A Path Analysis of Dependence and Quality of Life in Alzheimer’s Disease

2017 ◽  
Vol 32 (2) ◽  
pp. 108-115 ◽  
Author(s):  
Josep Garre-Olmo ◽  
Joan Vilalta-Franch ◽  
Laia Calvó-Perxas ◽  
Secundino López-Pousa ◽  
Keyword(s):  
Quality Of Life ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Path Analysis ◽  
Functional Disability ◽  
Cross Sectional ◽  
Clinical Indicators ◽  
Medical Comorbidities ◽  
Dependence Level

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. Conclusion: Direct and indirect effects exist between clinical indicators, dependence, and QoL.

scholarly journals A path analysis of patient dependence and caregiver burden in Alzheimer's disease

2016 ◽  
Vol 28 (7) ◽  
pp. 1133-1141 ◽  
Author(s):  
J. Garre-Olmo ◽  
J. Vilalta-Franch ◽  
L. Calvó-Perxas ◽  
O. Turró-Garriga ◽  
L. Conde-Sala ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Path Analysis ◽  
Caregiver Burden ◽  
Functional Disability ◽  
Sampling Procedure ◽  
Model Fit ◽  
Behavioral Disturbances ◽  
Cross Sectional ◽  
Dependence Level

ABSTRACTBackground:The concept of dependence has been proposed as an integrative measure to assess the progression of Alzheimer's disease (AD).This study aimed to investigate the association of patient's dependence level with the caregiver burden within a general theoretical model that includes other well-established determinants.Methods:Observational and cross-sectional multicenter study. The sample consisted of patients with AD recruited in outpatient consultation offices by a convenience sampling procedure stratified by dementia severity. Cognitive and functional status, behavioral disturbances, dependence level, medical comorbidities, and caregiver burden were assessed by using standardized instruments. A path analysis was used to test the hypothesized relationships between the caregiver burden and its determinants, including the level of dependence.Results:The sample consisted of 306 patients (33.3% mild, 35.9% moderate, 30.7% severe), the mean age was 78.5 years (SD = 7.8), and 66.2% were women. The model fit was acceptable and explained 29% of the caregiver burden variance. Primary stressors were the level of dependence and the distress related to behavioral disturbances. Caregiver's age, gender, and co-residence with the patient were the contextual factors related to caregiver burden. The job status of the caregiver was a significant secondary stressor, functional disability was indirectly associated with caregiver burden via dependence, and frequency of behavioral disturbances was indirectly associated with the caregiver burden via distress.Conclusions:Dependence was, apart from behavioral disturbances, the most important primary stressor directly related to caregiver burden irrespective of the disease severity.

scholarly journals Quality of life and factors affecting it in patients with Alzheimer’s disease: a cross-sectional study

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Burcu Akpınar Söylemez ◽  
Özlem Küçükgüçlü ◽  
Merve Aliye Akyol ◽  
Ahmet Turan Işık
Keyword(s):  
Quality Of Life ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Area Of Interest ◽  
Modifiable Factors

Abstract Background Quality of life (QoL) is a growing area of interest in dementia research. However, it remains a controversial topic. This study aimed to determine the QoL of people with Alzheimer’s disease (PwAD) and investigate the factors affecting patients’ and caregivers’ QoL scores. Methods A cross-sectional study design was used. A total of 98 home-dwelling PwADs and their primary caregivers were recruited in the study. Sociodemographic characteristics and QoL scores, activities of daily living (ADL) and instrumental ADL (IADL), Mini-mental State Examination (MMSE) scores, neuropsychiatric inventory (NPI), and NPI–distress were determined to assess the relevant outcomes. All statistical analyses were performed using SPSS version 22.0. Descriptive statistics, t-test, Pearson correlation, and multinomial regression were used for analysis. Results The patients’ ratings of their QoL were higher than those of the caregivers. Caregiver education, patients’ ADL, and IADL were associated with the patients’ score on the Quality of Life in Alzheimer’s Disease (QoL-AD) scale. In addition to these variables, MMSE, NPI, and NPI–distress were associated with the caregiver scores on QoL-AD. Conclusion From a clinical point of view, the proxy-rated scores of QoL cannot replace the self-ratings of the patients. This study suggests that both self- and proxy-rated QoL scores should be applied whenever possible. Focusing on the management of behavioral problems and supporting functionality and cognitive functions may be modifiable factors that may represent targets for intervention to improve the QoL. The findings of this study should also be used to design caregiver educational programs about the determinants of QoL.

Quality of life in Alzheimer's disease: different factors associated with complementary ratings by patients and family carers

2012 ◽  
Vol 24 (5) ◽  
pp. 708-721 ◽  
Author(s):  
Pascalle R. Bosboom ◽  
Helman Alfonso ◽  
Joanna Eaton ◽  
Osvaldo P. Almeida
Keyword(s):  
Quality Of Life ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Clinical Information ◽  
Primary Outcome Measure ◽  
Community Dwelling ◽  
Family Carers ◽  
Cross Sectional ◽  
Factors Associated

