title: Activity involvement and quality of life of people at different stages of dementia in long term care facilities.
abstract: OBJECTIVE
  Involvement in activities is assumed to positively influence the quality of life of people with dementia, yet activity provision in long-term care remains limited. This study aims to provide more insight into the value of activity involvement for domains of the quality of life of long-term dementia care residents, taking resident characteristics and cognitive status into account.
  
  
  METHODS
  Data were derived from 144 long-term care facilities participating in the second measurement (2010/2011) of the living arrangements for dementia study. Amongst 1144 residents, the relationship between time involved in activities (activity pursuit patterns; RAI-MDS) and quality of life (Qualidem) was studied using multilevel linear regression analyses. Analyses were adjusted for residents' age, gender, neuropsychiatric symptoms, ADL dependency and cognition. To check for effect modification of cognition, interactions terms of the variables activity involvement and cognitive status were added to the analyses.
  
  
  RESULTS
  Despite resident's cognitive status, their activity involvement was significantly related to better scores on care relationship, positive affect, restless tense behaviour, social relations, and having something to do. A negative relationship existed between the activity involvement and positive self-image. The explained variance in the quality of life between residents caused by the activity involvement was small.
  
  
  CONCLUSIONS
  Activity involvement seems to be a small yet important contributor to higher well-being in long-term care resident at all stages of dementia. Adjusting activities to individual preferences and capabilities might enlarge this relationship. Further research is needed to confirm this hypothesis, using measurement instruments less sensitive to recall bias and differentiating between the active and passive activity involvement.
authors.affiliation: a Department of Clinical Psychology , Faculty of Psychology and Education , Vrije Universiteit , Amsterdam , The Netherlands.|b Program on Aging , Netherlands Institute of Mental Health and Addiction , Utrecht , The Netherlands.
authors.forename: Dieneke
authors.initials: D
authors.lastname: Smit
authors.affiliation: c Research Centre Innovations in Care , Rotterdam University of Applied Sciences , Rotterdam , The Netherlands.
authors.forename: Jacomine
authors.initials: J
authors.lastname: de Lange
authors.affiliation: a Department of Clinical Psychology , Faculty of Psychology and Education , Vrije Universiteit , Amsterdam , The Netherlands.|b Program on Aging , Netherlands Institute of Mental Health and Addiction , Utrecht , The Netherlands.
authors.forename: Bernadette
authors.initials: B
authors.lastname: Willemse
authors.affiliation: d Department of Methodology and Applied Biostatistics , Faculty of Earth and Life Sciences , Vrije Universiteit , Amsterdam , The Netherlands.|e EMGO+ Institute for Health and Care research , Amsterdam , The Netherlands.
authors.forename: Jos
authors.initials: J
authors.lastname: Twisk
authors.affiliation: a Department of Clinical Psychology , Faculty of Psychology and Education , Vrije Universiteit , Amsterdam , The Netherlands.|b Program on Aging , Netherlands Institute of Mental Health and Addiction , Utrecht , The Netherlands.|e EMGO+ Institute for Health and Care research , Amsterdam , The Netherlands.|f School of Psychology , University of Queensland , Brisbane , Australia.
authors.forename: Anne Margriet
authors.initials: AM
authors.lastname: Pot
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D003071:Cognition / Q000502:physiology; D003704:Dementia / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D003858:Dependency, Psychological; D003863:Depression / Q000209:etiology; D005190:Family / Q000523:psychology; D005260:Female; D006801:Humans; D008134:Long-Term Care / Q000523:psychology*; D008297:Male; D015999:Multivariate Analysis; D009735:Nursing Homes; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology*; D012044:Regression Analysis; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
keywords: Alzheimer's disease; nursing homes; occupation; well-being