicas | NOVA Medical School. Universidade NOVA de Lisboa. Lisbon; Comprehensive Health Research Center (CHRC). Laboratório Associado REAL. Universidade NOVA de Lisboa. Lisbon. Portugal
| | - Luísa Alves
- Faculdade de Ciências Médicas | NOVA Medical School. Universidade NOVA de Lisboa. Lisbon; Hospital de Egas Moniz. Centro Hospitalar de Lisboa Ocidental. Lisbon. Portugal
| | - Teresa Alves Reis
- Comprehensive Health Research Center (CHRC). Laboratório Associado REAL. Universidade NOVA de Lisboa. Lisbon; Hospital do Espírito Santo. Portugal
| | - Bob Woods
- Dementia Services Development Centre Wales. Bangor University. Bangor
| | | | - Frans Verhey
- Alzheimer Centrum Limburg. Maastricht University. Maastricht
| |
Collapse
|
3
|
Barros D, Borges-Machado F, Silva-Fernandes A, Ribeiro O, Carvalho J. Do physical fitness and cognitive function mediate the relationship between basic activities of daily living and quality of life in older adults with dementia? Qual Life Res 2024; 33:917-926. [PMID: 38112863 PMCID: PMC10973068 DOI: 10.1007/s11136-023-03570-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2023] [Indexed: 12/21/2023]
Abstract
PURPOSE Independence in activities of daily living (ADLs) is associated with quality of life (QoL) in individuals with dementia. However, the contribution of physical and cognitive functions to this relationship needs further examination. This study aims to examine the mediating effect of physical fitness and cognitive function in the relationship between independence in basic ADLs and QoL among older adults with dementia. METHODS This cross-sectional study included 107 older adults with dementia (74.8% women; age 78.21 ± 7.70 years). Independence in basic ADL and QoL were evaluated using the Barthel Index (BI) and QoL- Alzheimer's Disease Scale, respectively. The Alzheimer's Disease Assessment Scale-Cognitive Subscale and the Mini-Mental State Examination were applied to assess cognitive function. Physical fitness was evaluated using the 30-s chair stand, 2-min step and the Timed-Up and Go tests. A structural equation modelling (SEM) with bootstrapping estimation was conducted to determine the relationship between all variables. RESULTS Independence in basic ADL positively affected QoL and this association was mediated by physical fitness (β = 0.242, p = 0.011). No statistically significant results were observed when testing cognitive function as a mediator between BI and QoL (β = 0.009, p = 0.345). CONCLUSIONS Physical fitness (i.e., lower body strength, aerobic capacity, and mobility) plays a role in the relationship between basic ADL independence and QoL of older adults with dementia, reinforcing the need to improve and monitor these parameters throughout the disease progression. Future longitudinal studies should explore the temporal relationship between physical and cognitive function and its contribution to basic ADL independence and QoL.
Collapse
Affiliation(s)
- Duarte Barros
- CIAFEL - Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal.
- ITR - Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal.
| | - Flávia Borges-Machado
- CIAFEL - Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
- ITR - Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal
- CEGOT - Centre of Studies in Geography and Spatial Planning, Faculty of Arts and Humanities, University of Coimbra, Coimbra, Portugal
| | - Anabela Silva-Fernandes
- Psychological Neuroscience Laboratory, School of Psychology, Psychology Research Center (CIPsi), University of Minho, Braga, Portugal
| | - Oscar Ribeiro
- CINTESIS@RISE - Center for Health Technology and Services Research at the Associate Laboratory RISE - Health Research Network, Aveiro, Portugal
- Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Joana Carvalho
- CIAFEL - Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
- ITR - Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal
| |
Collapse
|
4
|
Verdelho A, Correia M, Gonçalves-Pereira M, Madureira S, Vilela P, Santos AC, Rodrigues M, Borges M, Ferro JM, Santa-Clara H. Physical Activity in Mild Vascular Cognitive Impairment: Results of the AFIVASC Randomized Controlled Trial at 6 Months. J Alzheimers Dis 2024; 101:1379-1392. [PMID: 39269835 DOI: 10.3233/jad-240246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2024]
Abstract
Background Vascular cognitive impairment is frequent, in mild (mVCI) or severe forms (vascular dementia). Objective To do a randomized controlled-trial to evaluate the impact of physical activity on cognition (primary outcome), neurocognitive measures, quality of life, functional status, and physical function (secondary outcomes), in patients with mVCI. Methods A hundred and four patients with mVCI (mean age 71.2 years; 53 women) were randomized for a six-month intervention of moderate physical activity (60-minute sessions, 3 times/week) (n = 53) or best-practice "usual care" (n = 51). Comprehensive evaluations of primary and secondary outcomes included an objective measure of physical activity through accelerometry at baseline and after intervention. Results Mean session attendance was 58%. Adverse events were negligible. After 6 months, no significant primary outcome change was observed, either in the intervention or 'usual care' group. The intervention group improved significantly in some secondary outcomes in physical function - aerobic capacity (U = 403; p = 0.000) and agility (U = 453; p = 0.005) after 6 months. Regardless of randomization arm, a post-hoc analysis based on fulfilling at least 21.5 minutes/day of moderate or 10.7 minutes/day of vigorous physical activity (World Health Organization-WHO standards) revealed improvements. These were not only in motor capacity but also on the global measure of cognition, executive functions and memory. Conclusions Physical activity was safe and beneficial regarding domains of physical function. No significant cognitive decline was registered over 6-months, regardless of intervention allocation. Larger samples, longer follow-ups and focus on intervention adherence are needed to fully analyze the impact of WHO recommendations for physical activity in mVCI populations.
Collapse
Affiliation(s)
- Ana Verdelho
- Department of Neurosciences and Mental Health, Hospital de Santa Maria, Unidade de Saúde Local de Santa Maria, Centro de Estudos Egas Moniz, Instituto de Saúde Ambiental - ISAMB, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Manuel Correia
- Neurology Service, Hospital de Santo António, Unidade Local de Saúde de Santo António, Centro Hospitalar Universitário de Santo António and Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Universidade of Porto, Porto, Portugal
| | - Manuel Gonçalves-Pereira
- NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, CHRC, Associate Laboratory REAL (LA-REAL), Lisbon, Portugal
| | - Sofia Madureira
- Instituto Medicina Molecular João Lobo Antunes (IMM), Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Pedro Vilela
- Neuroradiology Department, Hospital da Luz, Lisbon, Portugal
| | | | - Mário Rodrigues
- Instituto de Saúde Ambiental - ISAMB, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Mariana Borges
- Instituto Medicina Molecular João Lobo Antunes (IMM), Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - José M Ferro
- Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Helena Santa-Clara
- Exercise and Health Laboratory, Faculdade de Motricidade Humana, Centro Interdisciplinar de Estudo da Performance Humana - CIPER, Universidade de Lisboa, Lisbon, Portugal
| |
Collapse
|
5
|
Osstyn SL, Handels R, Boots LMM, Balvert SCE, Evers SMAA, de Vugt ME. The effectiveness and health-economic evaluation of "Partner in Balance," a blended self-management program for early-stage dementia caregivers: study protocol for a cluster-randomized controlled trial. Trials 2023; 24:427. [PMID: 37349828 DOI: 10.1186/s13063-023-07423-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 05/29/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND Informal caregivers of people with dementia are crucial in dementia care. However, they are insufficiently supported and report caregiver burdens, which urges the need for cost-effective interventions aimed at supporting caregivers. This paper presents the design of a study evaluating the effectiveness, cost-effectiveness, and cost-utility of a blended self-management program for early-stage dementia caregivers. METHODS/DESIGN A pragmatic, cluster randomized controlled trial with a shared control group will be conducted. Participants will be informal caregivers of people with early-stage dementia and will be recruited by local care professionals. Randomization will be carried out at the level of the care professional level in a ratio of 35% to 65% (control arm vs. intervention arm). Participants in the control arm will receive care as usual and the intervention arm will receive the blended care self-management program "Partner in Balance" within a usual care setting in the Netherlands. Data will be collected at baseline and at 3-, 6-, 12-, and 24-month follow-ups. The primary outcome for effectiveness (part 1) is care management self-efficacy. For the health-economic evaluation (part 2) total care costs and the quality of life for individuals with dementia (cost-effectiveness) and quality-adjusted life years (cost-utility) will be the base case analysis. Secondary outcomes (parts 1 and 2) will include depression, anxiety, perceived informal caregiving stress, service-use self-efficacy, quality of life, caregivers' gain, and perseverance time. A process evaluation (part 3) will investigate the internal and external validity of the intervention. DISCUSSION In this trial, we plan to evaluate the effectiveness, cost-effectiveness, and cost-utility of "Partner in Balance" among informal caregivers of people with dementia. We expect to find a significant increase in care management self-efficacy, and the program to be cost-effective, and provide valuable insights to stakeholders of "Partner in Balance." TRIAL REGISTRATION ClinicalTrials.gov, NCT05450146. Registered on 4 November 2022.
