David Di Notte

Quality of life in older Belgian people: comparison between people with dementia, mild cognitive impairment, and controls

To assess the sensitivity of the ‘Alzheimers Disease Related Quality of Life’ instrument (ADRQL) applied to Belgian people with dementia (n = 357), mild cognitive impairment (MCI) (n = 36), and controls (n = 72). We also determined the clinical parameters that influence the quality of life (QOL) of people with dementia.

Relationship between quality of life and cognitive decline in dementia

Aims: We aimed to examine the association of cognitive decline with quality of life (QoL) in dementia compared to controls and to determine variables associated with QoL. Methods: Every subject was placed within a specific group depending on their designation by the Mini Mental State Examination and evaluated by the Alzheimer’s Disease Related Quality of Life (ADRQL) and clinical assessments. Results: QoL for the mild dementia group was lower (p = 0.08) than that of controls. The very severe dementia group had a significantly lower QoL than the other dementia groups, which all had similar ADRQL scores. The only predictor of ADRQL scores was found to be the behavioral and psychological symptoms of dementia. Conclusion: There is no direct relationship between cognitive decline and QoL.

Impact of place of residence on relationship between quality of life and cognitive decline in dementia.

The aim of this descriptive study was to estimate and compare the association between cognitive decline and quality of life (QOL) for 2 groups of dementia patients differing by place of residence: home or institution. Each subject was placed within a specific subgroup according to their Mini-Mental State Examination (MMSE) score and was evaluated by a QOL proxy-assessment [Alzheimer Disease Related Quality of Life (ADRQL)] and a dependency assessment (Katz Activities of Daily Living classification). For the “at home” and “institution” groups, global and subscale ADRQL scores showed significant differences between the 5 MMSE subgroups. Place of residence and MMSE subgroups significantly affected global and subscale ADRQL scores. The MMSE 4 to 8, 9 to 13, and 14 to 18 subgroups had ADRQL global scores significantly better in the institution group than the at home group. In contrast, the MMSE 19 to 23 and 0 to 3 subgroups had similar ADRQL global scores in both places of residence. In conclusion, there is no direct relationship between cognitive decline and QOL, and QOL does not seem to be better at home compared with the institution.