title: Quality of Life in relation to neuropsychiatric symptoms in Alzheimer's disease: 5-year prospective ALSOVA cohort study.
abstract: OBJECTIVE
  To examine the association between neuropsychiatric symptoms (NPS) with self- and caregiver-rated Quality of Life (QoL) for patients with Alzheimer's disease (AD) during a 5-year follow-up.
  
  
  METHODS
  The ALSOVA 5-year follow-up study included, at baseline, 236 patients with either very mild (Clinical Dementia Rating Scale (CDR) 0.5), or mild (CDR 1) AD, together with their caregivers from three Finnish hospital districts. QoL was evaluated using patient self-reported, and caregiver-rated, QoL in AD (QoL-AD) scores. NPS were assessed using the Neuropsychiatric Inventory (NPI), and AD severity was evaluated using the CDR, with cognition tested by the mini-mental state examination. The performance of daily activities was assessed using the Alzheimer's Disease Cooperative Study-Activities of Daily Living Inventory.
  
  
  RESULTS
  Over the 5-year follow-up period, patient self-reported QoL-AD scores did not change significantly (p = 0.245), despite increases in their NPS. However, caregiver-rated patient QoL-AD scores declined significantly (p ≤ 0.001), as total NPI scores increased during follow-up. No NPS at baseline, and only apathy at follow-up, correlated significantly (p = 0.007) with patient self-rated QoL-AD scores. Caregiver-rated patient QoL-AD scores correlated significantly with most NPS, especially (p ≤ 0.001) apathy, agitation, anxiety, irritability, depression, and delusions at baseline, and delusions, hallucinations, apathy, appetite disturbances, and anxiety during follow-up.
  
  
  CONCLUSIONS
  Patient rated QoL-AD scores are an unreliable tool with which to evaluate the success of therapy for NPS. Instead, caregiver-rated scores for patients correlated well with NPI scores, and health care professionals in the clinic should preferentially use these. Copyright © 2017 John Wiley & Sons, Ltd.
authors.affiliation: Institute of Clinical Medicine, Neurology, School of Medicine, University of Eastern Finland, Kuopio, Finland.|Institute of Public Health and Clinical Nutrition, Department of Geriatrics, University of Eastern Finland, Kuopio, Finland.|NeuroCentre, Neurology, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Kristiina
authors.identifier: http://orcid.org/0000-0002-3446-2751
authors.initials: K
authors.lastname: Hongisto
authors.affiliation: Institute of Clinical Medicine, Neurology, School of Medicine, University of Eastern Finland, Kuopio, Finland.
authors.forename: Ilona
authors.initials: I
authors.lastname: Hallikainen
authors.affiliation: Science Service Center, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Tuomas
authors.initials: T
authors.lastname: Selander
authors.affiliation: Pharmacoeconomics and Outcomes Research Unit (PHORU), School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
authors.forename: Soili
authors.initials: S
authors.lastname: Törmälehto
authors.affiliation: Pharmacoeconomics and Outcomes Research Unit (PHORU), School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
authors.forename: Saku
authors.initials: S
authors.lastname: Väätäinen
authors.affiliation: Pharmacoeconomics and Outcomes Research Unit (PHORU), School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
authors.forename: Janne
authors.initials: J
authors.lastname: Martikainen
authors.affiliation: Department of Nursing Science, University of Eastern Finland, Kuopio, Finland.
authors.forename: Tarja
authors.initials: T
authors.lastname: Välimäki
authors.affiliation: Kuopio Research Centre of Geriatric Care, School of Pharmacy, University of Eastern Finland, Kuopio, Finland.|Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Sirpa
authors.initials: S
authors.lastname: Hartikainen
authors.affiliation: Department of Neurology, Al-Ahli Hospital, Doha, Qatar.
authors.forename: Jaana
authors.initials: J
authors.lastname: Suhonen
authors.affiliation: Institute of Clinical Medicine, Neurology, School of Medicine, University of Eastern Finland, Kuopio, Finland.|NeuroCentre, Neurology, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Koivisto
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000523:psychology*; D017028:Caregivers / Q000523:psychology; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*
keywords: Alzheimer's disease; Quality of Life; neuropsychiatric symptoms; self- and caregiver-rated