[Differences Between Self- and Proxy-Assessment of Health-Related Quality of Life in Patients with Mild Cognitive Impairment and Alzheimer's Disease]

Psychiatr Prax. 2018 Mar;45(2):78-86. doi: 10.1055/s-0042-121169. Epub 2017 Feb 27.
[Article in German]

Abstract

Objective: The self-assessment of health-related quality of life (HrQoL) in patients with Alzheimer's disease (AD) and mild cognitive impairment is commonly higher than the proxy-assessment by caregivers. This study aims at evaluating sociodemographic and clinical factors to explain this difference.

Methods: HrQoL of 241 community-dwelling patients was analysed using the dementia-specific Quality of Life-Alzheimer's Disease questionnaire (QoL-AD). Behavioural and psychological symptoms and functional capacity were evaluated using the Geriatric Depression Scale (GDS), the Neuropsychiatric Inventory (NPI) and the Alzheimer's Disease Cooperative Study-Activities of Daily Living scale (ADCS-ADL).

Results: The self-assessment of patients' HrQoL was significantly higher than the caregiver-ratings (mean difference: 7.4 ± 5.6, p < 0.001). Considerable influencing factors were the extent of depressive symptoms (GDS), the degree of impairment in functional performance (ADCS-ADL) and the relationship between patients and caregivers.

Conclusion: Independent variables explained 23 % of the variance in the difference between self- and proxy-assessment of HrQoL. Future studies should include further influencing factors such as caregivers' mental health.

ZIEL: Patienten mit einer Alzheimer-Demenz (AD) und leichten kognitiven Beeinträchtigungen (LKB) beurteilen ihre gesundheitsbezogene Lebensqualität (LQ) häufig besser als ihre Angehörigen. Einflussfaktoren dieses Beurteilungsunterschieds werden evaluiert.

Methodik: Die LQ von 241 zu Hause lebenden Patienten wurde anhand des krankheitsspezifischen Quality of Life-Alzheimer’s Disease-Fragebogens (QoL-AD) erhoben.

Ergebnisse: Das Verwandtschaftsverhältnis, depressive Symptome und die Alltagsfunktionalität stellen relevante Einflussfaktoren bei Beurteilungsunterschieden der LQ dar.

Schlussfolgerung: Soziodemografische und klinische Variablen können Bewertungsunterschiede der LQ von Patienten mit AD und LKB teilweise erklären.

MeSH terms

  • Activities of Daily Living
  • Aged
  • Alzheimer Disease* / psychology
  • Caregivers
  • Cognitive Dysfunction*
  • Germany
  • Humans
  • Psychiatric Status Rating Scales
  • Quality of Life*