Severity of both neuropsychiatric symptoms and dementia is associated with quality of life in nursing home residents

Abstract

The aim was to investigate the association of severity of neuropsychiatric symptoms and health-related quality of life and their interaction with dementia severity among institutionalized older people with dementia. Findings Neuropsychiatric symptom burden was associated with higher health-related quality of life in residents with severe dementia, whereas among those residents with mild-moderate dementia this association was not seen. Very low functional capacity was linked to both low number of neuropsychiatric symptoms and low health-related quality of life among those with severe dementia. Message In severe dementia, higher neuropsychiatric symptom burden and better health-related quality of life indicate better functioning and higher vitality.

Demographic and clinical profile of residents living with dementia and depressive symptoms in Australian private residential aged care: Data from the Music Interventions for Dementia and Depression in ELderly care (MIDDEL) cluster‐randomised controlled trial

“…In particular, agitation, aggression, irritability, disinhibition, euphoria and apathy scores were higher in those with increased dementia severity. Similar findings have been reported in previous studies examining people with different types of dementia (AD, VaD and FTD) in community 6,7 and RAC contexts 8,9 . Findings from our study also showed that dementia severity was negatively associated with the quality of life.…”

“…8 A more recent cross-sectional cohort study in RAC facilities in Helsinki showed that the severity of neuropsychiatric symptoms and dementia severity were significant factors determining health-related quality of life. 9 In this study, higher scores in neuropsychiatric symptoms were associated with better quality of life in residents with severe dementia, while this association was not observed for mild-to-moderate dementia. The authors suggested that the differences may be partly due to study population, due to the inclusion of a higher proportion of residents with severe dementia (67%) in their which can be used to inform targeted, person-centred dementia care planning, staff training and allocation of resources.…”

“…In a large cohort of Dutch RAC residents, Zuidema and colleagues found that the prevalence of neuropsychiatric symptoms was associated with moderately severe cognitive decline, while specific symptoms such as physical aggression, anxiety and apathy were more frequent with very severe cognitive decline 8 . A more recent cross‐sectional cohort study in RAC facilities in Helsinki showed that the severity of neuropsychiatric symptoms and dementia severity were significant factors determining health‐related quality of life 9 . In this study, higher scores in neuropsychiatric symptoms were associated with better quality of life in residents with severe dementia, while this association was not observed for mild‐to‐moderate dementia.…”

“…7 In the RAC context, a number of studies have examined the relationship between neuropsychiatric symptoms with cognitive impairment and functional status in dementia. 8,9 In a large cohort of Dutch RAC residents, Zuidema and colleagues found that the prevalence of neuropsychiatric symptoms was associated with moderately severe cognitive decline, while specific symptoms such as physical aggression, anxiety and apathy were more frequent with very severe cognitive decline. 8 A more recent cross-sectional cohort study in RAC facilities in Helsinki showed that the severity of neuropsychiatric symptoms and dementia severity were significant factors determining health-related quality of life.…”

COVID‐19 and mental health: Impact on symptom burden in older people living with mental illness in residential aged care

“…It shows good correlation with other well‐established symptom rating scales. A total NPI score of >3 indicates clinically relevant symptoms, 4–12 indicates low symptom burden and ≥12 indicates high symptom burden 23 . Maximum total score is 144.…”