Person-centered care as a tool to reduce behavioral and psychological symptoms in older adults with dementia living in residential care facilities

Among older adults living in dementia residential care facilities (RCF) behavioral and psychological symptoms (BPSD) are common, affecting the quality of life (QOL) for the residents as well as being challenging for the staff. The person-centered care (PCC) approach addresses BPSD by giving trained staff mandate to focus on the relation and to adapt the encounter and the environment to increase QoL for the person with dementia. The aims with this study were to improve PCC, decrease BPSD and improve QOL among older persons with dementia living in RCFs, and to explore leaders' and healthcare staff's experiences of a PCC intervention. An educational program was implemented at two RCFs. Data was collected through questionnaires, from national quality registries and through focus group interviews. A significant increase in PCC and QOL at three months was seen. However, no significant difference in BPSD was seen. The interviews showed the importance of a trust-based relationship, and support from an active management to improve PCC, as well as changing old patterns and recognising competence among staff. Factors that affect implementation of PCC in RCF are discussed in the article.

Effects of a Family Caregiver-Delivered MultiSensory Cognitive Stimulation Intervention for Older People With Dementia During Coronavirus 2019: A Randomized Controlled Trial

BACKGROUND AND OBJECTIVES

Many community dementia services such as home-visiting services and center-based activities were suspended during the coronavirus 2019 pandemic. This study investigated the efficacy of a caregiver-delivered cognitive stimulation therapy (CDCST) on people with dementia during the pandemic.

RESEARCH DESIGN AND METHODS

This was a 2-arm randomized controlled trial involving 241 patient-caregiver dyads assigned to a 15-week CDCST or control group (usual care). We hypothesized that CDCST would facilitate significant improvements among people with dementia (cognition, behavioral/psychiatric symptoms, and quality of life) and their caregivers (caregiving appraisal, attitudes, and psychological well-being) at postintervention (T1) and at the 12-week follow-up (T2). Generalized estimating equations evaluated the study outcomes.

RESULTS

A total of 230 dyads completed the study, with good program adherence (93%). Participants in the CDCST showed significant improvements in cognition (p < .001), behavioral and psychiatric symptoms (p =. 027), and quality of life (p =.001) at the 3-month follow-up period. Family caregivers had improved positive aspects of caregiving (p = .008; p = .049) and decreased negative attitudes toward people with dementia (p =. 013; p < .001) at both T1 and T2. There were nonsignificant changes in the caregivers' perceived burden, distress, and psychological well-being.

DISCUSSION AND IMPLICATIONS

Family caregivers could be trained to provide cognitive stimulation at home for people with dementia, which could benefit both parties. CDCST could manage to improve the cognition, neuropsychiatric symptoms, and quality of life of people with dementia, while also improving caregiving appraisal and negative attitudes among family caregivers.

CLINICAL TRIAL REGISTRATION NUMBER

NCT03803592.

Machine learning analyses identify multi-modal frailty factors that selectively discriminate four cohorts in the Alzheimer's disease spectrum: a COMPASS-ND study

BACKGROUND

Frailty indicators can operate in dynamic amalgamations of disease conditions, clinical symptoms, biomarkers, medical signals, cognitive characteristics, and even health beliefs and practices. This study is the first to evaluate which, among these multiple frailty-related indicators, are important and differential predictors of clinical cohorts that represent progression along an Alzheimer's disease (AD) spectrum. We applied machine-learning technology to such indicators in order to identify the leading predictors of three AD spectrum cohorts; viz., subjective cognitive impairment (SCI), mild cognitive impairment (MCI), and AD. The common benchmark was a cohort of cognitively unimpaired (CU) older adults.

METHODS

The four cohorts were from the cross-sectional Comprehensive Assessment of Neurodegeneration and Dementia dataset. We used random forest analysis (Python 3.7) to simultaneously test the relative importance of 83 multi-modal frailty indicators in discriminating the cohorts. We performed an explainable artificial intelligence method (Tree Shapley Additive exPlanation values) for deep interpretation of prediction effects.

RESULTS

We observed strong concurrent prediction results, with clusters varying across cohorts. The SCI model demonstrated excellent prediction accuracy (AUC = 0.89). Three leading predictors were poorer quality of life ([QoL]; memory), abnormal lymphocyte count, and abnormal neutrophil count. The MCI model demonstrated a similarly high AUC (0.88). Five leading predictors were poorer QoL (memory, leisure), male sex, abnormal lymphocyte count, and poorer self-rated eyesight. The AD model demonstrated outstanding prediction accuracy (AUC = 0.98). Ten leading predictors were poorer QoL (memory), reduced olfaction, male sex, increased dependence in activities of daily living (n = 6), and poorer visual contrast.

