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Mood and behavioral problems are important predictors of quality of life of nursing home residents with moderate to severe dementia: A cross-sectional study


Autoři: Marinda Henskens aff001;  Ilse M. Nauta aff002;  Susan Vrijkotte aff003;  Katja T. Drost aff004;  Maarten V. Milders aff001;  Erik J. A. Scherder aff001
Působiště autorů: Department of Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands aff001;  Department of Neurology, MS Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands aff002;  Menzis, Wageningen, the Netherlands aff003;  tanteLouise, Bergen op Zoom, the Netherlands aff004
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0223704

Souhrn

Objectives

To examine the predictors associated with quality of life of nursing home residents with dementia, in order to identify which predictors are most important and hold most promise for future intervention studies.

Methods/Design

This cross-sectional analysis of data collected in two intervention trials included 143 participants with moderate to severe dementia who resided in 40 psychogeriatric wards in 13 nursing homes. The outcome measure quality of life was assessed with the Qualidem. Predictors examined were demographic factors, cognition, mood, behavioral problems, and comorbid conditions.

Results

Linear mixed regression analyses showed that all nine domains of quality of life showed independent (negative) associations with either depression, agitation, apathy, or a combination of these predictors. Agitation, apathy, depression, and the presence of neurological disease explained 50% of the variance in total quality of life. Male gender, psychiatric/mood disorders, and having one or more comorbid conditions was associated with worse social relations, while the presence of comorbid neurological diseases was associated with more social isolation and a worse care relationship. The presence of endocrine/metabolic disorders and pulmonary disorders was associated with less restless tense behavior.

Conclusions

Different domains of quality of life showed different associations, confirming the multidimensionality of quality of life in nursing home residents with dementia. Quality of life is independently associated with mood and behavioral problems, comorbid conditions, and gender. This knowledge may help to identify older persons at risk of a lower quality of life, and to offer targeted interventions to improve quality of life.

Trial registration

Dutch Trial registration NTR5641

Klíčová slova:

Behavior – Behavioral disorders – Cognitive impairment – Dementia – Depression – Emotions – Quality of life – Regression analysis


Zdroje

1. Olsen C, Pedersen I, Bergland A, Enders-Slegers MJ, Jøranson N, Calogiuri G, et al. Differences in quality of life in home-dwelling persons and nursing home residents with dementia–a cross-sectional study. BMC Geriatr. 2016;16(1):137.

2. Lawton MP. Quality of life in Alzheimer disease. Alzheimer Dis Assoc Disord. 1994;8:138–50. 7999340

3. The World Health Organization quality of life assessment (WHOQOL): position paper from the World Health Organization. Soc Sci Med. 1995;41(10):1403–9. doi: 10.1016/0277-9536(95)00112-k 8560308

4. Whitehouse P. Quality-of life assessment dementia drug development. Alzheimer Dis Assoc Disord. 1997;11:56–60. 9305519

5. Moniz-Cook E, Vernooij-Dassen M, Woods R, Verhey F, Chattat R, Vugt MD, et al. A European consensus on outcome measures for psychosocial intervention research in dementia care. Aging Ment Health. 2008;12(1):14–29. doi: 10.1080/13607860801919850 18297476

6. Schölzel‐Dorenbos CJ, Ettema TP, Bos J, Boelens‐van der Knoop E, Gerritsen DL, Hoogeveen F, et al. Evaluating the outcome of interventions on quality of life in dementia: selection of the appropriate scale. Int J Geriatr Psychiatry. 2007;22(6):511–9. doi: 10.1002/gps.1719 17133655

7. Ettema TP, Dröes RM, de Lange J, Mellenbergh GJ, Ribbe MW. QUALIDEM: development and evaluation of a dementia specific quality of life instrument. Scalability, reliability and internal structure. Int J Geriatr Psychiatry. 2007;22(6):549–56. doi: 10.1002/gps.1713 17152121

8. Netten A, Burge P, Malley J, Potoglou D, Towers AM, Brazier J, et al. Outcomes of social care for adults: developing a preference-weighted measure. Health Technol Asses. 2012;16(16):1–166.

