Factors associated with quality of life in patients with Alzheimer’s disease

Abstract

BackgroundEvaluation of health-related quality of life (HRQoL) in patients with Alzheimer’s disease (AD) is necessary to ensure optimal management. Several scales for assessing HRQoL of patients with AD exist, in particular the Quality of Life in Alzheimer’s Disease (QoL-AD), which includes an evaluation by the caregiver of the patient’s HRQoL. The aim of this study was to identify factors associated with patient, caregiver and overall HRQoL as assessed by the QoL-AD.MethodsCross-sectional multicenter study in subjects aged 65 years and older, with mild to moderate AD. HRQoL scores from the QoL-AD were recorded (3 scores, corresponding to patient, caregiver and overall), as well as sociodemographic variables for the patient and the caregiver, and data from the geriatric cognitive assessment (cognitive, psycho-behavioral, functional evaluations). Caregiver burden was evaluated using the Zarit caregiver burden scale. Factors associated with each QoL-AD score were identified by multivariate linear regression using t-tests and β estimations. Study was registered in Clinical Trial.gov (NCT02814773).ResultsIn total, 123 patients with AD were included. For the patient QoL-AD evaluation, depression was significantly associated with lower HRQoL (β = − 2.56 ± 1.28, p = 0.04), while polypharmacy (β = − 1.80 ± 0.99, p = 0.07) and anxiety (β = − 1.70 ± 1.01, p = 0.09) tended to be associated with lower HRQoL scores. In terms of caregiver evaluations, depression (β = − 3.46 ± 1.09, p = 0.002), polypharmacy (β = − 1.91 ± 0.92, p = 0.04) and the presence of caregiver burden (β = − 3.50 ± 0.91, p = 0.0002) were associated with lower HRQoL. For the overall evaluation, depression (β = − 3.26 ± 1.02, p = 0.002) and polypharmacy (β = − 1.85 ± 0.81, p = 0.03) were significantly related to lower HRQoL.ConclusionsDepression and polypharmacy were two factors influencing HRQoL in patients with AD, both by patient self-report and on the caregiver report. Thus, despite the discrepancies between HRQoL as assessed by patients with AD and HRQoL as assessed by their caregiver, the caregiver’s assessment may be used to guide patient management when the patient can no longer complete QoL evaluations. Moreover, the association between caregiver burden and the caregiver’s QoL-AD score underlines the need to take caregivers into consideration in the overall management of the AD patient.

Association of polypharmacy with decline in quality of life in mild cognitive impairment and mild dementia

“…Crosssectional analyses in past studies have shown that polypharmacy was associated with low QOL. [3][4][5] The present results show that more medications were associated with QOL decline after about 1 year in those with MCI or mild dementia.…”

“…2 In a cross-sectional study, polypharmacy was associated with lower QOL in patients with mild to moderate Alzheimer's disease (mean Mini-Mental State Examination [MMSE] score 20.74.5). 3 We previously found that polypharmacy was associated with lower QOL in patients with mild cognitive impairment (MCI). 4 Another study showed that polypharmacy was associated with QOL in a population without dementia.…”

Quality of life in nursing home residents with pain: pain interference, depression and multiple pain-related diseases as important determinants

“…relations to family or friends, may have increased the model's explained variance. Additional potential impact factors like polypharmacy and other diagnoses [23] should also be examined in future research. The authorized ethics committee (Ludwig-Maximilian University of Munich, Germany) approved the study protocol and the consent procedure of the PIASMA-study (WHO-UTN: U1111-1187-3174).…”

“…Depressive symptoms and cognitive impairment are phenomena known to affect HRQOL [1,3,5,7,22,23] significantly lower HRQOL. Moreover, the implemented educational intervention had a positive impact on HRQOL of the NHR (β = 0.173, p < 0.05).…”

Possible Epigenetic Role of Vitexin in Regulating Neuroinflammation in Alzheimer’s Disease

“…Not only the daily life of AD patients but also the people around them will be affected as every AD patient requires close attention in order to maintain the patients' quality of life (QoL) [2]. A comprehensive study conducted by Barbe et al on the factors that contribute to the QoL of AD patients as well as their caregiver has shown that depression strongly influences the lowest rate of QoL for both AD patients and the caregiver [3]. In the perspective of AD patients, depression is developed due to the need for many medication intake that stems from the presence of multiple comorbidities as well as the patients' perception on their health.…”