What is the quality of life in the oldest old?

Abstract

Background Maintaining and improving quality of life has become a major focus in geriatric medicine, but the oldest old have received limited attention in clinical investigations. We aimed to investigate the relationship between self-perceived and caregiver-perceived quality of life (QOL), cognitive functioning, and depressive symptoms in the oldest old. Methods This IRB-approved prospective study recruited community dwellers aged 90–99 years old. Collected data included neurological evaluation, DSM III-R criteria for dementia, Mini-Mental State Examination (MMSE), Dementia Rating Scale (DRS), Geriatric Depression Scale (GDS), Record of Independent Living (ROIL), and QOL assessment using the Linear Analogue Self Assessment (LASA). Results Data on 144 subjects (56 cognitively normal (normal), 13 mild cognitive impairment (MCI), 41 dementia (DEM), 34 dementia with stroke and parkinsonism (DEMSP)) over a three-year period were analyzed. Mean ages ranged from 93 to 94 years, and the majority were female with at least high school education. Overall functional ability was higher in groups without dementia (p < 0.0001). All subjects reported high overall QOL (range 6.76–8.3 out of 10), regardless of cognitive functioning. However, caregivers perceived the subjects’ overall QOL to be lower with increasing severity of cognitive impairment (p < 0.0001). Lower GDS scores correlate with higher self-perceived overall QOL (ρ = −0.38, p < 0.0001). Conclusions In our community sample of the oldest old, there was a fairly high level of overall QOL, whether or not cognitive impairment exists. Individuals perceive their QOL better than caregivers do, and the difference in subjects’ and caregivers’ perception is more pronounced for the groups with dementia. QOL is more strongly correlated with depressive symptoms than with dementia severity.

Influencia de la reserva cognitiva en la calidad de vida en sujetos con enfermedad de Alzheimer

“…Este mismo resultado aparece de forma reiterada en otros trabajos (Azpiazu et al 2002;Lapid et al, 2011;Logsdon, Gibbons, McCurry y Teri, 1999), lo que ha llevado a afirmar a autores como Thorgrimsen et al (2003) que el estado de ánimo es el principal determinante de la calidad de vida en todas las etapas de la demencia. En este sentido, Hoe et al (2009) llevaron a cabo un estudio con 238 pacientes con demencia, en el que valoraron a lo largo de 20 semanas, la percepción de la CV de los propios pacientes y sus cuidadores, concluyendo que el descenso en la calidad de vida de los pacientes, se podría predecir mediante la línea base de depresión y ansiedad, la calidad de vida previa y el deterioro cognitivo conseguido con el progreso de la enfermedad (Hoe et al 2009).…”

“…En este sentido, Hoe et al (2009) llevaron a cabo un estudio con 238 pacientes con demencia, en el que valoraron a lo largo de 20 semanas, la percepción de la CV de los propios pacientes y sus cuidadores, concluyendo que el descenso en la calidad de vida de los pacientes, se podría predecir mediante la línea base de depresión y ansiedad, la calidad de vida previa y el deterioro cognitivo conseguido con el progreso de la enfermedad (Hoe et al 2009). No obstante, la mayor parte de las publicaciones coinciden en afirmar que el estado emocional juega un papel más relevante en la calidad de vida percibida, que la gravedad de la demencia (Banerjee et al, 2006;Lapid et al, 2011).…”

ApoE and Quality of Life in Nonagenarians

“…All nonagenarians from a convent and two senior communities (which consist of independent living, assisted living and 24-hour nursing care facilities), and an additional random sample living elsewhere in Rochester, were sent letters describing the study and asked permission to contact them for participation. Those who agreed to participate were interviewed and enrolled in the study with details described in our previous reports (2, 17). …”

“…Quality of life (QOL) has lately emerged as an important issue and outcome measure in health care, especially in the geriatric population (1, 2). QOL is influenced by various environmental, functional and health factors, while health may be affected by genetic factors.…”

Lebensqualität von älteren Menschen mit leichten kognitiven Störungen

“…Probanden der meisten Studien sind selektierte Stichproben, die in Gedächtniskliniken oder Heimen rekrutiert wurden [9]. Nur wenige sind bevölkerungsrepräsentativ [12,13]. …”