Collapse
Affiliation(s)
- Sander L Osstyn
- Department of Psychiatry and Neuropsychology and Alzheimer Center Limburg, School for Mental Health and Neuroscience (MHeNS), Maastricht University, PO Box 6166200 MD, Maastricht, The Netherlands
| | - Ron Handels
- Department of Psychiatry and Neuropsychology and Alzheimer Center Limburg, School for Mental Health and Neuroscience (MHeNS), Maastricht University, PO Box 6166200 MD, Maastricht, The Netherlands
| | - Lizzy M M Boots
- Department of Psychiatry and Neuropsychology and Alzheimer Center Limburg, School for Mental Health and Neuroscience (MHeNS), Maastricht University, PO Box 6166200 MD, Maastricht, The Netherlands
| | - Sanne C E Balvert
- Department of Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Silvia M A A Evers
- Department of Health Services Research and Care and Public Health Research Institute (CAPHRI), Maastricht University, PO Box 6166200 MD, Maastricht, The Netherlands
- Centre of Economic Evaluations & Machine Learning, Trimbos Institute, Utrecht, The Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Marjolein E de Vugt
- Department of Psychiatry and Neuropsychology and Alzheimer Center Limburg, School for Mental Health and Neuroscience (MHeNS), Maastricht University, PO Box 6166200 MD, Maastricht, The Netherlands.
| |
Collapse
|
6
|
Brennan S, Doan T, Osada H, Hashimoto Y. Validation of the Japanese version of the quality of life-Alzheimer's disease for nursing homes. Aging Ment Health 2023; 27:281-291. [PMID: 35585714 DOI: 10.1080/13607863.2022.2076209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVES This study aims to validate the Japanese version of Quality of Life-Alzheimer's Disease for Nursing Homes (QOL-AD NH). This is the modified version of QOL-AD, initially developed for residents living with dementia in long-term care settings. METHODS Psychometric assessment was conducted in a sample of 101 residents and their professional care staff to obtain self-ratings and proxy-ratings of QOL, respectively. Residents' behavior was observed using Dementia Care Mapping (DCM) method, and their mood/engagement (ME) value was evaluated as a proxy measure of QOL. RESULTS Self-ratings were higher than proxy-ratings (t = 10.22, p<.001), with moderate correlation (r=.51, p<.001) and strong internal consistency (α=.87 for both). The exact agreement between the two groups was 38.23%. Convergent validity was confirmed with ME value and positive engagements of DCM. Exploratory factor analysis was performed for further validity testing. Three factors - self and life overall, social environment, and physical and psychological health, accounted for 85.9% of the total variance with Cronbach's α of .87, .73, .90, respectively. CONCLUSION Using a validated Japanese version of the QOL-AD NH may help assess the QOL of older residents living in long-term care settings to improve the continuum of care for dementia.
Collapse
Affiliation(s)
- Sumiyo Brennan
- Institute for Gerontology, J. F. Oberlin University, Tokyo, Japan
| | - Therese Doan
- School of Nursing, San Francisco State University, CA, USA
| | - Hisao Osada
- J. F. Oberlin University, Graduate School of International Advanced Studies MA&PhD Programs in Gerontology, Tokyo, Japan
| | - Yumiko Hashimoto
- Institute for Gerontology, J. F. Oberlin University, Tokyo, Japan
| |
Collapse
|
7
|
Urinary Hydration Biomarkers and Water Sources in Older Adults with Neurocognitive Disorder. Nutrients 2023; 15:nu15030548. [PMID: 36771256 PMCID: PMC9921382 DOI: 10.3390/nu15030548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 01/10/2023] [Accepted: 01/17/2023] [Indexed: 01/24/2023] Open
Abstract
The risk of dehydration in older adults with neurocognitive disorder (NCD) is controversial. The purpose of this study was to assess hydration status, its determinants, and water intake sources in older adults with NCD. A sample of 30 participants (≥60 years) was included. Sociodemographic, clinical data and one 24-h urine sample were collected. Urinary osmolality, sodium, potassium, volume, and creatinine were quantified. Inadequate hydration status corresponded to urine osmolality > 500 mOsm/Kg, or a negative Free Water Reserve (FWR). Two 24-h food recalls were used to assess dietary intake and water sources. The adequacy of total water intake (TWI) was estimated according to EFSA. The contribution of food and beverages to TWI was calculated, and their associations with the urinary osmolality median were tested. Of the total number of participants, 30% were classified as having inadequate hydration status, with no differences between sexes. Regarding TWI, 68.4% of women and 77.8% of men did not reach the reference values. Water (23%), followed by soup (17%), contributed the most to TWI, while vegetables (2%) and alcoholic/other beverages (3%) contributed the least. According to the median urinary osmolality, there was no significant difference in sociodemographic/clinical characteristics. It is critical not to overlook hydration in this vulnerable population.
Collapse
|
8
|
Pérez-Sáez E, Justo-Henriques SI, Alves Apóstolo JL. Multicenter randomized controlled trial of the effects of individual reminiscence therapy on cognition, depression and quality of life: Analysis of a sample of older adults with Alzheimer's disease and vascular dementia. Clin Neuropsychol 2022; 36:1975-1996. [PMID: 33467972 DOI: 10.1080/13854046.2021.1871962] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Objective: To determine the effectiveness of a 13-week individual reminiscence therapy (RT) intervention on cognition, memory, executive function, mood, and quality of life of people with Alzheimer's disease and vascular dementia. Method: Non-protocolized analysis using data from a larger multicenter, single-blind, randomized, parallel two-arm RCT of RT for people with neurocognitive disorders. A sample of 148 people with probable Alzheimer's disease or vascular dementia attending 23 Portuguese institutions providing care and support services for older adults were selected. Intervention group (n = 74) received 26 individual RT sessions, twice a week for 13 weeks. Control group (n = 74) maintained their treatment as usual. Outcomes were global cognitive function (MMSE), memory (MAT), executive function (FAB), mood (GDS-15), and self-reported quality of life (QoL-AD). All participants were assessed at baseline (T0) and 15 weeks later (T1). Results: The results showed a significant effect of the intervention on global cognition (Group X Time interaction F(1, 128) = 10.542, p = .001, ηp2 = .076), memory (F(1,128) = 9.881, p = .002, ηp2 = .072), and quality of life (F(1,128) = 0.181, p = .671, ηp2 = .001), with medium effect sizes. A small effect on executive function (F(1,127) = 11.118, p = .001, ηp2 = .080) was also found. No effects were found on depressive symptoms (F(1,128) = 0.181, p = .671, ηp2 = .001). Conclusion: Individual RT may have beneficial effects on cognition and quality of life of people with Alzheimer's disease or vascular dementia.
Collapse
Affiliation(s)
- Enrique Pérez-Sáez
- National Reference Centre for Alzheimer's and Dementia Care, Imserso, Spain
| | | | - João L Alves Apóstolo
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra, Portugal
| |
Collapse
|
9
|
Justo-Henriques SI, Pérez-Sáez E, Marques-Castro AE, Carvalho JO. Effectiveness of a year-long individual cognitive stimulation program in Portuguese older adults with cognitive impairment. AGING, NEUROPSYCHOLOGY, AND COGNITION 2022; 30:321-335. [PMID: 35012439 DOI: 10.1080/13825585.2021.2023458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Cognitive stimulation is a recommended therapy with positive effects on the cognitive performance of older adults with neurocognitive disorders. However, there are few one-on-one, long-term interventions applied by professionals. The aim of the present study was to determine the effectiveness of 47-week individual cognitive stimulation (iCS) interventions on cognition, mood, instrumental activities of daily living, and quality of life in older adults, with neurocognitive disorders using a single-blind, randomized, parallel two-arm RCT. A sample of 59 older adults with neurocognitive disorders (predominantly Alzheimer's disease), who were non-institutionalized but socially vulnerable, was selected. The intervention group (n = 30) received 47 iCS weekly sessions. The control group (n = 29) maintained their baseline treatments. Outcomes were global cognitive function, cognitive impairment, mood, instrumental activities of daily living, and self-reported quality of life. All participants were assessed at baseline, 25 weeks, and 50 weeks. The results showed a significant effect of the intervention on MMSE, MoCA, GDS-15. Individual cognitive stimulation may have beneficial effects on the cognitive function and mood of older adults with cognitive impairment.
Collapse
Affiliation(s)
- Susana I. Justo-Henriques
- Health Sciences Research Unit: Nursing (Uicisa: E), Nursing School of Coimbra (Esenfc), Portugal. Neuropsychologist and Invited Adjunct Professor, Polytechnic Institute of Beja, Beja, Portugal
| | - Enrique Pérez-Sáez
- Neuropsychologist, National Reference Centre for Alzheimer’s and Dementia Care, Imserso, Spain
| | | | - Janessa O. Carvalho
- Neuropsychologist and Associate Professor, Bridgewater State University, Bridgewater, MA, USA
| |
Collapse
|
10
|
Justo-Henriques SI, Pérez-Sáez E, Apóstolo JLA, Carvalho JO. Effectiveness of a Randomized Controlled Trial of Individual Reminiscence Therapy on Cognition, Mood and Quality of Life in Azorean Older Adults with Neurocognitive Disorders. J Clin Med 2021; 10:5395. [PMID: 34830677 PMCID: PMC8619984 DOI: 10.3390/jcm10225395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/14/2021] [Accepted: 11/17/2021] [Indexed: 12/02/2022] Open
Abstract
Reminiscence therapy (RT) is a form of cognitive stimulation therapy that incorporates discussion of past activities, events, and experiences to stimulate individual memories; it has had some success in treating persons with neurocognitive disorders. This research aims to evaluate the ability of individual RT, using a simple reminiscence format, to improve the overall cognitive function, memory, executive functions, emotional status, and quality of life in older adults with neurocognitive disorders who received social care and support services. A multicenter randomized controlled trial was completed in the Azores archipelago (an independent region of Portugal) using repeated measures (pre-intervention, post-intervention, and follow-up). The intervention group underwent individual RT sessions, twice weekly for 13 weeks, while the control group completed regular activities administered as part of their program. Results did not reveal any significant differences between the intervention and control groups. While results did not reveal significant effects, a number of historical and contextual factors are considered as possible explanations for the lack of effects-namely, data collection occurring during the COVID-19 global pandemic, participant cohort effects, and therapist heterogeneity.
