title: Quality of life (QoL) in community-dwelling and institutionalized Alzheimer's disease (AD) patients.
abstract: The purpose of this study was to describe and compare QoL and its determinants in two groups of patients with AD that differed in place of residence: community or nursing home. This study covered 200 patients with AD (mean age 79.3 ± 8.2 years, 74% female). Fifty-four per cent of the subjects were living in a nursing home and 46% lived at home. QoL was measured using the Alzheimer's Disease Related Quality of Life Scale (ADRQL). The ADRQL was answered by the family caregiver (community group) or the professional caregiver (nursing home group). Descriptive statistics, Chi-square test, Mann-Whitney test and multiple regression analysis were used to compare sociodemographic and clinical variables between the two study groups. The institutionalized patients were predominantly women (87.0% vs. 58.7%, p<0.001), were older (84 years vs. 74 years, p<0.001), and had more advanced dementia (Global Deterioration Scale (GDS)>5 79.6% vs. 19.6%, p<0.001). ADRQL total score was higher (i.e., better QoL) for patients living at home than for institutionalized patients (72.6 ± 19.9 vs. 64.8 ± 18.2, p<0.01). Neuropsychiatric symptoms, severity of dementia, depression and functional dependence were significant predictors of worst QoL. Once those variables were controlled a marginal effect of setting on QoL was found, which favored the nursing home (β=0.20, p<0.05).
authors.affiliation: Alzheimer Disease Research Unit, CIEN Foundation, Carlos III Institute of Health, Alzheimer Center Reina Sofia Foundation, Valderrebollo 5, 28031 Madrid, Spain. bleon@fundacioncien.es
authors.forename: Beatriz
authors.initials: B
authors.lastname: León-Salas
authors.forename: Javier
authors.initials: J
authors.lastname: Olazarán
authors.forename: Isabel
authors.initials: I
authors.lastname: Cruz-Orduña
authors.forename: Luis
authors.initials: L
authors.lastname: Agüera-Ortiz
authors.forename: José Luis
authors.initials: JL
authors.lastname: Dobato
authors.forename: Meritxell
authors.initials: M
authors.lastname: Valentí-Soler
authors.forename: Ruben
authors.initials: R
authors.lastname: Muñiz
authors.forename: Ma Teresa
authors.initials: MT
authors.lastname: González-Salvador
authors.forename: Pablo
authors.initials: P
authors.lastname: Martínez-Martín
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006707:Homes for the Aged / Q000706:statistics & numerical data; D006801:Humans; D057187:Independent Living / Q000523:psychology*; D007326:Institutionalization / Q000706:statistics & numerical data; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data; D011788:Quality of Life / Q000523:psychology*
keywords: Behavioral symptoms; Community; Dementia; Functional dependence; Nursing home; QoL; Severity of dementia