CONCLUSIONS

Both convergent and cohort-specific frailty factors discriminated the AD spectrum cohorts. Convergence was observed as all cohorts were marked by lower quality of life (memory), supporting recent research and clinical attention to subjective experiences of memory aging and their potentially broad ramifications. Diversity was displayed in that, of the 14 leading predictors extracted across models, 11 were selectively sensitive to one cohort. A morbidity intensity trend was indicated by an increasing number and diversity of predictors corresponding to clinical severity, especially in AD. Knowledge of differential deficit predictors across AD clinical cohorts may promote precision interventions.

The effectiveness of internet-based psychoeducation programs for caregivers of people living with dementia: a systematic review and meta-analysis

OBJECTIVE

The objectives of this systematic review and meta-analysis were to identify the characteristics of internet-based psychoeducational programs for caregivers of people living with dementia and to synthesise program effectiveness.

METHOD

Five English databases and four Chinese databases were searched in June 2021 with no time limit applied. A narrative summary was performed to describe the characteristics of studies reviewed. Meta-analysis was applied to synthesise the pooled effects where data were available.

RESULTS

A total of 14352 articles were identified from the database search and 19 were included in the final review. Interventions comprised educational, psychological, and behavioural training relevant to dementia care. Program duration ranged from 3 weeks to 12 months. Meta-analysis of 13 RCTs showed that internet-based psychoeducational programs had a significant effect on reducing caregivers' depressive symptoms (SMD -0.19; 95% CI -0.03 - 0.35) and stress (SMD -0.29; 95% CI -0.03 -0.54). However, these programs did not show an effect on quality of life, anxiety, burden or self-efficacy in caregivers.

CONCLUSION

Internet-based psychoeducational programs can improve some aspects of caregivers' mental health and emotional wellbeing. The effects of programs on self-efficacy, anxiety, burden and quality of life for caregivers remain inconclusive.

Understanding Capacity and Optimizing Meaningful Engagement among Persons Living with Dementia

Meaningful engagement is a key dimension of quality of life among persons living with dementia, yet little is known about how to best to promote it. Guided by grounded theory methods, we present analysis of data collected over a 1-year period in four diverse assisted living (AL) communities as part of the study, "Meaningful Engagement and Quality of Life among Assisted Living Residents with Dementia." Our aims are to: (a) learn how meaningful engagement is negotiated among AL residents with dementia and their care partners; and (b) identify how to create these positive encounters. Researchers followed 33 residents and 100 care partners (formal and informal) and used participant observation, resident record review, and semi-structured interviews. Data analysis identified "engagement capacity" as central to the negotiation of meaningful engagement. We conclude that understanding and optimizing the engagement capacities of residents, care partners, care convoys, and settings, are essential to creating and enhancing meaningful engagement among persons living with dementia.

The Impact of Music Therapists’ Perspectives on Quality of Life in Building Relationships with Older Adults with Chronic Illness

Older adults with chronic illnesses have diminished qualities of life (QoL) due to physical and mental decline. To promote their QoL, music therapists create meaningful shared music experiences and positive therapeutic relationships to address their psychosocial needs. However, within this relationship-building process, healthcare professionals, staff, and even caregivers appear to project their own perceptions and expectations of what positive QoL of older adults should be. This misapprehension may challenge therapists to meet older adults’ actual QoL needs adequately. To date, no studies have explored music therapists’ perspectives on QoL in building relationships with older adults experiencing chronic illness. Eleven music therapists participated in online, semi-structured phenomenological interviews that were thematically analyzed. Three themes emerged: participants gained an increased awareness of unconscious biases, a deepened understanding of older adults’ QoL, and a purposeful alignment with older adults’ QoL. These highlighted the significance of therapists’ consistent self-reflection within the relationship-building process. Identifying their shared commonalities with older adults guided therapists to engage with clients more salutogenically and empathically. Additionally, recognizing their own biases being projected onto older adults empowered therapists to be more intentional to reconcile their perceptual discrepancies while prioritizing older adults’ authentic voices and capable selves.

Determinants of quality of life among people with dementia: evidence from a South Asian population

BACKGROUND

Dementia has become a public health priority along with population aging worldwide. Owing to its chronic progressive nature in the absence of a cure, maintaining the best possible quality of life (QOL) has become the desired outcome for people with dementia (PWD).

