Assessing Quality of Life in Older Adults With Cognitive Impairment

Logsdon, Rebecca G.; Gibbons, Laura E.; McCurry, Susan M.; Teri, Linda

doi:10.1097/00006842-200205000-00016

Cited by 1,182 publications

(1,351 citation statements)

References 21 publications

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“…Both caregivers and patients completed two quality of life instruments, the Quality of Life in AD scale (QOL-AD) (10) and the Dementia Quality of Life scale (DEM-QOL) (15) and a recently validated suffering scale comprised of three subscales assessing psychological, existential, and physical suffering (16). The QOL-AD consists of 13 items assessing multiple dimensions of quality of life (e.g., mood, energy, friends, ability to do things for fun) as either poor (1), fair (2), good (3), or excellent (4; range 13-52; higher scores indicate higher quality of life).…”

Section: Methodsmentioning

confidence: 99%

“…Answering this question requires that we first identify factors that contribute to caregiver rating bias. Although not definitive, the literature suggests a number of candidate variables including caregiver depression (10, 13), burden (7, 10, 13), patient depression (10), patient cognitive status (6, 11, 14), and the domain being rated (e.g., subjective state vs. observable behavior) (6, 14). That is, larger discrepancies are reported when either the patient or caregiver is depressed, the patient is more cognitively impaired, the caregiver is more burdened, and the domains being rated are subjective states of the patient as opposed to observable behaviors such as physical functioning.…”

Section: Introductionmentioning

confidence: 99%

“…First, we compare caregiver and patient rating disparities for two widely used instruments, the Quality of Life in AD scale (QOL-AD) (10) and the Dementia Quality of Life scale (DEM-QOL) (15), to determine the level of proxy rater bias. Second, we extend proxy-patient comparisons to a recently validated measurement instrument designed to assess patient suffering in three domains: psychological, existential, and physical suffering (16).…”

Section: Introductionmentioning

confidence: 99%

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Magnitude and Causes of Bias Among Family Caregivers Rating Alzheimer Disease Patients

Schulz

Cook

Beach

et al. 2013

The American Journal of Geriatric Psychiatry

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Objective Family caregivers generally underestimate the health and well-being of Alzheimer’s disease (AD) patients when compared to patient self-assessments. The goals of this study were to identify caregiver, patient, and contextual factors associated with caregiver rating bias. Methods 105 patients with AD and their family caregivers were assessed twice by trained interviewers one year apart. In separate interviews, caregivers were asked to rate the quality of life and suffering of their patient relative, and patients provided self-ratings using the same structured instruments. Multivariate cross-sectional and longitudinal analyses were used to identify predictors of caregiver-patient discrepancies. Results Caregivers consistently reported significantly higher levels of suffering and lower levels of quality of life than patients. Caregiver psychological well-being and health status accounted for a substantial portion of the difference in caregiver and patient ratings in both cross-sectional and longitudinal analyses. Caregiver depression and burden were consistently positively associated with the magnitude of caregiver-patient discrepancy, and caregiver health status was negatively associated with the size of the discrepancy. Conclusions Caregiver assessments of dementia patients may determine the type and frequency of treatment received by the patient, and caregivers’ ability to reliably detect change in patient status can play a critical role in evaluating the efficacy of therapeutic interventions and pharmacologic agents. Clinicians and researchers working with dementia patients who rely on caregiver reports of patient status should be sensitive to the health and well-being of the caregiver and recognize that caregiver assessments may be negatively biased when the caregiver’s own well-being is compromised.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Magnitude and Causes of Bias Among Family Caregivers Rating Alzheimer Disease Patients

Schulz

Cook

Beach

et al. 2013

The American Journal of Geriatric Psychiatry

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Section: Study 1: Initial Scalementioning

confidence: 99%

“…Satisfactory internal consistency, stability, and construct validity have been reported for the QOL-AD. 19,20 With permission from Logsdon and associates, 19 the authors of the QOL-AD, the IOMSN committee made some small changes in the wording of the 13 QOL-AD items and added 10 more items to reflect the health conditions of people with MS and the impact of the disease on daily activities and interpersonal relationships.The 10 new items specific to MS pertained to mobility, bowel and bladder functioning, sexuality, personal care, nutrition, pain, communication, future goals, and motivation. Most items used a 4-point rating scale from 1 (poor) to 4 (excellent).…”

mentioning

confidence: 99%

Monitoring My Multiple Sclerosis

Gulick¹,

Namey²,

Halper³

2011

International Journal of MS Care

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Optimal health of people with multiple sclerosis (MS) can be promoted by patients' sharing of health information gained through periodic self-monitoring with their health-care providers. The purpose of this study was to develop a valid and reliable self-administered scale to obtain information about MS patients' health status and the impact of the disease on their daily lives. We named this scale "Monitoring My Multiple Sclerosis" (MMMS) Analysis of variance demonstrated that the total scale and the Physical subscale, but not the Relationships subscale, showed significantly worse functioning for patients with either moderate or severe disability as measured by the PDDS than for patients with mild disability (P < .001). The Cognitive/Mental subscale showed significantly worse functioning for patients with moderate disability than for patients with mild disability (P < .05). However, the Energy subscale showed significantly worse functioning among moderately disabled patients than among severely disabled patients (P < .01). Independent t tests demonstrated that patients classified as having secondary progressive multiple sclerosis had significantly worse scores on the total MMMS (P < .05) and the Physical subscale (P < .001) than those classified as having relapsing-remitting multiple sclerosis. The MMMS demonstrated satisfactory reliability and validity and is recommended for use by MS patients and their health-care providers as a mechanism to promote the sharing of health information, to the benefit of both patients and providers. Int J MS Care. 2011;13:137-145.. Multiple sclerosis (MS) is a chronic and progressive inflammatory autoimmune disease of the central nervous system (CNS), with onset usually occurring during young adulthood. 1 The disease is initially characterized by relapsing-remitting symptoms in most patients and may later take a progressive course. 2,3 The symptoms and signs of MS reflect the CNS area of neural impairment. 1 Neural impairment in the cerebrum affects cognition; cerebellum impairment affects balance and produces tremors; brainstem impairment is associated with diplopia, vertigo, and impaired speech and swallowing; and spinal cord impairment causes weakness, stiffness, painful spasms, bladder dysfunction, sexual dysfunction, and constipation. These symptoms are reflected in accumulating disabilities experienced by the person with MS that affect physical, social, and cognitive/mental functioning.Currently there is no cure for MS, although there are many partially effective treatments and interventions that focus on symptom management. Because of the great variability in symptoms and disabling conditions experienced by MS patients, ongoing monitoring of physical, social, and cognitive/mental functioning is important to determine both appropriate counseling and treatment and the effectiveness of such interventions. Self-monitoring by MS patients who then share health-related information with their health-care providers holds promise for controlling or alleviating symptoms, resulting in ...

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