Quality of life in early‐stage Alzheimer's disease: the moderator role of family variables and coping strategies from the patients' perspective

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.

Evaluation of a WeChat-based Dyadic Life Review Program for people with advanced cancer and family caregivers: A mixed-method feasibility study

“…Increasing communication between patients and family caregivers improves family intimacy and adaptability. 26 Additionally, our qualitative findings showed that the WeChat-based Dyadic Life Review Program inspired their feelings of gratitude for one another. Gordon et al 27 proposed that when an individual expresses gratitude to others, he or she will also be appreciated.…”

Quality of Life and the Experience of Living with Early-Stage Alzheimer’s Disease

“…In our study, depressive symptoms, feelings of hopelessness and stigma were frequent findings impacting on quality of life in a population with a short duration of illness (mean of 1.4 years since AD diagnosis) and minimal cognitive impairment (87.2% with a CDR-GS score of 0.5). Lima et al [ 26 ] found that poor physical activity and functionality, depression, and anxiety were associated with low quality of life in a sample of 158 patients with mild AD. Patients with mild cognitive impairment also have a reduction in their quality of life in crucial domains including cognition, mood, social relationships, and helping with household chores [ 27 ].…”

“…In addition, resilient coping was associated with greater autonomy and better quality of life than non-resilient patients in a study in mild cognitive impairment [ 43 ]. Patients’ coping strategies and family cohesion and flexibility as well as good communication among their members moderated the relationship between psychological problems and quality of life [ 26 ].…”

The Humanistic and Economic Burden of Alzheimer's Disease

“…Several studies have found that depression/mood/psychiatric comorbidity is a key factor in patients with a clinical diagnosis of AD dementia based on the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) and/or the 1984 National Institute of Neurological and Communicative Disorders and Stroke (NINCDS) and the Alzheimer's Disease and Related Disorders Association (ADRDA) guidelines [12,[18][19][20][21][22][23][24][25][26][27][28]. For example, in a French study of 123 patients with mild to moderate AD, when measured by the QoL-AD, depression (p \ 0.001) was significantly associated with poorer QoL for the overall score in multivariate analysis; this association was significant for both self-report (p \ 0.05) and caregiver report (p \ 0.001) [21].…”

“…Similarly, in a Spanish study of 92 patients with AD, depression had a more important effect on QoL, measured by the QoL-AD, than did the loss of functional abilities [20]. Several studies that developed regression models evaluating the various factors that affect QoL found that psychiatric comorbidity and/or depression were key predictors of lower QoL, particularly for caregiver-rated QoL [25][26][27][28].…”