AIM

The current study aimed to determine the factors associated with 'good QOL' in people with dementia in the Sri Lankan setting.

METHODS

An unmatched case-control study was conducted to identify the factors associated with 'good QoL. Cases in the study included dementia patients having 'good' QOL, whereas controls were those having 'poor' or 'average' QOL. Both cases and controls were selected from the same patient base at a premier tertiary care state hospital in Colombo District, Sri Lanka. They were identified using the validated DEMQOL (Dementia Specific Quality of Life) tool, adhering to strict eligibility criteria. An interviewer-administered questionnaire was used to assess the associated factors. Bivariate analysis followed by logistic regression modelling determined the associated factors for 'good QOL' adjusted for confounders using odds ratio (OR) and 95% confidence interval (CI).

RESULTS

The study sample consisted of 64 cases and 208 controls. After adjusting for confounders, education up to GCE O/Level and above (OR = 4.02; 95% CI = 2.97, 12.0), ever employed (OR = 3.21; 95% CI = 1.59, 11.06), good social functioning (OR = 4.14; 95% CI = 3.39, 16.46), mild functional impairment (OR = 1.77; 95% CI = 1.13, 9.67), little or no caregiver burden (OR = 2.96; 95% CI = 1.86, 10.94), absence of apathy (OR = 2.22; 95% CI = 1.27, 12.48) and absence of irritability (OR = 2.17; 95% CI = 1.72, 10.34) were found to be significantly associated with 'good QOL'. 60% of the variance of 'good' QOL among PWD was explained by the factors in the final model. CONCLUSIONS AND RECOMMENDATIONS: The identified determinants of 'good QOL' clearly show how the QOL improvement interventions need to be planned. Accordingly, such programmes should be primarily focused on strategies to improve PWDs' ADL (Activities of Daily living), reduce and manage neuropsychiatric symptoms effectively and to promote activities enhancing social functioning, and plan programmes to address caregiver burden.

Pain in nursing home residents with dementia and its association to quality of life

OBJECTIVES

We aimed to describe pain, use of analgesics and quality of life (QoL) in people with dementia admitted to a Norwegian nursing home (NH), and to explore if and how pain was associated with their QoL when adjusting for sociodemographic characteristics, other health conditions and use of analgesics.

METHOD

A total of 953 Norwegian NH residents with dementia (mean age 84.0, SD 7.5 years, 35.8% men) were included at admission to the NH. Pain and QoL were assessed using the Mobilization-Observation-Behavior-Intensity-Dementia-2 (MOBID-2) Pain Scale and the Quality of Life in Late-Stage Dementia (QUALID) scale, respectively. Severity of dementia, personal level of activities of daily living, general medical health, neuropsychiatric symptoms, and the use of psychotropic drugs and analgesics were assessed.

RESULTS

In total, 36% of the participants had clinically relevant pain intensity (MOBID-2 ≥ 3) and 52% received analgesics. Paracetamol was most frequently prescribed (45%). In an adjusted linear mixed model, more severe pain was associated with higher QUALID total scores, indicating poorer QoL (regression coefficient 0.52, 95% CI 0.36-0.69).

CONCLUSION

Pain prevalence at NH admission was high in residents with dementia; half used analgesics, particularly paracetamol. More severe pain was associated with poorer QoL when adjusting for sociodemographic characteristics, other health conditions, and use of analgesics. The routine assessment of pain at NH admission can uncover undiagnosed and untreated pain and allow for adequate non-pharmacological and pharmacological pain management and likely increased QoL.

Emotional well-being in people with dementia - A comparative study of farm-based and regular day care services in Norway

There is a focus on how to provide care for the increasing number of people with dementia, and day care services have been highlighted as an important service. The present study aims to provide an in-depth comparison of the emotional well-being of participants at farm-based and regular day care services related to different aspects of the care environments. We used the Maastricht Electronic Daily Life Observation-tool to observe and register aspects of the care environment at the services. Observations took place at ten farm-based day care services, with 42 participants, and seven regular day care centres, with 46 participants. Observed mood was considered an indicator for the emotional well-being of the participants and used as the primary outcome. The analyses showed a general positive mood for all participants, regardless of type of day care service. The unadjusted analyses showed more emotional well-being for the participants at farm-based day care across a range of factors compared to regular day care. The linear mixed model found that regardless of service type the activities (1) exercise and dancing, and (2) quiz, music and spiritual activities were associated with emotional well-being. In addition, social interaction, either with one person or two or more people, were also associated with emotional well-being regardless of service type. The mixed model further demonstrated an association between attending farm-based day care services and positive mood compared to regular day care services. Based on the findings social interaction and social activities seem important to emotional well-being. This highlights the social aspect of the day care services and future research should investigate how one can facilitate good social interactions at day care services. The positive association between farm-based day care services and emotional well-being may potentially reflect a positive influence of the farm setting and the farm service providers.