Collapse
Affiliation(s)
- Susana I Justo-Henriques
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3004-011 Coimbra, Portugal
| | - Enrique Pérez-Sáez
- National Reference Centre for Alzheimer's and Dementia Care, Imserso, 37008 Salamanca, Spain
| | - João L Alves Apóstolo
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3004-011 Coimbra, Portugal
| | - Janessa O Carvalho
- Psychology Department, Bridgewater State University, Bridgewater, MA 02325, USA
| |
Collapse
|
11
|
Cousi C, Igier V, Quintard B. French cross-cultural adaptation and validation of the Quality of Life-Alzheimer's Disease scale in Nursing Homes (QOL-AD NH). Health Qual Life Outcomes 2021; 19:219. [PMID: 34526034 PMCID: PMC8443115 DOI: 10.1186/s12955-021-01853-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 09/02/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND No specific scale to measure Quality of Life in Alzheimer's Disease in Nursing Homes (QoL-AD NH) exists in French. We aimed to translate and culturally adapt the QoL-AD NH participant scale into a French version and evaluate its psychometric properties with residents in French nursing homes (EHPAD). METHODS First, the QoL-AD NH was cross-culturally adapted into French according to guidelines. Secondly, a convenience group of residents with mild to moderate dementia answered the Folstein's test and the QoL-AD NH. They also answered the Dementia Quality of Life and the Geriatric Depression Scale to test convergent and divergent validity. Known-group validity was tested with a comparison group of residents without dementia. Exploratory Structural Equation Modeling (ESEM) was used after Exploratory Factor Analysis (EFA) to identify factors and measure invariance across age and mental state groups. Reliability (internal consistency, McDonald's omega and test-retest) were also measured. RESULTS Following successful adaptation of the QoL-AD NH, 174 residents (mean age 86.6) from 7 nursing homes with mild to moderate dementia participated in the validation study. We retained a 3-factor model of the scale after ESEM identifying: "Intra & interpersonal environment-related QoL", "Self-functioning-related QoL" and "Perceived current health-related QoL" that were invariant across age and mental state groups. The QoL-AD NH had acceptable convergent (ρ range 0.24-0.53) and divergent validity (ρ range - 0.43 to - 0.57) and good known-group validity with 33 residents without dementia (t(205) = 2.70, p = .007). For reliability, the results revealed very good and adequate internal consistency (α = 0.86 for total scale and ≥ 0.71 for subscales). All total omega values exceeded the threshold 0.70. The hierarchical omega was 0.50, supporting the multidimensionality of the scale. Hierarchical omega subscale values exceeded the minimal level 0.50 except for the third factor, although reliable, would deserve more items. Test-retest was good with ICC (3,1) = 0.76. CONCLUSIONS The QoL-AD NH French participant version has globally good reliability and validity for evaluating residents' quality of life. However, further studies must rework and confirm the factor structure, test sensitivity to change and responsiveness.
Collapse
Affiliation(s)
- Christophe Cousi
- CLESCO ED 326, Centre for Studies and Research in Psychopathology and Health (CERPPS), University of Toulouse Jean-Jaurès, Toulouse, France. .,INSERM BPH, UMR 1219, Team "Handicap, Activity, Cognition, Health", University of Bordeaux, Bordeaux, France.
| | - Valérie Igier
- CLESCO ED 326, Centre for Studies and Research in Psychopathology and Health (CERPPS), University of Toulouse Jean-Jaurès, Toulouse, France
| | - Bruno Quintard
- INSERM BPH, UMR 1219, Team "Handicap, Activity, Cognition, Health", University of Bordeaux, Bordeaux, France
| |
Collapse
|
12
|
Alvares-Pereira G, Silva-Nunes MV, Spector A. Validation of the cognitive stimulation therapy (CST) program for people with dementia in Portugal. Aging Ment Health 2021; 25:1019-1028. [PMID: 33089699 DOI: 10.1080/13607863.2020.1836473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Cognitive Stimulation Therapy (CST) is considered a gold-standard, evidence-based and cost-effective approach to improve cognitive function and quality of life of people with mild to moderate dementia. AIMS To validate CST for the Portuguese population and test its effectiveness. METHODS A single-blind, multi-center, randomized controlled trial recruited 112 older people with dementia. The primary outcome measure was cognition and secondary measures were quality of life, communication, autonomy, anxiety, depression, and global functioning. We also explored whether CST benefits people differently according to context, gender and level of cognitive reserve. RESULTS Fifty-five people were randomized to the intervention and 57 to the control group. In the post-test, the intervention group significantly improved relative to controls in cognition (ADAS-Cog, p = 0.013), communication (HCS, p = 0.045), behaviour (CAPE-BRS, p = 0.017) and in global dementia rating (CDR, p = 0.008). Quality of life, depression and anxiety had no significant differences. The estimated number needed to treat was four for one to benefit a cognitive improvement (ADAS-Cog). CONCLUSIONS Group CST is valid for the Portuguese population with benefits for people with mild to moderate dementia.
Collapse
Affiliation(s)
- G Alvares-Pereira
- Health Sciences Institute, Portuguese Catholic University, Lisboa, Portugal
| | - M V Silva-Nunes
- Health Sciences Institute, Portuguese Catholic University, Lisboa, Portugal.,Interdisciplinary Health Research Center, Catholic University of Portugal, Lisboa, Portugal
| | - A Spector
- Clinical, Educational & Health Psychology, University College London, London, UK
| |
Collapse
|
13
|
Vicente de Sousa O, Mendes J, Amaral TF. Association between nutritional and functional status indicators with caregivers' burden in Alzheimer's disease. Nutr Diet 2021; 79:380-389. [PMID: 34031961 DOI: 10.1111/1747-0080.12679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 04/24/2021] [Accepted: 05/02/2021] [Indexed: 01/16/2023]
Abstract
AIM To investigate the association between nutritional and functional status of Alzheimer's disease patients and caregivers' burden. METHODS A cross-sectional study was conducted among 79 community-dwelling Alzheimer's disease patients living with their caregivers. Caregivers' burden was assessed using the Zarit Burden-Interview. Multinomial logistic regressions were carried out using caregivers' burden as the dependent variable. RESULTS Caregivers' severe overload was strongly associated with weight loss of more than 3 kg during the previous 3 months (OR = 7.34; 95% CI: 2.02-26.65), lower values of calf girth (OR = 3.20; 95% CI: 1.03-9.93), sarcopenia status (OR = 3.50; 95% CI: 1.09-11.22), and lower gait speed values (OR = 3.83; 95% CI: 1.18-12.47). Otherwise, overweight or obesity (OR = 0.21; 95% CI: 0.05-0.83), was related to lower odds of higher caregivers' burden. CONCLUSION In community-dwelling older adults with Alzheimer's disease, the nutritional and functional status impairments were strongly associated with increasing caregivers' burden, whereas overweight conferred protection.
Collapse
Affiliation(s)
- Odete Vicente de Sousa
- Psychogeriatrics Unit of Hospital de Magalhães Lemos E.P.E., Porto, Portugal.,UNIFAI/ICBAS (Research and Education Unit on Aging), Department of Behavioral Sciences, Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal.,Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Joana Mendes
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal.,Department of Biomedicine, Biochemistry Unit, Faculty of Medicine, University of Porto, Porto, Portugal.,I3S-Institute for Research and Innovation in Health, University of Porto, Porto, Portugal
| | - Teresa F Amaral
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal.,UISPA-IDMEC, Faculty of Engineering, University of Porto, Porto, Portugal
| |
Collapse
|
14
|
Justo-Henriques SI, Pérez-Sáez E, Alves Apóstolo JL. Multicentre randomised controlled trial about the effect of individual reminiscence therapy in older adults with neurocognitive disorders. Int J Geriatr Psychiatry 2021; 36:704-712. [PMID: 33176394 DOI: 10.1002/gps.5469] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 11/01/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVES To evaluate the effectiveness of a 13-week individual reminiscence therapy (RT) intervention to improve the overall cognitive function, memory, executive function, mood and quality of life (QoL) of people with neurocognitive disorders. METHODS A single-blind, multicentre, randomised parallel two-arm controlled trial recruited 251 people with neurocognitive disorders attending 24 institutions providing care and support services for older adults in Portugal. The primary outcome measure was cognitive function (Mini-Mental State Examination [MMSE]). Secondary outcomes were memory (Memory Alteration Test [MAT]), executive function (Frontal Assessment Battery [FAB]), mood (Geriatric Depression Scale-15 [GDS-15]) and self-reported QoL-Alzheimer's disease AD). Participants in the intervention group (n = 131) received 26 individual RT sessions, twice a week, over the course of 13 weeks. Participants in the control group (n = 120) maintained their treatment as usual. RESULTS Intention-to-treat analysis showed that, at endpoint assessment, the intervention group had significantly improved in relation to the control group in MMSE (mean difference 1.84, 95% CI [0.80, 2.89], p = .001, d = .44), MAT (mean difference 2.82, 95% CI [0.72, 4.91], p = .009, d = .34) and QoL-AD (mean difference 1.78, 95% CI [0.17, 3.39], p = .031, d = .28). Non-significant improvements were found on FAB (mean difference 0.74, 95% CI [-0.04, 1.52], p = .062, d = .24) and GDS-15 (mean difference -0.63, 95% CI [-1.45, 0.19], p = .130, d = .19). CONCLUSIONS For people with neurocognitive disorders attending social care and support services, the individual RT designed for this trial should be considered an intervention with the potential to improve cognition, memory and QoL.
