title: [Change patterns, influencing factors and predictors of quality of life in patients with Alzheimer's disease].
abstract: OBJECTIVE
  To explore the change patterns, influencing factors and predictors of quality of life for 4 years in patients with Alzheimer's disease (AD).
  
  
  METHODS
  A total of 96 mild-moderate AD patients on combined therapies of medicine and recuperation were enrolled. Their clinical symptoms were graded by mini-mental state examination (MMSE), activity of daily living (ADL), global deterioration scale (GDS), neuropsychiatric inventory (NPI), Hamilton depression scale (HRSD), Hamilton anxiety scale (HAMA) and Pittsburgh sleep quality index (PQSI). And their qualities of life were evaluated by Quality of Life-Alzheimer's Disease (QOL-AD) at baseline and at the end of 1, 2, 3, 4 year.
  
  
  RESULTS
  (1) During a 4-year follow-up, the scores of QOL-AD, MMSE, ADL, GDS, NPI, HRSD, HAMA and PQSI decreased markedly compared with baseline [(17.5±1.9), (12±3), (45±9), (5.2±0.8), (31±11), (20±6), (14±6), (14±4) vs (30.5±4.6), (21±4), (34±10), (3.3±0.9), (22±9), (18±6), (11±4), (12±4) respectively, t=25.31, 15.42, -7.16, -14.83, -5.56, -2.94, -4.45, -5.60, all P<0.01]. With the deterioration of AD, their qualities of life decreased significantly. (2) Spearman's correlation analysis showed that the scores of 4-year QOL-AD were correlated with the 4-year score changes of MMSE, ADL, GDS (r=0.344, 0.368, 0.213; P=0.002, 0.001, 0.047). (3) Multiple Logistic regression model showed that the baseline scores of NPI and HRSD were strong predictors of loss of quality of life (OR=1.697, 1.269; P=0.000, 0.006). And the area under the curve of receiver operating characteristic (ROC) of NPI and HRSD were 0.918 (95% CI: 0.844-0.991) and 0.878 (95% CI: 0.804-0.953) respectively.
  
  
  CONCLUSIONS
  With the deterioration of AD, the quality of life decreases significantly and has correlations with the score changes of MMSE, ADL and GDS. High scores of NPI and HRSD are the important predictors for a loss of quality of life in AD patients. Early detection and timely interventions are necessary.
authors.affiliation: Department of Geriatrics, General Hospital of Jianghan Oil Field, Qianjiang 433121, China.
authors.forename: Mingqiu
authors.initials: M
authors.lastname: Li
authors.affiliation: Department of Geriatrics, General Hospital of Jianghan Oil Field, Qianjiang 433121, China; Email: hbqjhuang@163.com.
authors.forename: Haihua
authors.initials: H
authors.lastname: Huang
authors.affiliation: Department of Geriatrics, General Hospital of Jianghan Oil Field, Qianjiang 433121, China.
authors.forename: Gaoxuan
authors.initials: G
authors.lastname: Jiang
authors.affiliation: Department of Geriatrics, General Hospital of Jianghan Oil Field, Qianjiang 433121, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Mou
authors.affiliation: Department of Geriatrics, General Hospital of Jianghan Oil Field, Qianjiang 433121, China.
authors.forename: Qinghong
authors.initials: Q
authors.lastname: Chen
mesh_terms: D000203:Activities of Daily Living; D000544:Alzheimer Disease; D006801:Humans; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life