title: Greater Independence in Activities of Daily Living is Associated with Higher Health-Related Quality of Life Scores in Nursing Home Residents with Dementia.
abstract: Health-related quality of life (HRQL) for nursing home residents is important, however, the concept of quality of life is broad, encompasses many domains and is difficult to assess in people with dementia. Basic activities of daily living (ADL) are measured routinely in nursing homes using the Resident Assessment Instrument-Minimum Data Set Version 2.0 (RAI-MDS) and Functional Independence Measure (FIM) instrument. We examined the relationship between HRQL and ADL to assess the future possibility of ADL dependency level serving as a surrogate measure of HRQL in residents with dementia. To assess ADL, measures derived from the RAI-MDS and FIM data were gathered for 111 residents at the beginning of our study and at 6-month follow-up. Higher scores for independence in ADL were correlated with higher scores for a disease-specific HRQL measure, the Quality of Life-Alzheimer's Disease Scale. Preliminary evidence suggests that FIM-assessed ADL is associated with HRQL for these residents. The associations of the dressing and toileting items with HRQL were particularly strong. This finding suggests the importance of ADL function in HRQL. The RAI-MDS ADL scales should be used with caution to evaluate HRQL.
authors.affiliation: Faculty of Agricultural, Life and Environmental Sciences, University of Alberta, Edmonton, AB T6G 2R3, Canada. charice@ualberta.ca.
authors.forename: Charice S
authors.initials: CS
authors.lastname: Chan
authors.affiliation: Faculty of Nursing, University of Alberta, Edmonton, AB T6G 2R3, Canada. susan.slaughter@ualberta.ca.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Slaughter
authors.affiliation: Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada. cajones@ualberta.ca.
authors.forename: C Allyson
authors.initials: CA
authors.lastname: Jones
authors.affiliation: Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2R3, Canada. wagg@ualberta.ca.
authors.forename: Adrian S
authors.initials: AS
authors.lastname: Wagg
keywords: Functional Independence Measure; Resident Assessment Instrument-Minimum Data Set; activities of daily living; dementia; health-related quality of life