title: 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.
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, U.S.A.
authors.forename: Maria I
authors.initials: MI
authors.lastname: Lapid
authors.forename: Teresa A
authors.initials: TA
authors.lastname: Rummans
authors.forename: Bradley F
authors.initials: BF
authors.lastname: Boeve
authors.forename: Joan K
authors.initials: JK
authors.lastname: McCormick
authors.forename: V Shane
authors.initials: VS
authors.lastname: Pankratz
authors.forename: Ruth H
authors.initials: RH
authors.lastname: Cha
authors.forename: Glenn E
authors.initials: GE
authors.lastname: Smith
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Ivnik
authors.forename: Eric G
authors.initials: EG
authors.lastname: Tangalos
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Petersen
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000369:Aged, 80 and over / Q000523:psychology*; D060825:Cognitive Dysfunction / Q000523:psychology; D003704:Dementia / Q000523:psychology; D003863:Depression / Q000523:psychology; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D064232:Visual Analog Scale