Effectiveness of cognitive stimulation therapy (CST) on cognition, quality of life and neuropsychiatric symptoms for patients living with dementia: A meta-analysis

INTRODUCTION

Many scholars have explored the effect of cognitive stimulation therapy (CST) on dementia patients, however, due to different experimental designs and insufficient sample sizes, research results are inconsistent. Furthermore, there is a scarcity of high-quality quantitative results.

OBJECTIVE

To assess the effectiveness of CST for improving cognition, quality of life (QoL) and neuropsychiatric symptoms in people with dementia (PwD).

METHODS

Chinese and English databases were searched for randomized controlled trials (RCTs) between establishment of and April 2022, with another search done in May 2022. Finally, 10 studies on the application of CST in PwD for improving cognition, QoL, behavior, language and activities of daily living were reviewed.

RESULTS

Based on the results of the 10 RCTs, CST significantly improved cognitive performance (MMSE: WMD = 1.98, 95% CI: 1.24-2.72, P<0.01), QoL (WMD = 3.12, 95% CI: 2.52-3.72, P<0.01), language (NLT: WMD = 2.71, 95% CI: 1.07-4.35, P<0.01) and activities of daily living (DAD: WMD = 7.27, 95% CI: 0.97-13.56, P<0.01) in PwD. However, no significant improvements in ADAS-Cog (WMD = 0.55, 95% CI: -3.04-4.14, P = 0.76), depression (SMD = -0.12,95% CI: -0.29-0.04, P = 0.15), anxiety (RAID: WMD = -1.05, 95% CI: -3.85-1.75, P = 0.46) or neuropsychiatric symptoms (NPI: WMD = 0.23, 95% CI: -2.62-3.07, P = 0.88) were found.

CONCLUSION

CST improved the cognitive ability, QoL, language and activities of daily living of PwD. However, the effect of neuropsychiatric symptoms on PwD requires further exploration.

Use of an Ambient Activity Technology for Long-Term Care Residents With Dementia

The purpose of the current pilot study was to determine the impact of an ambient activity technology, ABBY^®, on responsive behavior and family visiting in a long-term care (LTC) home. We were also interested in family and staff perceptions of the technology. A mixed methods research study was conducted over a 6-month period and data were collected using standardized measures and focus groups. Although no significant differences were noted in responsive resident behaviors, focus group data showed the ABBY enriched the care environment and provided additional opportunities for families and staff to engage residents. Although the introduction of a new technology can create challenges for staff, with time, these challenges can be overcome. [Journal of Gerontological Nursing, 48(1), 35-41.].

Clinical Observation on the Effect of Systematic Nursing Intervention on Cognitive Function, Life Activity Ability, and Quality of Life of Senile Dementia Patients

OBJECTIVE

To explore the influence of systematic nursing intervention on the life ability and quality of senile dementia patients.

METHODS

Total of 82 senile dementia patients who were admitted to our hospital from January 2018 to January 2020 were divided into two groups according to the random number table, and the nursing intervention was analyzed. 41 patients in the control group were given routine nursing care, and 41 patients in the observation group were given systematic nursing intervention. Patients were assessed cognitively using the Montreal Cognitive Assessment Scale (MoCA). The Barthel index and SF-36 were used to evaluate the patients' daily activity function and quality of life. A Symptom Checklist-90-Revised (SCL-90-R) was used to assess mental distress. The Social-Adaptive Function Rating Scale (SAFE) and Social Skills Inventory (SSC) were used to evaluate the patients' social interaction ability before and after nursing intervention. Nursing satisfaction was distributed to patients in the form of a self-prepared nursing satisfaction questionnaire for scoring.