Collapse
Affiliation(s)
| | - Enrique Pérez-Sáez
- National Reference Centre for Alzheimer's and Dementia Care, Imserso, Salamanca, Spain
| | - João L Alves Apóstolo
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra, Coimbra, Portugal
| |
Collapse
|
15
|
Pereira MG, Abreu AR, Rego D, Ferreira G, Lima S. Contributors and Moderators of Quality of Life in Caregivers of Alzheimer´s Disease Patients. Exp Aging Res 2021; 47:357-372. [PMID: 33724160 DOI: 10.1080/0361073x.2021.1895594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Aim and objective: This study aimed to identify the variables that contributed to Quality of Life (QoL) of Alzheimer's Disease (AD) caregivers, taking into consideration the caregiving context, stressors, role strains, and resources.Methods: The sample included 102 caregivers of AD patients who answered the following instruments: Depression, Anxiety and Stress Scale-21; Satisfaction with Social Support Scale; Revised Memory and Behavioral Problems Checklist; Family Communication and Satisfaction Scales; Spiritual and Religious Attitudes in Dealing with Illness; and Quality of Life in Alzheimer's Disease - Caregiver Version.Results: Caregivers who were employed, chose the caregiving role, and received help in caring showed better QoL. Also, being younger, less caregiving daily hours, caring for patients with less memory and behavior problems, lower distress, and family satisfaction predicted better QoL. Finally, spirituality was a moderator between family communication and QoL but not between family satisfaction and QoL.Conclusion: Caregiving-context variables (age, professional status, choosing to care, receiving help in the caregiving role and duration of daily care); role strains (family dissatisfaction); stressors (caregivers' distress and patients' memory and behavioral problems); and resources (spirituality) had an impact on caregivers' QoL emphasizing the adequacy of the Stress Process Model. Intervention should also focus on spirituality given its moderating role.
Collapse
Affiliation(s)
- M Graça Pereira
- Psychology Research Centre (CIPsi), School of Psychology, University of Minho, Braga, Portugal
| | - Ana R Abreu
- Psychology Research Centre (CIPsi), School of Psychology, University of Minho, Braga, Portugal
| | - Daniela Rego
- Psychology Research Centre (CIPsi), School of Psychology, University of Minho, Braga, Portugal
| | - Gabriela Ferreira
- Psychology Research Centre (CIPsi), School of Psychology, University of Minho, Braga, Portugal
| | - Sara Lima
- Psychology Research Centre (CIPsi), School of Psychology, University of Minho, Braga, Portugal.,CESPU, Institute of Research and Advanced Training in Health Sciences and Technologies, Paredes-Porto, Portugal
| |
Collapse
|
16
|
Rombach I, Iftikhar M, Jhuti GS, Gustavsson A, Lecomte P, Belger M, Handels R, Castro Sanchez AY, Kors J, Hopper L, Olde Rikkert M, Selbæk G, Stephan A, Sikkes SAM, Woods B, Gonçalves-Pereira M, Zanetti O, Ramakers IHGB, Verhey FRJ, Gallacher J, Actifcare Consortium, LeARN Consortium, Landeiro F, Gray AM. Obtaining EQ-5D-5L utilities from the disease specific quality of life Alzheimer's disease scale: development and results from a mapping study. Qual Life Res 2021; 30:867-879. [PMID: 33068236 PMCID: PMC7952290 DOI: 10.1007/s11136-020-02670-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2020] [Indexed: 11/08/2022]
Abstract
PURPOSE The Quality of Life Alzheimer's Disease Scale (QoL-AD) is commonly used to assess disease specific health-related quality of life (HRQoL) as rated by patients and their carers. For cost-effectiveness analyses, utilities based on the EQ-5D are often required. We report a new mapping algorithm to obtain EQ-5D indices when only QoL-AD data are available. METHODS Different statistical models to estimate utility directly, or responses to individual EQ-5D questions (response mapping) from QoL-AD, were trialled for patient-rated and proxy-rated questionnaires. Model performance was assessed by root mean square error and mean absolute error. RESULTS The response model using multinomial regression including age and sex, performed best in both the estimation dataset and an independent dataset. CONCLUSIONS The recommended mapping algorithm allows researchers for the first time to estimate EQ-5D values from QoL-AD data, enabling cost-utility analyses using datasets where the QoL-AD but no utility measures were collected.
Collapse
Affiliation(s)
- Ines Rombach
- Nuffield Department of Population Health, Health Economics Research Centre, University of Oxford, Old Road Campus, Oxford, OX3 7LF, United Kingdom.
| | - Marvi Iftikhar
- Nuffield Department of Population Health, Health Economics Research Centre, University of Oxford, Old Road Campus, Oxford, OX3 7LF, United Kingdom
| | - Gurleen S Jhuti
- Global Access, Centre of Excellence F.Hoffmann-La Roche Ltd, CH-4070, Basel, Switzerland
| | - Anders Gustavsson
- Quantify Research, Stockholm, 112 21, Sweden
- Division of Neurogeriatrics, Department for Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, 171 64, Sweden
| | - Pascal Lecomte
- Global Head Health Economic Modelling and Methodology, Novartis Pharma AG, 4002, Basel, Switzerland
| | - Mark Belger
- Global Statistical Sciences, Eli Lilly and company, Erl Wood Manor, Windlesham, GU20 6PH, United Kingdom
| | - Ron Handels
- Division of Neurogeriatrics, Department for Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, 171 64, Sweden
- Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, 6200 MD, The Netherlands
| | | | - Jan Kors
- Department of Medical Informatics, Erasmus MC-University Medical Center Rotterdam, Rotterdam, 3015 GD, The Netherlands
| | - Louise Hopper
- School of Psychology, Dublin City University, Dublin 9, Ireland
| | - Marcel Olde Rikkert
- Department of Geriatrics, Radboudumc Alzheimer Center, Donders Center for Medical Neuroscience, Radboud University Medical Center, Nijmegen, 6525 GA, The Netherlands
| | - Geir Selbæk
- National Advisory Unit of Ageing and Health, Vestfold Hospital Trust, 3103, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, 0372, Norway
- Faculty of Medicine, University of Oslo, Oslo, 0372, Norway
| | - Astrid Stephan
- Institute for Health and Nursing Science, Martin Luther University Halle-Wittenberg, Halle (Saale), 06112, Germany
| | - Sietske A M Sikkes
- Alzheimer Center Amsterdam, Amsterdam University Medical Centers/Amsterdam Neuroscience, Amsterdam, 1007 MB, The Netherlands
| | - Bob Woods
- Dementia Services Development Centre Wales (DSDC), Bangor University, Bangor, LL57 2PZ, United Kingdom
| | - Manuel Gonçalves-Pereira
- Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, 1169-056, Portugal
- CHRC (Comprehensive Health Research Centre), Lisbon, Portugal
| | - Orazio Zanetti
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, 25125, Italy
| | - Inez H G B Ramakers
- Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, 6200 MD, The Netherlands
| | - Frans R J Verhey
- Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, 6200 MD, The Netherlands
| | - John Gallacher
- Dementias Platform UK, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, United Kingdom
| | | | | | - Filipa Landeiro
- Nuffield Department of Population Health, Health Economics Research Centre, University of Oxford, Old Road Campus, Oxford, OX3 7LF, United Kingdom
| | - Alastair M Gray
- Nuffield Department of Population Health, Health Economics Research Centre, University of Oxford, Old Road Campus, Oxford, OX3 7LF, United Kingdom
| |
Collapse
|
17
|
Lima S, Garrett C, Machado JC, Vilaça M, Pereira MG. Quality of life in patients with mild Alzheimer disease: the mediator role of mindfulness and spirituality. Aging Ment Health 2020; 24:2103-2110. [PMID: 31411042 DOI: 10.1080/13607863.2019.1650891] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
OBJECTIVES This study examined the mediator role of mindfulness and spirituality in the relationship between psychological morbidity, awareness of the disease, functionality, social support, family satisfaction, and quality of life (QoL) in patients with mild AD. METHOD The sample consisted of 128 patients who answered the Cognitive and Affective Mindfulness Scale-Revised (CAMS-R), the Assessment Scale of Psychosocial Impact of the Diagnosis of Dementia (ASPIDD), the Hospital Anxiety and Depression Scales (HADS), the Satisfaction with Social Support Scale (SSSS), the Family Satisfaction Scale (FSS), the Spiritual and Religious Attitudes in Dealing with Illness (SpREUK), the Index of Barthel, and the Quality of Life-Alzheimer's Disease (QoL-AD). RESULTS Mindfulness and spirituality mediated the relationship between functionality, awareness of the disease, family satisfaction and QoL. Psychological morbidity had a direct negative impact on QoL and was negatively associated with awareness of the disease, family satisfaction and social support. Mindfulness was negatively associated with spirituality and the latter was negatively associated with QoL. More social support was associated with greater awareness of the disease and family satisfaction. More functionality, awareness of the disease and family satisfaction contributed to more QoL and this relationship was mediated by mindfulness and spirituality. CONCLUSION Interventions directed at the promotion of the QoL of patients with mild AD should focus on the promotion of mindfulness skills in AD patients, in addition to the reduction of psychological morbidity and the promotion of functionality, awareness of the disease, family relationships and social support.