9. Beerens HC, Zwakhalen SM, Verbeek H, Ruwaard D, Hamers JP. Factors associated with quality of life of people with dementia in long-term care facilities: a systematic review. Int J Nurs Stud. 2013;50(9):1259–70. doi: 10.1016/j.ijnurstu.2013.02.005 23465959

10. Banerjee S, Smith S, Lamping D, Harwood R, Foley B, Smith P, et al. Quality of life in dementia: more than just cognition. An analysis of associations with quality of life in dementia. J Neurol Neurosurg Psychiatry. 2006;77(2):146–8. doi: 10.1136/jnnp.2005.072983 16421113

11. Missotten P, Ylieff M, Di Notte D, Paquay L, De Lepeleire J, Buntinx F, et al. Quality of life in dementia: a 2‐year follow‐up study. Int J Geriatr Psychiatry. 2007;22(12):1201–7. doi: 10.1002/gps.1814 17503544

12. Banerjee S, Samsi K, Petrie CD, Alvir J, Treglia M, Schwam EM, et al. What do we know about quality of life in dementia? A review of the emerging evidence on the predictive and explanatory value of disease specific measures of health related quality of life in people with dementia. Int J Geriatr Psychiatry. 2009;24(1):15–24. doi: 10.1002/gps.2090 18727132

13. Barca ML, Engedal K, Laks J, Selbæk G. Quality of life among elderly patients with dementia in institutions. Dement Geriatr Cogn Disord. 2011;31(6):435–42. doi: 10.1159/000328969 21757909

14. González‐Salvador T, Lyketsos CG, Baker A, Hovanec L, Roques C, Brandt J, et al. Quality of life in dementia patients in long‐term care. Int J Geriatr Psychiatry. 2000;15(2):181–9. doi: 10.1002/(sici)1099-1166(200002)15:2<181::aid-gps96>3.0.co;2-i 10679850

15. Hoe J, Hancock G, Livingston G, Orrell M. Quality of life of people with dementia in residential care homes. Br J Psychiatry. 2006;188(5):460–4.

16. Samus QM, Rosenblatt A, Steele C, Baker A, Harper M, Brandt J, et al. The association of neuropsychiatric symptoms and environment with quality of life in assisted living residents with dementia. Gerontologist. 2005;45(suppl_1):19–26.

17. Nakanishi K, Hanihara T, Mutai H, Nakaaki S. Evaluating the quality of life of people with dementia in residential care facilities. Dement Geriatr Cogn Disord. 2011;32(1):39–44. doi: 10.1159/000329443 21846987

18. Wetzels R, Zuidema SU, de Jonghe JF, Verhey F, Koopmans R. Determinants of quality of life in nursing home residents with dementia. Dement Geriatr Cogn Disord. 2010;29(3):189–97. doi: 10.1159/000280437 20215750

19. Winzelberg GS, Williams CS, Preisser JS, Zimmerman S, Sloane PD. Factors associated with nursing assistant quality-of-life ratings for residents with dementia in long-term care facilities. Gerontologist. 2005;45(suppl_1):106–14.

20. Zimmerman S, Sloane PD, Williams CS, Reed PS, Preisser JS, Eckert JK, et al. Dementia care and quality of life in assisted living and nursing homes. Gerontologist. 2005;45(suppl_1):133–46.

21. Beer C, Flicker L, Horner B, Bretland N, Scherer S, Lautenschlager NT, et al. Factors associated with self and informant ratings of the quality of life of people with dementia living in care facilities: a cross sectional study. PloS ONE. 2010;5(12):e15621. doi: 10.1371/journal.pone.0015621 21179448

22. Missotten P, Squelard G, Ylieff M, Di Notte D, Paquay L, De Lepeleire J, et al. Relationship between quality of life and cognitive decline in dementia. Dement Geriatr Cogn Disord. 2008;25(6):564–72. doi: 10.1159/000137689 18544978

23. Ballard C, O'Brien J, James I, Mynt P, Lana M, Potkins D, et al. Quality of life for people with dementia living in residential and nursing home care: the impact of performance on activities of daily living, behavioral and psychological symptoms, language skills, and psychotropic drugs. Int Psychogeriatr. 2001;13(1):93–106. doi: 10.1017/s1041610201007499 11352339