RESULTS

After the nursing intervention, the MoCA scores of patients in the two groups were higher than those before the nursing intervention, and the scores in the observation group were higher than those in the control group (P < 0.05). After the nursing intervention, the Barthel index scores of patients in the two groups were higher than those before the nursing intervention, and the scores in the observation group were higher than those in the control group (P < 0.05). After the nursing intervention, the SF-36 scores of patients in the two groups were higher than those before the nursing intervention, and the scores in the observation group were higher than those in the control group (P < 0.05). After nursing intervention, the SCL-90-R scores of patients in the two groups were lower than those before nursing intervention, and the scores in the observation group were lower than those in the control group (P < 0.05). After the nursing intervention, the SAFE scores of patients in the two groups were lower than those before the nursing intervention, and the safe scores of the observation group were lower than those of the control group (P < 0.05). After the nursing intervention, the SSC scores of patients in the two groups were lower than those before the nursing intervention, and the scores in the observation group were lower than those in the control group (P < 0.05). After nursing intervention, the total satisfaction degree of the control group (80.49%) was lower than that of the observation group (97.56%) (P < 0.05).

CONCLUSION

The implementation of systematic nursing intervention is conducive to improve the cognitive function, activity of life, and quality of life of senile dementia patients who have a positive effect, and nursing satisfaction is higher.

Feasibility and Effectiveness of a Biography-Based Physical Activity Intervention in Institutionalized People With Dementia: Quantitative and Qualitative Results From a Randomized Controlled Trial

The objective of this multicenter randomized controlled trial was to evaluate the feasibility and effectiveness of a physical activity intervention for institutionalized people with dementia, individualized by capacity and biography. The intervention group (n = 34; age: mean = 86.09 years; 79.40% female; mean Mini-Mental State Examination value = 18.59) participated in a multicomponent training program, which included daily activities, dancing, gardening, and sports/games, twice weekly for 3 months. The control group (n = 29; age: mean = 86.34 years; 75.90% female; mean Mini-Mental State Examination value = 19.90) received standard care. Feasibility was evaluated by means of focus groups and feedback questionnaires. Functional performance (Short Physical Performance Battery and Timed Up and Go Test), activities of daily living, and gait were outcomes for effectiveness. A high adherence rate (80.46%) and uniformly positive feedback indicate that the piloted training program is feasible. The results show preliminary effectiveness on functional performance (Short Physical Performance Battery mean t0 = 3.15; mean t1 = 4.50; p = .006) and gait (e.g., velocity mean t0 = 46.97; mean t1 = 58.04; p = .007).

Adapting a guided low-intensity behavioural activation intervention for people with dementia and depression in the Swedish healthcare context (INVOLVERA): a study protocol using codesign and participatory action research

INTRODUCTION

Dementia is a worldwide health concern with incident rates continuing to increase. While depression prevalence is high in people with dementia and psychological interventions such as cognitive behavioural therapy (CBT) are effective, access to psychological interventions remains limited. Reliance on traditional CBT for people with dementia and depression may present difficulties given it is a complex psychological approach, costly to deliver, and professional training time is lengthy. An alternative approach is behavioural activation (BA), a simpler psychological intervention for depression. The present study seeks to work with people with dementia, informal caregivers, community stakeholders, and healthcare professionals, to adapt a guided low-intensity BA intervention for people with dementia and depression, while maximising implementation potential within the Swedish healthcare context.

METHODS AND ANALYSIS

A mixed methods study using codesign, principles from participatory action research (PAR) and normalisation process theory to facilitate the cultural relevance, appropriateness and implementation potential of the intervention. The study will consist of four iterative PAR phases, using focus groups with healthcare professionals and community stakeholders, and semi-structured interviews with people with dementia and informal caregivers. A content analysis approach will be adopted to analyse the transcribed focus groups and semi-structured interviews recordings.

ETHICS AND DISSEMINATION

The study will be conducted in accordance with the Declaration of Helsinki and data handled according to General Data Protection Regulation. Written informed consent will be obtained from all study participants. In accordance with the Swedish Health and Medical Services Act, capacity to consent will be examined by a member of the research team. Ethical approval has been obtained from the Swedish Ethical Review Authority (Dnr: 2020-05542 and Dnr: 2021-00925). Findings will be published in an open access peer-reviewed journal, presented at academic conferences, and disseminated among lay and healthcare professional audiences.

Relationship Between Quality of Life of People with Dementia and Their Caregivers in Indonesia

BACKGROUND

Caregivers, as one of the most important roles in caring for a person with dementia, have a challenging task. Therefore, maintaining the quality of life (QoL) of caregivers is an integral part of dementia care.

OBJECTIVE

To explore the relationship between the QoL of people with dementia and their caregivers in Indonesia.