Collapse
Affiliation(s)
- Sara Lima
- School of Psychology, University of Minho, Braga, Portugal
| | | | - José C Machado
- Institute of Social Sciences, University of Minho, Braga, Portugal
| | | | | |
Collapse
|
18
|
Lima S, Sevilha S, Pereira MG. Quality of life in early-stage Alzheimer's disease: the moderator role of family variables and coping strategies from the patients' perspective. Psychogeriatrics 2020; 20:557-567. [PMID: 32212217 DOI: 10.1111/psyg.12544] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 10/16/2019] [Accepted: 02/22/2020] [Indexed: 11/30/2022]
Abstract
AIM This study assessed the effects of sociodemographic and psychological variables on quality of life (QOL), as well as the moderator role of family variables and coping strategies in the relationship between psychological morbidity and QOL, based on patients' perspective. METHODS This study used a cross-sectional design. A total of 158 patients with early Alzheimer's disease completed the Mini-Mental State Examination, the Montreal Cognitive Assessment, the Hospital Anxiety and Depression Scale, the Ways of Coping Questionnaire, the Spiritual and Religious Attitudes in Dealing with Illness, the Family Adaptability and Cohesion Evaluation Scales, the Family Satisfaction Scale, the Family Communication Scale, the Barthel Index, and the Quality of Life in Alzheimer's Disease Scale. RESULTS Being a man, having a higher education, and engaging in more exercise activity were associated with better QOL. Lower levels of cognitive impairment, psychological morbidity, and spirituality predicted better QOL. Also, lower levels of functionality, family communication, family satisfaction, and family functioning contributed to worse QOL. Gender, psychological morbidity, and functionality contributed significantly to QOL. Family satisfaction, family communication, and coping strategies moderated the relationship between psychological morbidity and QOL. CONCLUSION Intervention in early-stage Alzheimer's disease should focus on patients' coping strategies and family context, particularly family satisfaction and communication, to foster QOL.
Collapse
Affiliation(s)
- Sara Lima
- School of Psychology, University of Minho, Braga, Portugal
| | | | | |
Collapse
|
19
|
Stypa V, Haussermann P, Fleiner T, Neumann S. Validity and Reliability of the German Quality of Life-Alzheimer's Disease (QoL-AD) Self-Report Scale. J Alzheimers Dis 2020; 77:581-590. [PMID: 32675413 DOI: 10.3233/jad-200400] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The Quality of Life-Alzheimer's Disease (QoL-AD) scale is a widely used measure of quality of life (QoL) in dementia. Although the instrument has been validated in several languages, the psychometric properties of the German self-report version have not yet been analyzed. OBJECTIVE This study examines the internal consistency, test-retest reliability, and construct validity of the German QoL-AD self-report scale. METHODS The sample included 30 patients suffering from mild to moderate Alzheimer's disease or vascular dementia (19 females; mean age 77.3 years; mean Mini-Mental State Examination (MMSE) score 19.7 points). To determine test-retest reliability, the QoL-AD self-report scale was re-administered four to seven days apart. For construct validity analysis, the Dementia Quality of Life instrument (DQoL), Geriatric Depression Scale (GDS), MMSE, and an adapted short form of the Neuropsychiatric Inventory (NPI) were used. RESULTS The German QoL-AD self-report scale shows an internal consistency of α= 0.79 and a test-retest reliability of r = 0.75 (p < 0.01). Regarding construct validity, there was a significant positive correlation between the total scores of the QoL-AD and DQoL (r = 0.47, p < 0.05). The analysis revealed no significant correlations with the GDS or the adapted NPI. No association could be observed between the QoL-AD and the MMSE (r = 0.01), confirming divergent validity. CONCLUSION The results indicate that the German QoL-AD self-report scale is a suitable instrument for assessing QoL in patients suffering from mild to moderate dementia, thus supporting its use in clinical practice and research.
Collapse
Affiliation(s)
- Vanessa Stypa
- Department of Geriatric Psychiatry and Psychotherapy, LVR-Hospital Cologne, Cologne, Germany
| | - Peter Haussermann
- Department of Geriatric Psychiatry and Psychotherapy, LVR-Hospital Cologne, Cologne, Germany
| | - Tim Fleiner
- Department of Geriatric Psychiatry and Psychotherapy, LVR-Hospital Cologne, Cologne, Germany.,Institute of Movement and Sport Gerontology, German Sport University Cologne, Cologne, Germany
| | - Sandra Neumann
- Inclusive Education of Children with Communication Needs, University Erfurt, Erfurt, Germany
| |
Collapse
|
20
|
Instruments to measure quality of life in institutionalised older adults: Systematic review. Geriatr Nurs 2020; 41:445-462. [PMID: 32178880 DOI: 10.1016/j.gerinurse.2020.01.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 01/18/2020] [Accepted: 01/20/2020] [Indexed: 11/24/2022]
Abstract
This study analysed the available instruments intended to measure the quality of life of institutionalised older adults, the psychometric properties of said instruments, and their use. This review was conducted using six international databases. The quality of the psychometric properties was assessed using the COSMIN checklist. Risk of bias was assessed using the QUADAS-2 tool. Twenty-four instruments which measure quality of life were analysed. The instruments assessed are related to two areas, thus establishing two stages of the concept of quality of life in the ageing process. The Dementia Quality of Life (DQoL) scale and the FACIT-Sp Spiritual Well-Being Scale were found to be the instruments with the best combination of length, high methodological quality, and bias control for use in older people with and without cognitive impairment, respectively. Knowing which instruments have higher quality will facilitate the evaluation of the aspects that influence quality of life in geriatric institutions.
Collapse
|
21
|
O'Shea E, Hopper L, Marques M, Gonçalves-Pereira M, Woods B, Jelley H, Verhey F, Kerpershoek L, Wolfs C, de Vugt M, Stephan A, Bieber A, Meyer G, Wimo A, Michelet M, Selbaek G, Portolani E, Zanetti O, Irving K. A comparison of self and proxy quality of life ratings for people with dementia and their carers: a European prospective cohort study. Aging Ment Health 2020; 24:162-170. [PMID: 30381955 DOI: 10.1080/13607863.2018.1517727] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Objectives: To identify correlates of self-rated and proxy-rated quality of life (QoL) in people with dementia on (i) a dementia-specific and (ii) a capability-wellbeing QoL measure at baseline and 12-month follow-up, and to consider such factors in the context of QoL intervention development.Method: Prospective clinical and demographic data were collected from 451 community-dwelling dyads (mild-moderate dementia) across eight European countries. QoL was measured using the QOL-AD and the ICECAP-O. Multivariate modelling identified correlates of self- and proxy-rated QoL at baseline and at 12-month follow-up.Results: Carer's proxy-ratings of QoL were significantly lower than self-ratings at all time-points for both measures. Proxy-ratings declined over time, but self-ratings remained stable. Baseline predictors of greater self-rated QoL were education, and greater functional ability and relationship quality. Greater proxy-rated QoL was associated with education and greater functional ability, relationship quality, carer social support and carer QoL, lower carer anxiety/depression and less severe neuropsychiatric symptoms in people with dementia. At follow-up, greater self-rated QoL was predicted by greater functional ability, relationship quality, carer social support and having a spousal carer. Greater proxy-rated QoL at follow-up was associated with the same factors as at baseline; however, the dyad living together was an additional predictive factor.Conclusion: Both proxy-ratings and self-ratings of QoL should be interpreted with caution and in the context of each individual caregiving relationship. Different functional, psychosocial, relational and contextual factors influence self- and proxy-ratings, and both sets of factors should be considered in the context of QoL intervention development for the dyad.
