title: A Path Analysis of Dependence and Quality of Life in Alzheimer's Disease.
abstract: OBJECTIVE
  To determine the direct and indirect relationships of cognitive, functional, and behavioral factors and other medical comorbidities with the quality of life (QoL) of patients with Alzheimer's disease (AD) according to the theoretical model of dependence.
  
  
  METHODS
  Observational and cross-sectional study. Cognitive and functional status, behavior, dependence, medical comorbidities, and QoL were assessed by using standardized instruments. A path analysis was used to model the direct and indirect relationships among clinical indicators according to the theoretically based model of dependence.
  
  
  RESULTS
  The sample consisted of 343 patients with AD (32.1% mild, 36.7% moderate, and 31.2% severe). Medical comorbidities, disease severity, and dependence level had a direct relationship with QoL. The functional disability and the behavior disturbances were indirectly related to QoL via dependence level, and the cognitive impairment was indirectly related to QoL via severity level.
  
  
  CONCLUSIONS
  Direct and indirect effects exist between clinical indicators, dependence, and QoL.
authors.affiliation: 1 Girona Biomedical Research Institute (IDIBGI), Girona, Spain.|2 Institut d'Assistència Sanitària, Girona, Spain.|3 Department of Medical Sciences, University of Girona, Girona, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Garre-Olmo
authors.affiliation: 1 Girona Biomedical Research Institute (IDIBGI), Girona, Spain.|2 Institut d'Assistència Sanitària, Girona, Spain.|3 Department of Medical Sciences, University of Girona, Girona, Spain.|4 Dementia Unit, Hospital de Santa Caterina, Girona, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Vilalta-Franch
authors.affiliation: 1 Girona Biomedical Research Institute (IDIBGI), Girona, Spain.
authors.forename: Laia
authors.initials: L
authors.lastname: Calvó-Perxas
authors.affiliation: 1 Girona Biomedical Research Institute (IDIBGI), Girona, Spain.|2 Institut d'Assistència Sanitària, Girona, Spain.|4 Dementia Unit, Hospital de Santa Caterina, Girona, Spain.
authors.forename: Secundino
authors.initials: S
authors.lastname: López-Pousa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index
keywords: Alzheimer’s disease; dementia; dependence; quality of life