ABSTRACTBackground: Quality of life (QoL) in dementia is a complex construct and factors that predict QoL ratings are unclear. We designed this study to determine: (1) the agreement in QoL ratings between community-dwelling patients with mild to moderate dementia and family carers; and (2) the factors associated with self-reported and two types of carer-reported QoL ratings: carer–carer perspective and carer–patient perspective.Methods: A cross-sectional study was carried out of 80 community-dwelling patients with the diagnosis of probable Alzheimer's disease (AD) of mild or moderate severity according to NINCDS-ADRD criteria, and their 80 family carers. The QoL-AD was the primary outcome measure. We collected patients’ self-reported QoL ratings and two types of carer-reported QoL ratings: carer–patient and carer–carer perspectives. Explanatory variables included demographics, lifestyle, and clinical information from patients and carers, along with cognition, awareness, psychopathology, burden-of-care, and functionality in daily life. Bland-Altman plots guided the interpretation of agreement by visualizing the distribution of all the ratings. Univariate and multivariate regression analyses were conducted to examine the contribution of candidate explanatory factors.Results: Patients and their carers showed good agreement in their QoL ratings, although the total scores of carers (regardless of perspective) were lower than the scores of patients. Depression, insight and use of anti-dementia agents were associated with QoL self-ratings, whereas cognitive function was directly associated and depression inversely associated with carers’ QoL ratings.Conclusion: Mild to moderate community-dwelling AD patients and their carers (with different perspectives) agree within an acceptable range in QoL ratings but the ratings are driven by different factors, and consequently are not interchangeable but complementary. They provide valuable information when used separately, not in a composite score.

scholarly journals Investigation of the Factors Affecting Quality of Life in Patients with Mild to Moderate Alzheimer's Disease: A Cross-Sectional Study from Turkey

2021 ◽  
Author(s):  
Elvan Felekoğlu ◽  
Sevgi ÖZALEVLİ ◽  
Hazal YAKUT ◽  
Rıdvan AKTAN ◽  
Görsev YENER
Keyword(s):  
Quality Of Life ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Alzheimer Disease ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Cross Sectional ◽  
Self Rating ◽  
Proxy Rating

Abstract Background Like other chronic diseases with limited medical treatment, the most important goal of Alzheimer’s disease rehabilitation is to provide a better quality of life. The purpose of this study was to investigate the factors affecting the quality of life of the patients with Alzheimer's Disease (according to parts of the Quality of Life in Alzheimer’ Disease Questionnaire: patient, proxy and total score). Methods In this cross-sectional study, 73 home-dwelling patients with Alzheimer's Disease and their caregivers were recruited. Cognition, depression and Quality of Life in Alzheimer’ Disease -self rating were asked to the patient. The caregiver was asked about patient’s sociodemographic information, sleepiness, activities of daily living and Quality of Life in Alzheimer’ Disease -proxy rating. Results The Quality of Life in Alzheimer’ Disease -self rating were higher than the Quality of Life in Alzheimer’ Disease -proxy rating. Cognition (p = 0.02), sleepiness (p < 0.01) and depression (p = 0.03) were correlated with the Quality of Life in Alzheimer’ Disease -self rating, while the independence level of the patient in activities of daily living was correlated to the Quality of Life in Alzheimer’ Disease -proxy rating (p < 0.05). Predicting quality of life according to linear regression analysis those were statistically significant in respectively; depression is for Quality of Life in Alzheimer’ Disease, depression and cognition were for Quality of Life in Alzheimer’ Disease -self rating and instrumental activities of daily living was for QoL-AD-PR (p < 0.01). Conclusion While subjective situations such as psychology is important for the patients with Alzheimer's Disease, objective conditions such as the independence of the patient’s in daily life activities are important for the caregiver. While evaluating the quality of life, both the evaluations of the patients with Alzheimer's Disease and the caregiver should be applied, because different things are prioritized by them and priorities of both should be taken into account when planning the treatment program.

scholarly journals Intracranial pressure waveform changes in Alzheimer’s disease and mild cognitive impairment

2021 ◽  
Vol 12 ◽  
pp. 172
Author(s):  
Estela Barbosa Ribeiro ◽  
Luiza D’Ottaviano Cobos ◽  
Nicollas Nunes Rabelo ◽  
Gustavo Frigeri ◽  
Francisco Assis Carvalho Vale
Keyword(s):  
Quality Of Life ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Intracranial Pressure ◽  
Quantitative Character ◽  
Cross Sectional ◽  
Significant Difference

Background: Alzheimer’s disease (AD) is known to cause an enormous impairment to the quality of life and impact in the health system; meanwhile, studies show that in the coming years, the number of affected individuals will continue to grow. It is also believed that amnestic mild cognitive impairment (MCI) could represent an early symptomatic form of AD, which precedes dementia. Methods: The present study aimed to evaluate the intracranial pressure (ICP) through a noninvasive method in patients with AD and MCI, seeking for differences when compared to healthy elderlies. This is a cross-sectional, correlational, and observational study of a quantitative character, carried out in a Brazilian city, with patients from the ANEC of the UFSCar. Results: It was found a statistically significant difference between the ICP morphology when analyzing the results in patients with AD and MCI, compared to healthy volunteers. It is known that dementias means a progressive disorder that leads to the loss of independency and function of the patient, although, it is believed that it can be found early ICP alterations in these patients. Nevertheless, considering this is an unprecedent study, it was not possible to compare results with previous studies and literatures. However, the study has a limitation related to the sample size; an expansion of it could possibility lead to different findings. Conclusion: The findings through the ICP measurement could indicate an early diagnosis, which would lead to an early treatment and an improvement in the quality of life of patients with AD. Thus, further investigation and widening studies are encouraged.

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