Collapse
Affiliation(s)
- E O'Shea
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - L Hopper
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - M Marques
- CEDOC, Chronic Diseases Research Centre, Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
| | - M Gonçalves-Pereira
- CEDOC, Chronic Diseases Research Centre, Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
| | - B Woods
- Dementia Services Development Centre, Bangor University, Bangor, UK
| | - H Jelley
- Dementia Services Development Centre, Bangor University, Bangor, UK
| | - F Verhey
- School for Mental Health and Neuroscience, Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - L Kerpershoek
- School for Mental Health and Neuroscience, Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - C Wolfs
- School for Mental Health and Neuroscience, Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - M de Vugt
- School for Mental Health and Neuroscience, Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - A Stephan
- Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - A Bieber
- Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - G Meyer
- Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - A Wimo
- Department of Neurobiology, Care sciences and Society, Karolinska Institut, Stockholm, Sweden
| | - M Michelet
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - G Selbaek
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - E Portolani
- Alzheimer's Research Unit-Memory Clinic, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - O Zanetti
- Alzheimer's Research Unit-Memory Clinic, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - K Irving
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | | |
Collapse
|
22
|
Assessing the quality of life and well-being of older adults with physical and cognitive impairments in a German-speaking setting: A systematic review of validity and utility of assessments / Die Erfassung von Lebensqualität und Wohlbefinden älterer Menschen mit psychischen und kognitiven Einschränkungen: ein systematisches Literaturreview zur Validität und Praktikabilität deutschsprachiger Assessments. INTERNATIONAL JOURNAL OF HEALTH PROFESSIONS 2019. [DOI: 10.2478/ijhp-2019-0014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Abstract
Background
For health professionals working with older adults with physical and cognitive impairments, improving or maintaining clients’ quality of life and well-being is of crucial importance. The aim of this study was to evaluate validity and utility of assessments of quality of life and well-being in German suitable for this group of clients.
Methods
In an initial literature search, we identified potentially viable assessments based on existing systematic reviews. We then conducted a systematic literature search in the databases Medline, CINAHL, and PsycINFO using keywords related to validity, utility, client group, and German. Assessments for which sufficient evidence was found were evaluated regarding their validity and utility when used with older adults with physical and cognitive impairments.
Results
For 14 of 27 initially identified assessments, sufficient evidence was found to evaluate validity and utility with this client group. WHOQOL-BREF, WHOQOL-OLD, WHO-5, EUROHIS-QOL 8, SF-36, SF-12, EQ-5D, NHP, SEIQOL-DW, SWLS, PANAS, DQOL, QOL-AD, and QUALIDEM were evaluated based on 82 studies. Of these, WHOQOL-BREF, WHO-5, SF-36, SF-12, EQ-5D, NHP, QUALIDEM, QOL-AD and DQOL are presented here.
Conclusion
Assessments differed widely in the way they operationalized quality of life/well-being, use of self-evaluation or evaluation-by-proxy, and amount of available evidence for their validity and utility. On the basis of our results in regard to the assessments’ validity, utility, and appropriateness of operationalization of quality of life/well-being to the client group, three assessments were recommended for use: WHOQOL-BREF for self-evaluation, QUALIDEM for evaluation-by-proxy in case of severe dementia, and EQ-5D for cost-utility analyses.
Collapse
|
23
|
Pereira MG, Vilaça M, Pedras S, Vieira S, Lima S. Validation of the spiritual and religious attitudes in dealing with illness (SpREUK) in Portuguese Alzheimer‘s patients. JOURNAL OF RELIGION SPIRITUALITY & AGING 2019. [DOI: 10.1080/15528030.2019.1610989] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | - M. Vilaça
- Universirty of Minho, Braga, Portugal
| | - S. Pedras
- Universirty of Minho, Braga, Portugal
| | - S. Vieira
- Universirty of Minho, Braga, Portugal
| | - S. Lima
- CESPU, Institute of Research and Advanced Training in Health Technologies Resarch Centre, Gandra, Portugal
| |
Collapse
|
24
|
Nelis SM, Wu YT, Matthews FE, Martyr A, Quinn C, Rippon I, Rusted J, Thom JM, Kopelman MD, Hindle JV, Jones RW, Clare L. The impact of co-morbidity on the quality of life of people with dementia: findings from the IDEAL study. Age Ageing 2019; 48:361-367. [PMID: 30403771 PMCID: PMC6503940 DOI: 10.1093/ageing/afy155] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 09/12/2018] [Indexed: 12/26/2022] Open
Abstract
Background The aim was to investigate the co-morbidity profile of people with dementia and examine the associations between severity of co-morbidity, health-related quality of life (HRQoL) and quality of life (QoL). Methods The improving the experience of Dementia and Enhancing Active Life (IDEAL) cohort consisted of 1,547 people diagnosed with dementia who provided information on the number and type of co-morbid conditions. Participants also provided ratings of their health-related and dementia-specific QoL. Results The majority of the sample were living with more than one chronic condition. Hypertension was commonly reported and frequently combined with connective tissue disease, diabetes and depression. The number of co-morbid conditions was associated with low QoL scores, and those with severe co-morbidity (≥5 conditions) showed the greatest impact on their well-being. Conclusions Co-morbidity is an important risk factor for poor QoL and health status in people with dementia. Greater recognition of the nature and impact of co-morbidity is needed to inform support and interventions for people with dementia and a multidisciplinary approach to care provision is recommended.
Collapse
Affiliation(s)
- Sharon M Nelis
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School and College of Life and Environmental Sciences, St Luke’s Campus, Exeter, UK
| | - Yu-Tzu Wu
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School and College of Life and Environmental Sciences, St Luke’s Campus, Exeter, UK
- King’s College London, Social Epidemiology Research Group, Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Fiona E Matthews
- Institute of Health and Society, Newcastle University, Newcastle Upon Tyne, UK
| | - Anthony Martyr
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School and College of Life and Environmental Sciences, St Luke’s Campus, Exeter, UK
| | - Catherine Quinn
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School and College of Life and Environmental Sciences, St Luke’s Campus, Exeter, UK
| | - Isla Rippon
- College of Health and Life Sciences, Brunel University London, London, UK
| | | | - Jeanette M Thom
- School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - Michael D Kopelman
- King’s College London, Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, UK
| | - John V Hindle
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School and College of Life and Environmental Sciences, St Luke’s Campus, Exeter, UK
| | - Roy W Jones
- RICE (The Research Institute for the Care of Older People), Bath, UK
| | - Linda Clare
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School and College of Life and Environmental Sciences, St Luke’s Campus, Exeter, UK
- Wellcome Centre for Cultures and Environments of Health, University of Exeter, Exeter, UK
| |
Collapse
|
25
|
Verdelho A, Madureira S, Correia M, Ferro JM, Rodrigues M, Gonçalves-Pereira M, Gonçalves M, Santos AC, Vilela P, Bárrios H, Borges M, Santa-Clara H. Impact of physical activity in vascular cognitive impairment (AFIVASC): study protocol for a randomised controlled trial. Trials 2019; 20:114. [PMID: 30744681 PMCID: PMC6371566 DOI: 10.1186/s13063-019-3174-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 01/02/2019] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Cognitive impairment and cerebrovascular pathology are both frequent with ageing. Cognitive impairment due to vascular pathology of the brain, termed vascular cognitive impairment (VCI), is one of the most frequent causes of cognitive impairment in elderly subjects. Thus far, VCI has no specific pharmacological treatment. Recent observational studies have suggested a protective effect of physical activity in cognition, but adequate randomised controlled trials (RCT) are lacking. METHODS AFIVASC is a multi-centre randomised controlled trial, with a 6-month intervention treatment and an additional follow-up of 6 months, that aims to estimate the impact of 6 months of moderate intensity physical activity on cognition (the primary outcome) at 6 and 12 months in subjects with VCI. Participants are community dwellers with criteria for VCI without dementia or who have had previous stroke or transient ischaemic attack (TIA). Patients may be self-referred or referred from a medical appointment. After confirming the inclusion criteria, a run-in period of 1 month is conducted to access adherence; only after that are subjects randomly assigned (using a computerised program blinded to clinical details) to two groups (intervention group and best practice usual care group). The intervention consists of three physical activity sessions of 60 min each (two supervised and one unsupervised) per week. The primary outcome is measured by the presence or absence of decline in cognitive status. Secondary outcomes include changes in neuro-cognitive measures, quality of life, and functional and motor status. Primary and secondary outcomes are evaluated at 6 and 12 months by investigators blinded to both intervention and randomisation. A required sample size of 280 subjects was estimated. Statistical analyses will include regression analysis with repeated measures. The study was approved by the Ethics Committee for Health of Centro Hospitalar de Lisboa Norte (ref. no. 1063/13) and by the Ethics Committee for Health of Centro Hospitalar do Porto CHP (ref. no. 2016.055(049-DEFI/048-CES)). DISCUSSION We aim to show whether or not moderate physical activity has a beneficial impact on cognition, quality of life, motor, and functional status in people with vascular cognitive impairment, and to generate new insights on the applicability of implementing physical activity in this specific population. TRIAL REGISTRATION ClinicalTrials.gov, NCT03578614 July 6, 2018.
