Yes / Objectives: We aimed to examine change over time in self-rated quality of life (QoL) in people with
mild-to-moderate dementia and identify sub-groups with distinct QoL trajectories.
Method: We used data from people with mild-to-moderate dementia followed up at 12 and 24 months
in the IDEAL cohort study (baseline n=1537). A latent growth model approach examined
mean change over time in QoL, assessed with the QoL-AD scale, and investigated
associations of baseline demographic, cognitive and psychological covariates with the
intercept and slope of QoL. We employed growth mixture modelling to identify multiple
growth trajectories.
Results: Overall mean QoL scores were stable and no associations with change over time were
observed. Four classes of QoL trajectories were identified: two with higher baseline QoL
scores, labelled Stable (74.9%) and Declining (7.6%), and two with lower baseline QoL
scores, labelled Stable Lower (13.7%) and Improving (3.8%). The Declining class had higher
baseline levels of depression and loneliness, and lower levels of self-esteem and optimism,
than the Stable class. The Stable Lower class was characterised by disadvantage related to
social structure, poor physical health, functional disability, and low psychological well-being The Improving class was similar to the Stable Lower class but had lower cognitive test scores.
Discussion: Understanding individual trajectories can contribute to personalised care planning. Efforts to
prevent decline in perceived QoL should primarily target psychological well-being. Efforts to
improve QoL for those with poorer QoL should additionally address functional impairment,
isolation, and disadvantage related to social structure. / This work was supported by Economic and Social Research Council (ESRC, part of UK Research and Innovation, UKRI) and National Institute for Health Research (NIHR) grant ES/L001853/2. Alzheimer‟s Society Centre of Excellence grant 348, ASPR2-16-001
| Identifer | oai:union.ndltd.org:BRADFORD/oai:bradscholars.brad.ac.uk:10454/18762 |
| Date | 17 February 2022 |
| Creators | Clare, L., Gamble, L.D., Martyr, A., Sabatini, S., Nelis, S.M., Quinn, Catherine, Pentecost, C., Victor, C., Jones, R.W., Jones, I.R., Knapp, M., Litherland, R., Morris, R.G., Rusted, J.M., Thom, J.M., Collins, R., Henderson, C., Matthews, F.E., IDEAL study team |
| Source Sets | Bradford Scholars |
| Language | English |
| Detected Language | English |
| Type | Article, Published version |
| Rights | © The Author(s) 2022. This is an Open Access article distributed under the Creative Commons CC-BY license (https://creativecommons.org/licenses/by/4.0/), CC-BY |
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