24. Klapwijk MS, Caljouw MA, Pieper MJ, van der Steen JT, Achterberg WP. Characteristics associated with quality of life in long-term care residents with dementia: a cross-sectional study. Dement Geriatr Cogn Disord. 2016;42(3–4):186–97. doi: 10.1159/000448806 27668927

25. Henskens M, Nauta IM, Drost KT, Scherder EJA. The effects of movement stimulation on activities of daily living performance and quality of life in nursing home residents with dementia: a randomized controlled trial. Clin Interv Aging. 2018;13:805 doi: 10.2147/CIA.S160031 29750023

26. Henskens M, Nauta IM, Scherder EJA, Oosterveld FGJ, Vrijkotte S. Implementation and effects of Movement-oriented Restorative Care in a nursing home–a quasi-experimental study. BMC Geriatr. 2017;17(1):243. doi: 10.1186/s12877-017-0642-x 29058632

27. Henskens M, Nauta IM, Van Eekeren MC, Scherder EJA. Effects of Physical Activity in Nursing Home Residents with Dementia: A Randomized Controlled Trial. Dement Geriatr Cogn Disord. 2018;46(1–2):60–80. doi: 10.1159/000491818 30145595

28. Huntleigh A. ARJO Guidebook for Architects and Planners: Elderly Care Facilities. ARJO Hospital equipment. Mälmo, ARJO; 2005.

29. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatry Res. 1975;12(3):189–98.

30. Ettema TP, Dröes RM, de Lange J, Mellenbergh GJ, Ribbe MW. QUALIDEM: development and evaluation of a dementia specific quality of life instrument––validation. Int J Geriatr Psychiatry. 2007;22(5):424–30. doi: 10.1002/gps.1692 17044131

31. Bouman A, Ettema T, Wetzels R, Van Beek A, De Lange J, Dröes R. Evaluation of Qualidem: a dementia‐specific quality of life instrument for persons with dementia in residential settings; scalability and reliability of subscales in four Dutch field surveys. Int J Geriatr Psychiatry. 2011;26(7):711–22. doi: 10.1002/gps.2585 20845397

32. Kok R, Verhey F. Dutch translation of the Mini Mental State Examination (Folstein et al.,1975). Altrecht: GGZ; 2002.

33. Lezak MD, Howieson DB, Loring DW, Fischer JS. Neuropsychological assessment: Oxford University Press, USA; 2004.

34. Egberink IJL, Leng WE, Vermeulen CSM. COTAN beoordeling 2000, Qualidem (COTAN Review 2000, Qualidem). 2019 (retrieved july 29). Available from: www.cotandocumentatie.nl

35. Bossers WJ, Van der Woude LH, Boersma F, Scherder EJA, van Heuvelen MJ. Recommended measures for the assessment of cognitive and physical performance in older patients with dementia: a systematic review. Dement Geriatr Cogn Disord Extra. 2012;2(1):589–609.

36. Droës R. Dutch translation of the Cornell-Scale for Depression in Dementia. Amsterdam: VU University; 1993.

37. Dröes R. The Dutch version of the Cornell scale for depression in dementia. Amsterdamse Ontmoetingscentra, een nieuwe vorm van ondersteuning voor dementerende mensen en hun verzorgers: Thesis Publishers Nijkerk; 1996; 157.

38. Lueken U, Seidl U, Völker L, Schweiger E, Kruse A, Schröder J. Development of a short version of the Apathy Evaluation Scale specifically adapted for demented nursing home residents. Am J Geriatr Psychiatry. 2007;15(5):376–85. doi: 10.1097/JGP.0b013e3180437db3 17463188

39. Jonghe JF, Kat MG. Factor structure and validity of the Dutch version of the Cohen-Mansfield Inventory (CMAI-D). J Am Geriatr Soc. 1996;44(7):888–9. doi: 10.1111/j.1532-5415.1996.tb03762.x 8675952

40. Cohen-Mansfield J, Marx MS, Rosenthal AS. A description of agitation in a nursing home. J Gerontol. 1989;44(3):M77–M84. doi: 10.1093/geronj/44.3.m77 2715584

41. Leontjevas R, Evers-Stephan A, Smalbrugge M, Pot AM, Thewissen V, Gerritsen DL, et al. A comparative validation of the abbreviated Apathy Evaluation Scale (AES-10) with the Neuropsychiatric Inventory apathy subscale against diagnostic criteria of apathy. JAMDA. 2012;13(3):308.e1-308.e6.