Collapse
Affiliation(s)
- Ana Verdelho
- Department of Neurosciences and Mental Health, Faculdade de Medicina, Centro Hospitalar Universitário Lisboa Norte Hospital de Santa Maria, Instituto de Medicina Molecular (IMM) and Instituto de Saúde Ambiental (ISAMB), Universidade de Lisboa, Avenida Professor Egas Moniz, 1649035 Lisbon, Portugal
| | - Sofia Madureira
- Department of Psychology, ISCTE-IUL, NOVA Medical School / Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Instituto de Medicina Molecular (IMM), Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Manuel Correia
- Neurology Service, Hospital de Santo António, Centro Hospitalar do Porto and Instituto de Ciências Biomédicas Abel Salazar (ICBAS), University of Porto, Porto, Portugal
| | - José Manuel Ferro
- Instituto de Medicina Molecular (IMM), Faculdade de Medicina, Universidade de Lisboa and Department of Neuroscience, Hospital de Santa Maria-CHLN, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Mário Rodrigues
- Instituto de Medicina Molecular (IMM), Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Manuel Gonçalves-Pereira
- CEDOC, Chronic Diseases Research Center, NOVA Medical School /Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Mafalda Gonçalves
- Instituto de Medicina Molecular (IMM), Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Ana Catarina Santos
- Instituto de Medicina Molecular (IMM), Faculdade de Medicina, Universidade de Lisboa and Dementia Unit, Hospital do Mar, Lisbon, Portugal
| | - Pedro Vilela
- Neuroradiology - Imaging Department, Hospital da Luz, Lisbon, Portugal
| | - Helena Bárrios
- NOVA Medical School, Universidade Nova de Lisboa, Portugal and Instituto de Medicina Molecular (IMM), Hospital do Mar Lisboa, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Mariana Borges
- Instituto de Medicina Molecular (IMM), Faculdade de Medicina, Universidade de Lisboa and Faculdade de Motricidade Humana,Universidade de Lisboa, Lisbon, Portugal
| | - Helena Santa-Clara
- Faculdade de Motricidade Humana, Universidade de Lisboa, CIPER – Centro Interdisciplinar de Estudo da Performance Humana, Lisbon, Portugal
| |
Collapse
|
26
|
Kisvetrová H, Školoudík D, Herzig R, Vališ M, Jurašková B, Krulová P, Langová K, Bermellová J, Yamada Y. Psychometric Validation of the Czech Version of the Quality of Life - Alzheimer's Disease Scale in Patients with Early-Stage Dementia. Dement Geriatr Cogn Disord 2018; 46:109-118. [PMID: 30145599 DOI: 10.1159/000492490] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 07/26/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND/AIMS The aim of this study was to perform a psychometric validation of the Czech version of the Quality of Life - Alzheimer's Disease scale (QoL-AD) for patients with early-stage dementia. METHODS The sample included 212 patient-proxy pairs. For convergent validity, the Czech version of the Bristol Activities of Daily Living Scale (BADLS-CZ), the Short Physical Performance Battery (SPPB), and the Geriatric Depression Scale (GDS) were used. RESULTS The reliability of the QoL-AD for patients and caregivers was good (Cronbach's α = 0.85, ICC = 0.25-0.54). A positive correlation existed between the QoL-AD and the SPPB, and negative correlations existed between the QoL-AD and the BADLS-CZ as well as between the QoL-AD and the GDS. Factor analysis resulted in a three-factor solution (physical and mental health, family life, and social security). CONCLUSION The Czech version of the QoL-AD has good psychometric properties in compliance with international recommendations.
Collapse
Affiliation(s)
- Helena Kisvetrová
- Center for Research and Science, Faculty of Health Sciences, Palacký University, Olomouc, Czech Republic
| | - David Školoudík
- Center for Research and Science, Faculty of Health Sciences, Palacký University, Olomouc, Czech Republic
| | - Roman Herzig
- Neurology Clinic, University Hospital, Hradec Králové, Czech Republic
| | - Martin Vališ
- Neurology Clinic, University Hospital, Hradec Králové, Czech Republic
| | - Božena Jurašková
- Third Internal Clinic of Gerontology and Metabolism, University Hospital, Hradec Králové, Czech Republic
| | - Petra Krulová
- Neurology Clinic, University Hospital, Ostrava, Czech Republic
| | - Kateřina Langová
- Center for Research and Science, Faculty of Health Sciences, Palacký University, Olomouc, Czech Republic
| | - Jana Bermellová
- Center for Research and Science, Faculty of Health Sciences, Palacký University, Olomouc, Czech Republic
| | - Yukari Yamada
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| |
Collapse
|
27
|
Dichter MN, Wolschon EM, Schwab CGG, Meyer G, Köpke S. Item distribution and inter-rater reliability of the German version of the quality of life in Alzheimer's disease scale (QoL-AD) proxy for people with dementia living in nursing homes. BMC Geriatr 2018; 18:145. [PMID: 29914389 PMCID: PMC6006695 DOI: 10.1186/s12877-018-0834-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 06/10/2018] [Indexed: 01/05/2023] Open
Abstract
Background The Quality of Life in Alzheimer’s disease scale (QoL-AD) is a widely used Health Related Quality of Life (HRQoL) instrument. However, studies investigating the instrument’s inter-rater reliability (IRR) are missing. This study aimed to determine the item distribution and IRR of the German proxy version of the QoL-AD (13 Items) and a nursing home-specific instrument version (QoL-AD NH, 15 Items). Methods The instruments were applied to 73 people with dementia living in eight nursing homes in Germany. Individuals with dementia were assessed two times by blinded proxy raters. The IRR analyses were based on methodological criteria of the quality appraisal tool for studies of diagnostic reliability (QAREL), the COSMIN group and the single-measure Intra-Class Correlation Coefficient (ICC) for absolute agreement ≥0.70. Results All items for both instrument versions demonstrated acceptable item difficulty, with the exception of one item (QoL-AD proxy). The IRR was moderate for the QoL-AD (ICC: 0.65) and insufficient for the QoL-AD NH (ICC: 0.18). The additional computation of the average measure ICC for two proxy-raters demonstrated a strong IRR (ICC: 0.79) for the QoL-AD and a weak IRR for the QoL-AD NH (ICC: 0.31). The detailed analysis of the IRR for each item underpinned the need for the further development of both instruments. Conclusions The unsatisfactory IRRs for both instruments highlight the need for the development of a user guide including general instructions for instrument application as well as definitions and examples reflecting item meaning. Priority should be given to the development of reliable proxy-person versions of both instruments. Trial registration ClinicalTrials.gov: NCT02295462, Date of registration: 11–20-2014.
Collapse
Affiliation(s)
- Martin Nikolaus Dichter
- German Center for Neurodegenerative Diseases (DZNE), Stockumer Straße 12, 58453, Witten, Germany. .,School of Nursing Science, Witten/Herdecke University, Stockumer Straße 12, 58453, Witten, Germany.
| | - Eva-Maria Wolschon
- Institute of Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Christian G G Schwab
- German Center for Neurodegenerative Diseases (DZNE), Stockumer Straße 12, 58453, Witten, Germany.,School of Nursing Science, Witten/Herdecke University, Stockumer Straße 12, 58453, Witten, Germany
| | - Gabriele Meyer
- Institute for Health and Nursing Science, Medical Faculty, Martin Luther University, Halle-, Wittenberg, Germany
| | - Sascha Köpke
- Institute of Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| |
Collapse
|
28
|
Salihović D, Smajlović D, Mijajlović M, Zoletić E, Ibrahimagić OĆ. Cognitive syndromes after the first stroke. Neurol Sci 2018; 39:1445-1451. [PMID: 29779138 DOI: 10.1007/s10072-018-3447-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 05/10/2018] [Indexed: 11/24/2022]
Abstract
AIM The aim of this study is to determine impairments of certain cognitive functions in certain vascular cognitive syndromes and to identify predictors of dementia. PATIENTS AND METHODS One-year prospective study included 275 patients, who were hospitalized at the Department of Neurology Tuzla and therefore fulfilled certain criteria. Patients were divided into following subgroups of vascular cognitive impairment (VCI): dementia of strategic infarct (DSI), cortical dementia (CD), sub cortical dementia (SCD), hemorrhagic dementia (HD), and patients without dementia. Each of the patients underwent the clinical examination and scoring with appropriate measurement scales. RESULTS Some of the types of VCI were verified in 190 (69%) patients, and the most common was SCD (58%). There was statistically significant connection between the level of intelligence and occurrence of VCI in patients after stroke (p < 0.001). We found significant connection between occurrence of dementia and impairment in narrative memory, numerical memory, visual perceptive, and visual constructive functions in patients with dementia compared with non-demented (p = 0.0001). The executive functions were statistically impaired in patients with CD (p = 0.004) and SCD (p < 0.001). Patients without dementia have significantly better quality of life than the demented ones (p < 0.0001). The algorithm "tree of decision" can help us in the prediction of dementia based on the impairment of certain cognitive functions. CONCLUSION Vascular cognitive syndromes are common after stroke. Some of the cognitive functions are significantly impaired in patients with dementia. Impairment of the certain cognitive functions can help in predicting the onset of dementia. Patients without dementia have better quality of life.
