Quality of life in patients with Alzheimer's disease as reported by patient proxies.
OBJECTIVE
To measure behaviors indicative of quality of life (QOL) in patients with Alzheimer's disease and to examine correlates of patient QOL.


METHODS
Cross-sectional investigation.


METHODS
Multi-center study.


METHODS
Sample of 130 diagnosed patients. PRINCIPAL OUTCOME MEASURES: Proxy ratings of (1) the frequency, opportunity, and enjoyment of 15 non-ADL activities potentially within the capacity of a demented person, and (2) the frequency of a series of positive and negative affects, evident in clearly demarcated facial and bodily expressions.


RESULTS
QOL ratings were reliably elicited. Family and institutional caregivers differed only in reports of opportunity for patient activity. Frequency of activities declined with increasing severity of dementia. The frequency of negative affects increased and positive affects declined with increasing severity of dementia, but correlations were weak. High QOL, defined by frequent activity and positive affect, was evident in a quarter of the sample. In multivariate models, functional and cognitive status independently predicted QOL among community-resident older adults; only absence of antipsychotics was related to QOL among older people in nursing homes. Patient education, a marker of premorbid state, independently predicted some activity patterns.


CONCLUSIONS
Although the subjective world of the demented patient is not directly accessible, readily observable behaviors offer a basis for assessing QOL.
Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
S M
SM
Albert
C
C
Del Castillo-Castaneda
M
M
Sano
D M
DM
Jacobs
K
K
Marder
K
K
Bell
F
F
Bylsma
G
G
Lafleche
J
J
Brandt
M
M
Albert
Y
Y
Stern
D000339:Affect; D000368:Aged; D000544:Alzheimer Disease / Q000523:psychology*; D014150:Antipsychotic Agents / Q000627:therapeutic use; D017028:Caregivers / Q000523:psychology*; D003430:Cross-Sectional Studies; D004522:Educational Status; D005190:Family / Q000523:psychology*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011788:Quality of Life; D015203:Reproducibility of Results; D012720:Severity of Illness Index
D014150:Antipsychotic Agents