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Cognitive functioning and quality of life: Diverging views of older adults with Alzheimer and professional care staff
- Authors:
- DEWITTE Laura, VANDENBULCKE Mathieu, DEZUTTER Jessie
- Journal article citation:
- International Journal of Geriatric Psychiatry, 33(8), 2018, pp.1074-1081.
- Publisher:
- Wiley
Objective: Staff ratings of quality of life (QOL) in dementia are often lower and more strongly related to the cognitive functioning of the person with dementia than self‐ratings. However, cognition‐related items in QOL measures and limited cognitive screening measures hamper a clear understanding of the relationship, two issues addressed in the current study. Methods: The authors collected data of 88 pairs of older adults with Alzheimer disease and their professional caregivers in 9 residential care settings. Both self‐report and staff report of the QOL of residents were assessed with the Quality of Life in Alzheimer's Disease. Cognitive functioning was assessed with the Mini‐Mental State Examination and a battery of specific cognitive measures. Results: Intraclass correlations and a paired sample t test confirmed a discrepancy between self‐rating and staff rating, with staff significantly underestimating QOL as experienced by the resident. After removing the possibly confounding memory item of the Quality of Life in Alzheimer's Disease, Mini‐Mental State Examination score remained a significant predictor of staff ratings but not self‐ratings in regression analyses. Exploratory analyses of specific cognitive measures showed a significant contribution of a memory test of intentional visual association learning in the prediction of staff‐rated QOL. Conclusions: Staff reports cannot simply substitute reports of the subjective experience of residents with Alzheimer, so both judgments should be taken into account to form an adequate picture of QOL. Staff might be guided more strongly by a cognitive point of view when evaluating QOL of residents with Alzheimer disease, while the latter might have shifted their evaluation standards to cope adequately with the challenges posed by their disease. (Edited publisher abstract)
Behavioral symptoms in mild cognitive impairment as compared with Alzheimer's disease and healthy older adults
- Authors:
- VAN DER MUSSELE Stefan, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 28(3), 2013, pp.265-275.
- Publisher:
- Wiley
Mild cognitive impairment (MCI) is a clinical concept that describes patients who are in an intermediate state between normal aging and dementia. It does not generally affect their activities of daily living but complex instrumental functions may be minimally impaired. Although behavioural symptoms are common in MCI they are not included in the concept. The aim of this study was to characterise behaviour in MCI compared with Alzheimer's disease (AD) and healthy older patients. The data were drawn from the baseline of a longitudinal study of behavioural symptoms of dementia and MCI. The study population, consisting of 270 MCI, 402 AD patients, and 108 healthy controls from Antwerp, underwent a battery of tests and assessments. Moderate-to-severe behavioural symptoms were present in 13% of MCI patients, compared with 39% in AD patients and 3% in controls. The general severity of behavioural symptoms was intermediate between controls and AD patients. The three most common symptoms in MCI patients were aggressiveness (49%), affective disturbance (45%), and anxiety (38%); in AD patients, they were aggressiveness (60%), activity disturbances (54%), and psychosis (40%). Overall the prevalence and severity of frontal lobe symptoms, aggressiveness, activity disturbances, and delusions was intermediate between normal aging and AD and the severity of physically non-aggressive, verbally agitated behaviour and the severity of depressive symptoms were also intermediate.
Dementia, care and education: what needs do demented persons have?; what should caregivers attach importance to?
- Authors:
- HOEG Dorthe, NIELSEN Eva Bonde, SAMUELSSON Gillis
- Publisher:
- Danish National Institute for Elderly Education
- Publication year:
- 1999
- Pagination:
- 78p.,tables.
- Place of publication:
- Frederiksberg
Report of a Europe wide project aiming to promote quality of life for people suffering from neuro-degenerative diseases through an innovative training programme for caregivers developed and adapted to the conditions of the participating member states. The programme also aims to integrate formal and informal care. Contains chapters on: quality of life, the care model, and the GBS scale; organisations involved and population profiles of participating countries; methods used in the studies; needs of people with dementia and what caregivers see as important; the Danish and Finish training programmes; and visions for the future.