Affiliations: [a] Faculty of Psychology, University of Barcelona, Spain
| [b] Aging, Disability and Health Research Group, Biomedical Research Institute of Girona (IdIBGi), Catalonia, Spain
| [c] Department of Neurology, Dementia Unit, Bellvitge University Hospital, Hospitalet de Llobregat, Spain
Correspondence:
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Correspondence to: Josep L. Conde-Sala, Faculty of Psychology, University of Barcelona, Passeig Vall d’Hebron, 171, 08035 Barcelona, Spain. Tel.: +34 93 3125814; Fax: +34 93 4021368; E-mail: jllconde@ub.edu.
Abstract: The objective was to analyze the factors that influence self-perceived quality of life (QoL) in patients with Alzheimer’s disease (AD), contrasting two different longitudinal models. A total of 127 patients were followed up over 24 months. The instruments applied were: Quality of Life in Alzheimer’s Disease scale (QoL-AD), Geriatric Depression Scale-15, Anosognosia Questionnaire-Dementia, Disability Assessment in Dementia, Neuropsychiatric Inventory, and the Mini-Mental State Examination. Two models for grouping patients were tested: 1) Baseline score on the QoL-AD (QoL-Baseline), and 2) Difference in QoL-AD score between baseline and follow-up (QoL-Change). Generalized estimating equations were used to analyze longitudinal data, and multinomial regression analyses were performed. Over the follow-up period the QoL-Baseline model showed greater variability between groups (Wald χ2 = 172.3, p < 0.001) than did the QoL-Change model (Wald χ2 = 1.7, p = 0.427). In the QoL-Baseline model the predictive factors were greater depression (odds ratio [OR] = 1.20; 95% CI: 1.00– 1.45) and lower functional ability (OR = 0.92; 95% CI: 0.85– 0.99) for the Low QoL group (< 33 QoL-AD), and less depression (OR = 0.68; 95% CI: 0.52– 0.88), more anosognosia (OR = 1.07; 95% CI: 1.01– 1.13), and fewer neuropsychiatric symptoms (OR = 0.95; 95% CI: 0.91– 0.99) for the High-QoL group (>37 QoL-AD). The model based on baseline scores (QoL-Baseline) was better than the QoL-Change model in terms of identifying trajectories and predictors of QoL in AD.
Keywords: Alzheimer’s disease, analytic models, anosognosia, depression, longitudinal study, quality of life
