title: The relationship between quality of life, Mini-Mental State Examination, and the Instrumental Activities of Daily Living in patients with Alzheimer's disease.
abstract: Alzheimer's disease (AD) affects the cognitive function and capacity for independent living of the elderly, however little is known about the measurement of patient's overall health-related quality of life (HRQoL) and its relationship to these effects. We examined the relationship between patient/caregiver-rated HRQoL and cognition (using the Mini-Mental State Examination (MMSE)) or Instrumental Activities of Daily Living (IADL). One hundred AD patients participating in an open-label trial of donepezil were followed for 6 months. Cognition and function were assessed using the MMSE (clinician-rated) and IADL scale (caregiver-rated). Patient QoL, as assessed by the Assessment of Quality of Life (AQoL) scale, was rated separately by patients and their primary caregivers. Mean patient-rated AQoL was 0.60, whilst caregiver-rated AQoL was 0.50. Patient and caregiver AQoL assessments correlated (r = 0.37, P = 0.0038) for all levels of disease severity. Patient-rated AQoL scores ranged from 0.52 for patients with severe AD, to 0.71 for patients with mild AD. Caregiver-rated AQoL scores ranged from 0.40 to 0.59. There were approximately linear relationships between the AQoL and MMSE scores (patient-rated r = 0.30, P < 0.0001; caregiver-rated r = 0.28, P < 0.0001), and AQoL and IADL scores (patient-rated r = 0.36, P < 0.0001; caregiver-rated r = 0.43, P < 0.0001). Patient self-assessment of AQoL is a useful instrument for measuring HRQoL in AD that displays an approximately linear relationship with MMSE, IADL, and caregiver-rated AQoL.
authors.affiliation: John Wlodarczyk Consulting Services, 10 Mirral Crescent, New Lambton, NSW 2305, Australia. jwlod@ozemail.com.au
authors.forename: John H
authors.initials: JH
authors.lastname: Wlodarczyk
authors.forename: Henry
authors.initials: H
authors.lastname: Brodaty
authors.forename: Graeme
authors.initials: G
authors.lastname: Hawthorne
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000544:Alzheimer Disease / Q000188:drug therapy / Q000523:psychology*; D000704:Analysis of Variance; D001315:Australia; D000077265:Donepezil; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007189:Indans / Q000627:therapeutic use; D008297:Male; D008609:Mental Status Schedule; D018697:Nootropic Agents / Q000627:therapeutic use*; D010880:Piperidines / Q000627:therapeutic use; D011788:Quality of Life / Q000523:psychology*
chemical_list: D007189:Indans; D018697:Nootropic Agents; D010880:Piperidines; D000077265:Donepezil