Collapse
Affiliation(s)
- Denisa Salihović
- Department of Neurology, University Cinical Center Tuzla, Prof. dr. Ibre Pašića bb, 75000, Tuzla, Bosnia and Herzegovina.
| | - Dževdet Smajlović
- Department of Neurology, University Cinical Center Tuzla, Prof. dr. Ibre Pašića bb, 75000, Tuzla, Bosnia and Herzegovina
| | - Milija Mijajlović
- Neurology Clinic, Clinical Center of Serbia and School of Medicine, University of Belgrade, Dr Subotića 6, 11000, Belgrade, Serbia
| | - Emina Zoletić
- Department of Psychology, University Clinical Center Tuzla, Prof. dr. Ibre Pašića bb, 75000, Tuzla, Bosnia and Herzegovina
| | - Omer Ć Ibrahimagić
- Department of Neurology, University Cinical Center Tuzla, Prof. dr. Ibre Pašića bb, 75000, Tuzla, Bosnia and Herzegovina
| |
Collapse
|
29
|
Lima S, Gago M, Garrett C, Pereira MG. Predictors and Moderators of Quality of Life in Alzheimer's Disease Patients. J Alzheimers Dis 2018; 54:1113-1121. [PMID: 27567826 DOI: 10.3233/jad-160256] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Alzheimer's disease (AD) is a chronic degenerative disease leading to global cognitive and functional decline. Quality of Life (QOL) is an important variable in the effectiveness of intervention programs in dementia. OBJECTIVE This study analyzed the relationships between gender, psychological variables and QOL, the predictors of QOL, and the role of spirituality as a moderator between functionality and QOL. METHOD A cross-sectional study was conducted with 128 patients with mild AD. RESULTS Being a male, good social support, and high functionality were significant predictors of better QOL. Spirituality was a moderator in the relationship between functionality and QOL. CONCLUSION These results reinforce the importance of gender, psychological morbidity, social support, and functionality, with special emphasis on the role of spirituality, regarding intervention programs that promote QOL, in patients with mild AD.
Collapse
Affiliation(s)
- Sara Lima
- School of Psychology, University of Minho, Braga, Portugal.,Research Group of Family Health and Ilness for Research Center on Psychology, University of Minho, Braga, Portugal.,CESPU - Cooperativa de Ensino Superior Politécnico e Universitário, Portugal and Institute of Research and Advanced Training in Heath Sciences and Technologies (INFACTS/CESPU), Portugal
| | - Miguel Gago
- Serviço de Neurologia for Department of Neurology, Hospital Senhora da Oliveira, Guimarães, Portugal.,Academic Center Human Research Program, Hospital Senhora da Oliveira, Guimarães, Portugal.,Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
| | - Carolina Garrett
- Faculty of Medicine, University of Porto, Portugal.,Department of Neurology, Hospital S. João, Portugal
| | - M Graça Pereira
- School of Psychology, University of Minho, Braga, Portugal.,Research Group of Family Health and Ilness for Research Center on Psychology, University of Minho, Braga, Portugal
| |
Collapse
|
30
|
Torisson G, Stavenow L, Minthon L, Londos E. Reliability, validity and clinical correlates of the Quality of Life in Alzheimer's disease (QoL-AD) scale in medical inpatients. Health Qual Life Outcomes 2016; 14:90. [PMID: 27301257 PMCID: PMC4908755 DOI: 10.1186/s12955-016-0493-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 06/07/2016] [Indexed: 11/14/2022] Open
Abstract
Background There is a lack of standardisation in quality of life (QoL) measurements to be used in older multimorbid patients. An ideal QoL measurement should be reliable, valid, subjective, multidimensional, feasible and generic. We hypothesised that the QoL-AD (Quality of Life in Alzheimer’s Disease) scale could have these properties. Our aim was to determine the psychometric properties and clinical correlations of QoL-AD in a population of elderly, multimorbid medical inpatients. Methods QoL-AD was performed in 200 medical inpatients, and available caregivers. Reliability was determined using cronbach’s alpha and corrected item-total correlations. The agreement between patient and proxy ratings were examined using intra-class correlations (ICC). Correlations between QoL-AD and demographic data, comorbidity, cognitive tests, ADL (activities of daily living) and depression were examined. To characterise the underlying constructs of QoL-AD, an exploratory factor analysis was performed. Results In total, 199 patients fulfilled the QoL-AD rating, with 139 proxy ratings. Cronbach’s alpha (95 % CI) was 0.74 (0.68–0.79) for patients and 0.86 (0.83–0.90) for proxies. Patient-proxy ICC (95 % CI) was 0.31 (0.16–0.46). Lower QoL was correlated to depression, cognitive impairment, ADL impairment and solitary living, but not with comorbidity. The factor analysis gave a three-factor solution, with factors representing phsyical, social and psychological well-being. Conclusion The QoL-AD scale showed some promising properties but more research is needed before it can be recommended in this setting. If replicated, the finding that cognitive impairment, depression and ADL impairment were more associated with lower QoL than somatic comorbidity could have clinical implications for further studies aiming to improve QoL in this population. Electronic supplementary material The online version of this article (doi:10.1186/s12955-016-0493-8) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Gustav Torisson
- Clinical Memory Research Unit, Lund University, Simrisbanvägen 14, S 20502, Malmö, Sweden.
| | - Lars Stavenow
- Deparment of Internal Medicine, Skåne University Hospital, Malmö, Sweden
| | - Lennart Minthon
- Clinical Memory Research Unit, Lund University, Simrisbanvägen 14, S 20502, Malmö, Sweden
| | - Elisabet Londos
- Clinical Memory Research Unit, Lund University, Simrisbanvägen 14, S 20502, Malmö, Sweden
| |
Collapse
|
31
|
Dichter MN, Schwab CGG, Meyer G, Bartholomeyczik S, Halek M. Linguistic validation and reliability properties are weak investigated of most dementia-specific quality of life measurements-a systematic review. J Clin Epidemiol 2015; 70:233-45. [PMID: 26319270 DOI: 10.1016/j.jclinepi.2015.08.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 07/20/2015] [Accepted: 08/11/2015] [Indexed: 01/08/2023]
Abstract
OBJECTIVE For people with dementia, the concept of quality of life (Qol) reflects the disease's impact on the whole person. Thus, Qol is an increasingly used outcome measure in dementia research. This systematic review was performed to identify available dementia-specific Qol measurements and to assess the quality of linguistic validations and reliability studies of these measurements (PROSPERO 2013: CRD42014008725). STUDY DESIGN AND SETTING The MEDLINE, CINAHL, EMBASE, PsycINFO, and Cochrane Methodology Register databases were systematically searched without any date restrictions. Forward and backward citation tracking were performed on the basis of selected articles. RESULTS A total of 70 articles addressing 19 dementia-specific Qol measurements were identified; nine measurements were adapted to nonorigin countries. The quality of the linguistic validations varied from insufficient to good. Internal consistency was the most frequently tested reliability property. Most of the reliability studies lacked internal validity. CONCLUSION Qol measurements for dementia are insufficiently linguistic validated and not well tested for reliability. None of the identified measurements can be recommended without further research. The application of international guidelines and quality criteria is strongly recommended for the performance of linguistic validations and reliability studies of dementia-specific Qol measurements.
Collapse
Affiliation(s)
- Martin Nikolaus Dichter
- German Center for Neurodegenerative Diseases (DZNE), Stockumer Straße 12, 58453 Witten, Germany; School of Nursing Science, Witten/Herdecke University, Stockumer Straße 12, 58453 Witten, Germany.
| | - Christian G G Schwab
- German Center for Neurodegenerative Diseases (DZNE), Stockumer Straße 12, 58453 Witten, Germany; School of Nursing Science, Witten/Herdecke University, Stockumer Straße 12, 58453 Witten, Germany
| | - Gabriele Meyer
- School of Nursing Science, Witten/Herdecke University, Stockumer Straße 12, 58453 Witten, Germany; Institute for Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112 Halle (Saale), Germany
| | - Sabine Bartholomeyczik
- School of Nursing Science, Witten/Herdecke University, Stockumer Straße 12, 58453 Witten, Germany
| | - Margareta Halek
- German Center for Neurodegenerative Diseases (DZNE), Stockumer Straße 12, 58453 Witten, Germany; School of Nursing Science, Witten/Herdecke University, Stockumer Straße 12, 58453 Witten, Germany
| |
Collapse
|
32
|
Pereira A, de Mendonça A, Silva D, Guerreiro M, Freeman J, Ellis J. Enhancing prospective memory in mild cognitive impairment: The role of enactment. J Clin Exp Neuropsychol 2015; 37:863-77. [PMID: 26313515 DOI: 10.1080/13803395.2015.1072499] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Prospective memory (PM) is a fundamental requirement for independent living which might be prematurely compromised in the neurodegenerative process, namely in mild cognitive impairment (MCI), a typical prodromal Alzheimer's disease (AD) phase. Most encoding manipulations that typically enhance learning in healthy adults are of minimal benefit to AD patients. However, there is some indication that these can display a recall advantage when encoding is accompanied by the physical enactment of the material. The aim of this study was to explore the potential benefits of enactment at encoding and cue-action relatedness on memory for intentions in MCI patients and healthy controls using a behavioral PM experimental paradigm. METHOD We report findings examining the influence of enactment at encoding for PM performance in MCI patients and age- and education-matched controls using a laboratory-based PM task with a factorial independent design. RESULTS PM performance was consistently superior when physical enactment was used at encoding and when target-action pairs were strongly associated. Importantly, these beneficial effects were cumulative and observable across both a healthy and a cognitively impaired lifespan as well as evident in the perceived subjective difficulty in performing the task. CONCLUSIONS The identified beneficial effects of enacted encoding and semantic relatedness have unveiled the potential contribution of this encoding technique to optimize attentional demands through an adaptive allocation of strategic resources. We discuss our findings with respect to their potential impact on developing strategies to improve PM in AD sufferers.
Collapse
Affiliation(s)
- Antonina Pereira
- a Department of Psychology & Counselling , University of Chichester , Chichester , UK
| | | | | | | | | | | |
Collapse
|