title: Predictors of patient self-ratings of quality of life in Alzheimer disease: cross-sectional results from the Canadian Alzheimer's Disease Quality of Life Study.
abstract: OBJECTIVE
  To assess whether the core symptoms of Alzheimer disease (AD) consistently predict patient self-rated quality of life (QOL) as assessed by a variety of QOL measures in a large national sample of AD patients.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Fifteen dementia and geriatric clinics across Canada.
  
  
  METHODS
  Community-living patients with AD (n = 370) with Mini-Mental State Exam (MMSE) scores greater than 10.
  
  
  METHODS
  Patients rated their QOL by using two utility indexes, the European QOL-5 Dimensions and the Quality of Well-Being Scale, a global QOL Visual Analog Scale, and the disease-specific QOL-AD instrument. Cognition was assessed with the AD Assessment Scale-Cognitive subscale and MMSE, function with the Disability Assessment for Dementia, and behavioral and psychological symptoms with the Neuropsychiatric Inventory and the Geriatric Depression Scale (GDS). One-way analysis of variance and fully adjusted multiple linear regression were used to assess the relationship between core dementia symptoms and QOL ratings.
  
  
  RESULTS
  The QOL measures had only small-to-moderate correlations with each other. For all QOL measures, patient ratings were significantly lower among patients with more depressive symptoms. In multivariable analyses, the GDS score was the only significant independent predictor of patient self-ratings for all four QOL measures.
  
  
  CONCLUSIONS
  Self-rated symptoms of depression were a consistent independent predictor of patient-rated QOL across diverse QOL measures, while performance-based measures of cognition and informant-based functional status were not. These findings confirm the importance of identifying and treating depression in patients with AD and endorse the use of measures of self-rated depressive symptoms and QOL as outcomes in AD clinical trials.
authors.affiliation: Division of General Internal Medicine (GN, MK), University Health Network, Toronto, Ontario, Canada. gary.naglie@utoronto.ca
authors.forename: Gary
authors.initials: G
authors.lastname: Naglie
authors.forename: David B
authors.initials: DB
authors.lastname: Hogan
authors.forename: Murray
authors.initials: M
authors.lastname: Krahn
authors.forename: B Lynn
authors.initials: BL
authors.lastname: Beattie
authors.forename: Sandra E
authors.initials: SE
authors.lastname: Black
authors.forename: Chris
authors.initials: C
authors.lastname: Macknight
authors.forename: Morris
authors.initials: M
authors.lastname: Freedman
authors.forename: Christopher
authors.initials: C
authors.lastname: Patterson
authors.forename: Michael
authors.initials: M
authors.lastname: Borrie
authors.forename: Howard
authors.initials: H
authors.lastname: Bergman
authors.forename: Anna
authors.initials: A
authors.lastname: Byszewski
authors.forename: David
authors.initials: D
authors.lastname: Streiner
authors.forename: Jane
authors.initials: J
authors.lastname: Irvine
authors.forename: Paul
authors.initials: P
authors.lastname: Ritvo
authors.forename: Janna
authors.initials: J
authors.lastname: Comrie
authors.forename: Matthew
authors.initials: M
authors.lastname: Kowgier
authors.forename: George
authors.initials: G
authors.lastname: Tomlinson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D002170:Canada; D003071:Cognition; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications / Q000523:psychology; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011788:Quality of Life / Q000523:psychology*; D057566:Self Report; D012720:Severity of Illness Index