Background: Quality of Life (QoL) is now an important outcome for people with dementia but the nature of the illness means that there may be difficulty in measuring it. Aims: This thesis, using an established dementia specific outcome measure, the QOL-AD, aims to assess the validity of measuring QoL in severe dementia and to investigate determinants both of QoL and of change in QoL in dementia. Method: In the first study, 224 people with Alzheimer's disease living in community and institutional settings and their caregivers were interviewed. In the second study, 238 people with dementia living in residential homes and staff were interviewed with a follow up assessment at 20 weeks.;Results: People with a MMSE scores of < 12 and 3 could provide valid and reliable ratings of their own QoL and mood, functional ability and psychosocial factors were associated with QoL in this group. Secondly, the person with dementia's self-ratings of QoL were independently predicted by current mood, cholinesterase inhibitor treatment and living environment, whereas family caregiver ratings of the person with dementia's QoL were predicted by mood and neuropsychiatric symptoms. Similarly, in residential homes, mood was the strongest predictor of self-rated QoL but staff ratings of resident's QoL were predicted by levels of dependency. Lastly, cognition, mood function and behaviour were investigated as putative factors influencing change in QoL over 20 weeks. Change in QoL was predicted by changes in mood and cognition. Conclusion: People with severe dementia (MMSE > 2) can comment on their QoL. People with dementia's perception of QoL differs from their caregiver's perception of it. Many people with dementia experience a decline in QoL and this may be linked to deterioration in mood or cognitive function. This suggests that psychological and pharmacological interventions aimed at improving mood or cognition may also benefit QoL.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:722218 |
| Date | January 2006 |
| Creators | Hoe, Juanita |
| Publisher | University College London (University of London) |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://discovery.ucl.ac.uk/1446449/ |
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