Determinants of quality of life in Alzheimer's disease: perspective of patients, informal caregivers, and professional caregivers.
BACKGROUND
Alzheimer's disease (AD) is a chronic medical condition with symptoms that compromise patients' quality of life (QoL). The identification of the factor predicting QoL in AD is essential to develop more effective interventions. Recent research suggests that these factors could be different for the distinct informants. This study explores the QoL predictors considering three different sources of information: patients, caregivers, and healthcare staff.


METHODS
In this cross-sectional study, a sample of 102 patients, their primary caregivers, and 15 members of the healthcare staff evaluated patients' QoL (QoL-AD Scale). Patients' and caregivers' demographic and clinical data (cognitive function, neuropsychiatric symptoms, depression, and caregivers' burden) were considered as QoL predictors.


RESULTS
In multivariate-adjusted linear regression analyses, we observed that patients' ratings were mainly affected by their mood whereas caregivers' ratings were also negatively influenced by patients' irritability and burden. According to staff ratings, both psychotic symptoms and neuroleptics were associated with lower QoL.


CONCLUSIONS
Our findings suggest that depression is the main variable related to patients' QoL and that more careful management of neuropsychiatric disorders is necessary. Both proxies' ratings are not equivalent to patients' reports in terms of predictors but they are complementary. Thus, a thorough QoL assessment should consider separately the perspective of the different informants.
Department of Psychology, Catholic University of Murcia, Murcia, Spain. mgomezg@um.es
Maria
M
Gómez-Gallego
Jesus
J
Gómez-Amor
Juan
J
Gómez-García
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications / Q000175:diagnosis / Q000523:psychology; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D001526:Behavioral Symptoms / Q000209:etiology; D017028:Caregivers / Q000523:psychology*; D003072:Cognition Disorders / Q000209:etiology; D003430:Cross-Sectional Studies; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D007398:Interpersonal Relations; D007508:Irritable Mood / Q000187:drug effects; D008297:Male; D016743:Mental Competency; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000188:drug therapy / Q000209:etiology; D011788:Quality of Life; D012044:Regression Analysis; D018434:Sickness Impact Profile; D013030:Spain
D014150:Antipsychotic Agents