title: Predictors of self- and caregiver-rated quality of life for people with dementia living in the community and in nursing homes in northern Taiwan.
abstract: BACKGROUND
  Factors affecting quality of life (QOL) ratings for people with dementia (PWD) have been well studied, but few studies have examined the effect of residence on PWD- and caregiver-rated QOL for PWDs. We designed this study to determine the factors related to PWD- and caregiver-rated QOL in dementia as well as factors related to the discrepancy in these ratings.
  
  
  METHODS
  For this cross-sectional study, we analyzed data from a convenience sample of 106 PWD-family caregiver dyads (58 community-dwelling dyads and 48 nursing-home dyads). PWDs' data included socio-demographic variables, QOL (assessed by the Quality of Life-Alzheimer's Disease [QOL-AD] scale), cognition, dementia severity, depression, comorbidities, and quality of the dyadic relationship. Caregivers' data included socio-demographic variables, depressive symptoms, and mutuality of the dyadic relationship.
  
  
  RESULTS
  QOL-AD scores were lower when rated by caregivers than by PWDs. The key factors positively related to both PWD- and caregiver-rated QOL for PWDs were fewer PWD depressive symptoms and higher quality of the PWD-caregiver relationship. The key factors related to the discrepancy in PWD- and caregiver-rated QOL in dementia were PWD residence in a nursing home and lower dementia severity, as well as higher caregiver depression, being an adult child caregiver, and lower caregiver-PWD mutuality.
  
  
  CONCLUSIONS
  Caregiver-rated QOL for PWDs and the discrepancy in rated QOL were significantly associated with PWD residence. If caregiver-rated QOL is needed, the effect of residence of PWD should be taken into consideration. Caregivers' depressive status and mutuality with PWD must be also carefully assessed.
authors.affiliation: School of Nursing,College of Medicine,Chang Gung University,Tao-Yuan,Taiwan.
authors.forename: Hsiu-Li
authors.initials: HL
authors.lastname: Huang
authors.affiliation: School of Nursing,College of Medicine,Chang Gung University,Tao-Yuan,Taiwan.
authors.forename: Li-Chueh
authors.initials: LC
authors.lastname: Weng
authors.affiliation: School of Nursing,College of Medicine,Chang Gung University,Tao-Yuan,Taiwan.
authors.forename: Yu-Hsia
authors.initials: YH
authors.lastname: Tsai
authors.affiliation: School of Nursing,College of Medicine,Chang Gung University,Tao-Yuan,Taiwan.
authors.forename: Yi-Chen Yulanda
authors.initials: YC
authors.lastname: Chiu
authors.affiliation: School of Nursing,College of Medicine,Chang Gung University,Tao-Yuan,Taiwan.
authors.forename: Kang-Hua
authors.initials: KH
authors.lastname: Chen
authors.affiliation: Department of Neurology,Chang Gung Memorial Hospital,No. 199,Tun-Hwa North Road,Taipei,10547Taiwan.
authors.forename: Chin-Chang
authors.initials: CC
authors.lastname: Huang
authors.affiliation: Cardinal Tien Hospital,No.362,Chung Cheng Rd.,Hsintien Taipei Hsien 23137,Taiwan.
authors.forename: John Sai-Hung
authors.initials: JS
authors.lastname: Tang
authors.affiliation: School of Nursing,College of Medicine,Chang Gung University,Tao-Yuan,Taiwan.
authors.forename: Woan-Shyuan
authors.initials: WS
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology; D003430:Cross-Sectional Studies; D003704:Dementia / Q000523:psychology* / Q000628:therapy; D005260:Female; D006801:Humans; D057187:Independent Living / Q000523:psychology* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D009735:Nursing Homes / Q000706:statistics & numerical data; D011581:Psychological Tests; D011788:Quality of Life / Q000523:psychology; D012647:Self-Assessment; D012720:Severity of Illness Index; D013624:Taiwan; D055815:Young Adult
keywords: depression