title: Variables associated with change in quality of life among persons with dementia in nursing homes: a 10 months follow-up study.
abstract: OBJECTIVE
  To investigate variables associated with change in quality of life (QOL), measured by QUALID scale and three subscales; tension, sadness and wellbeing, among dementia patients in nursing homes.
  
  
  METHODS
  A 10 months follow-up study including 198 (female 156, 79%) nursing home patients, mean age 87 (s.d 7.7) years. Scales applied; quality of life in late stage dementia (QUALID) scale and three subscales (wellbeing, sadness and tension), neuropsychiatric inventory questionnaire 10 items (NPI-10-Q), clinical dementia rating (CDR) scale, physical self-maintenance (PSMS) scale and a scale of general medical health. Use of psychotropic medication, gender and age was collected from the patient's records.
  
  
  RESULTS
  Mean baseline QUALID score: 20.6 (s.d.7.0), follow-up score: 22.9 (s.d.7.4), mean change 2.8 (s.d.7.4). QOL improved in 30.8%, were unchanged in 14.7%, deteriorated in 54.6% of patients. A regression analysis revealed that change in QUALID score was significantly associated with: QUALID baseline score (beta -.381, p-value.000), change in NPI score (beta.421, p-value.000), explained variance 38.1%. Change in score on wellbeing subscale associated with: change in PSMS score (beta.185, p-value.019), wellbeing baseline score (beta -.370, p-value.000), change in NPI score (beta.186, p-value.017), explained variance 25.3%. Change in score on tension subscale associated with: change in CDR sum-of-boxes (beta.214, p-value.003), change in NPI score (beta.270, p-value.000), tension baseline score (beta -.423, p-value.000), explained variance 34.6%. Change in score on sadness subscale associated with: change in NPI score (beta.404, p-value.000), sadness baseline score (beta -.438, p-value.000), explained variance 38.8%.
  
  
  CONCLUSIONS
  The results imply that a lower baseline score (better QOL) results in a larger change in QOL (towards worse QOL). Change in QOL is mostly associated with change in neuropsychiatric symptoms. In almost 50% of patients QOL did not deteriorate.
authors.affiliation: Norwegian Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.
authors.forename: Marit
authors.initials: M
authors.lastname: Mjørud
authors.affiliation: Norwegian Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.
authors.forename: Janne
authors.initials: J
authors.lastname: Røsvik
authors.affiliation: Molde University College, Norwegian Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.
authors.forename: Anne Marie Mork
authors.initials: AM
authors.lastname: Rokstad
authors.affiliation: Department of nursing science, Institute of health and society, University of Oslo, Oslo, Norway.
authors.forename: Marit
authors.initials: M
authors.lastname: Kirkevold
authors.affiliation: Norwegian Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.
authors.forename: Knut
authors.initials: K
authors.lastname: Engedal
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology*; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D009735:Nursing Homes; D011788:Quality of Life