title: Quality of life of institutionalized older adults by dementia severity.
abstract: BACKGROUND
  The goal of the study was to analyze the factors associated with quality of life (QoL) in institutionalized older adults with dementia, based on self and proxy ratings, and if these characteristics differ by dementia severity.
  
  
  METHODS
  Cross-sectional study of 525 people with dementia (PwD) and their caregivers (professional or family caregivers). Two different QoL questionnaires, leading to three measures, were used: QoL in Alzheimer's disease scale (QOL-AD), self and proxy-rated, and QoL in late-stage dementia scale (QUALID), proxy-rated. Multivariate linear regression models were tested for each QoL measure and for mild/moderate and severe stages of dementia.
  
  
  RESULTS
  Multiple regression analyses showed a significant association between the three QoL measures and depression. Functional ability was significantly associated with QoL when assessed by proxy. Other factors such as education level, leisure activities and frequency of visits were significantly related with QOL-AD by proxy. The associated factors that differed by dementia severity were education level for moderate dementia, and frequency of visits and who answered the questionnaire (professional vs. family member) for severe dementia.
  
  
  CONCLUSIONS
  QoL was consistently associated with depressive symptoms independently of the measures as well as functional ability and social leisure activities when the QoL questionnaire was rated by proxy. Treating depressive symptoms, increasing social activities and maintaining the functional ability may decrease the deterioration of QoL in institutionalized older adults with dementia.
authors.affiliation: Preventive Medicine Service.Hospital Universitario12 de Octubre.Madrid,Spain.
authors.forename: Emilia
authors.initials: E
authors.lastname: Castro-Monteiro
authors.affiliation: Preventive Medicine Service.Complexo Hospitalario Universitario de A Coruña.Sergas, A Coruña,Spain.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Alhayek-Aí
authors.affiliation: Preventive Medicine Service.Hospital General Universitario Gregorio Marañón.Madrid,Spain.
authors.forename: Alicia
authors.initials: A
authors.lastname: Diaz-Redondo
authors.affiliation: National School of Public Health,Carlos III Institute of Health and REDISSEC,Carlos III Institute of Health.Madrid,Spain.
authors.forename: Alba
authors.initials: A
authors.lastname: Ayala
authors.affiliation: National Centre of Epidemiology,Carlos III Institute of Health and CIBERNED,Carlos III Institute of Health.Madrid,Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Rodriguez-Blazquez
authors.affiliation: Institute of Economics,Geography and Demography.Centre for Human and Social Sciences.Spanish National Research Council.Madrid,Spain.
authors.forename: Fermina
authors.initials: F
authors.lastname: Rojo-Perez
authors.affiliation: National Centre of Epidemiology,Carlos III Institute of Health and CIBERNED,Carlos III Institute of Health.Madrid,Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Martinez-Martin
authors.affiliation: National School of Public Health,Carlos III Institute of Health and REDISSEC,Carlos III Institute of Health.Madrid,Spain.
authors.forename: Maria João
authors.initials: MJ
authors.lastname: Forjaz
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers; D003430:Cross-Sectional Studies; D003704:Dementia / Q000523:psychology*; D003863:Depression / Q000175:diagnosis*; D005190:Family; D005260:Female; D006801:Humans; D007326:Institutionalization; D007899:Leisure Activities; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D019727:Proxy; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011788:Quality of Life; D057566:Self Report; D012720:Severity of Illness Index; D013030:Spain
keywords: associated factors; dementia; institutionalized; quality of life