METHODS

This is a cross-sectional study using binary correlations to analyze the relationship between people with dementia and caregivers' QoL. Conducted in Cipto Mangunkusumo Hospital in Jakarta, the subjects were 42 people diagnosed with dementia according to the PPDGJ-III (adapted from the ICD 10) and 42 primary caregivers with at least 6 hours duration of caregiving per day. The QoL of people with dementia was measured by EuroQol-5D and VAS EQ-5D, while severity of dementia was measured by MMSE. Caregivers underwent an interview using WHO Quality of Life Instrument (WHOQOL-BREF) and NPI.

RESULTS

Most caregivers were women, aged 40-70 years old. The study found caregivers' QoL environmental domain strongly correlated with people with dementia's QoL (r = 0.839). Severity of dementia had a strong correlation with caregivers' QoL physical domain (r = 0.946). Age, duration of caregiving per day, period of care provided by caregivers, and caregiver's distress had a strong correlation with caregiver QoL for specific domains.

CONCLUSION

There was a strong correlation between people with dementia's QoL and caregiver QoL, so in managing dementia, clinicians should consider caregivers' wellbeing as an essential part significantly affecting the quality of elderly care improvement.

Coping with Everyday Life for Home-Dwelling Persons with Dementia: A Qualitative Study

Aim

This study aimed to gain insight into factors that influence everyday coping strategies as described by persons with early to intermediate dementia.

Background

Living with dementia presents difficulties coping with everyday life. This study focuses on coping with everyday life for persons with mild to moderate dementia in order to facilitate their ability to live at home.

Design

A qualitative study.

Methods

Individual interviews with 12 persons with dementia were conducted in their own homes.

Findings

Coping with everyday life can be influenced by the experience of the diagnostic process and by information about dementia. It can also be affected by stigmatization of persons with dementia, as well as by challenges in everyday life. In addition, challenges in receiving help may include poor continuity of services and healthcare staff with limited competence. By contrast, person-centered care led to positive experiences that supported everyday coping skills. Most of the respondents wanted to participate in day care several days a week. Other positive experiences were making new friends and participating in meaningful activities; such experiences could enhance to coping strategies.

Conclusion

To strengthen everyday coping for persons with dementia living at home, there is a need for openness about the disease. Follow-up for persons with dementia must be carried out by reputable professionals trained and educated in dementia care. Finally, the municipalities must have contact persons, dementia coordinator/-team, who are available for persons with dementia at the time of diagnosis position and afterwards.

Health-related physical indicators and self-rated quality of life in older adults with neurocognitive disorder

PURPOSE

This study aimed to identify the association between health-related physical indicators-sarcopenia-related factors, physical fitness, independence in activities of daily living (ADL) and habitual physical activity-and self-rated quality of life (QoL) in people with neurocognitive disorder (NCD).

METHODS

This cross-sectional study included 115 participants (78.22 ± 7.48 years; 74.8% female) clinically diagnosed with NCD. Self-rated QoL was evaluated using The Quality of Life-Alzheimer's Disease (QoL-AD). Dual energy X-ray Absorptiometry, handgrip strength, Short Physical Performance Battery, and the 6-m Walk test were used to assess sarcopenia-related factors. Senior Fitness Test and One Leg Balance test, Barthel Index, Baecke Modified Habitual Physical Activity Questionnaire were used to determine physical fitness, independence in ADL and physical activity, respectively. Regressions analyses were performed to examine associations between these variables and QoL-AD.

RESULTS

Data from univariable linear regression analysis revealed that self-rated QoL was associated with sarcopenia-related factors (lower body function, handgrip strength, gait speed, and appendicular skeletal muscle mass index-ASMI), physical fitness (upper-and-lower-body strength, agility/dynamic balance, cardiorespiratory fitness and body mass index), habitual physical activity and independence in ADL. Results from multivariable regression analysis showed that ASMI (B = 1.846, 95% CI 0.165-3.527, p = 0.032) and lower body function (B = 0.756, 95% CI 0.269-1.242, p = 0.003) were positively associated with self-rated QoL. These variables explained 20.1% of the variability seen in self-rated QoL, controlling for age, sex, marital status and education.

CONCLUSION

Sarcopenia-related factors, namely lower body function and ASMI, should be acknowledged in future research studies as critical health-related indicators associated with QoL in people with NCD.

TRIAL REGISTRATION

ClinicalTrials.gov-identifier number NCT04095962.