42. Centers for Medicare & Medicaid Services. Revised long-term care facility resident assessment instrument user’s manual version 2.0. Baltimore: CMS; 2008.

43. IBM CORP. Released 2017. IBM SPSS Statistics for Windows VA, NY: IBM Corp.

44. Helmer C, Pérès K, Letenneur L, Guttiérez-Robledo LM, Ramaroson H, Barberger-Gateau P, et al. Dementia in subjects aged 75 years or over within the PAQUID cohort: prevalence and burden by severity. Dement Geriatr Cogn Disord. 2006;22(1):87–94. doi: 10.1159/000093459 16710088

45. Burton RL, O’Connell ME, Morgan DG. Cognitive and Neuropsychiatric Correlates of Functional Impairment Across the Continuum of No Cognitive Impairment to Dementia. Arch Clin Neuropsych. 2017;33(7):1–13.

46. Berlim MT, Fleck MP. Quality of life and major depression. Quality of life impairment in schizophrenia, mood and anxiety disorders: Springer, Dordrecht; 2007. pp. 241–52.

47. Livingston G, Kelly L, Lewis-Holmes E, Baio G, Morris S, Patel N, et al. Non-pharmacological interventions for agitation in dementia: systematic review of randomised controlled trials. Br J Psychiatry. 2014;205(6):436–42. doi: 10.1192/bjp.bp.113.141119 25452601

48. Backhouse T, Killett A, Penhale B, Gray R. The use of non-pharmacological interventions for dementia behaviours in care homes: findings from four in-depth, ethnographic case studies. Age Ageing. 2016;45(6):856–63. doi: 10.1093/ageing/afw136 27543054

49. Rabins PV, Lyketsos CG, Steele CD. Practical dementia care: OUP USA; 2006.

50. Donkers H. Social participation dilemmas in dementia. Doctoral dissertation, the Radboud University of Nijmegen. 2018. Available from: https://repository.ubn.ru.nl/bitstream/handle/2066/191609/191609.pdf?sequence=1

51. Verma R, Harris NM, Friedler BD, Crapser J, Patel AR, Venna V, et al. Reversal of the detrimental effects of post-stroke social isolation by pair-housing is mediated by activation of BDNF-MAPK/ERK in aged mice. Sci Rep. 2016;6:25176. doi: 10.1038/srep25176 27125783

52. Robinson RG, Bolduc PL, Kubos KL, Starr LB, Price TR. Social functioning assessment in stroke patients. Arch Phys Med Rehabil. 1985;66(8):496–500. 4026549

53. Garcia-Aymerich J, Félez MA, Escarrabill J, Marrades RM, Morera J, Elosua R, et al. Physical activity and its determinants in severe chronic obstructive pulmonary disease. Med Sci Sports Exerc. 2004;36(10):1667–73. doi: 10.1249/01.mss.0000142378.98039.58 15595285

54. Thomas N, Alder E, Leese G. Barriers to physical activity in patients with diabetes. Postgrad Med J. 2004;80(943):287–91. doi: 10.1136/pgmj.2003.010553 15138320

55. Sprangers MA, de Regt EB, Andries F, van Agt HM, Bijl RV, de Boer JB, et al. Which chronic conditions are associated with better or poorer quality of life? J Clin Epidemiol. 2000;53(9):895–907. doi: 10.1016/s0895-4356(00)00204-3 11004416

56. Lyketsos CG, Sheppard J-ME, Rabins PV. Dementia in elderly persons in a general hospital. Am J Psychiatry. 2000;157(5):704–7. doi: 10.1176/appi.ajp.157.5.704 10784461

57. Lyketsos CG, Toone L, Tschanz J, Rabins PV, Steinberg M, Onyike CU, et al. Population-based study of medical comorbidity in early dementia and “cognitive impairment, no dementia (CIND)”: association with functional and cognitive impairment: The Cache County Study. Am J Geriatr Psychiatry. 2005;13(8):656–64. doi: 10.1176/appi.ajgp.13.8.656 16085781

58. Desai AK, Grossberg GT. Recognition and management of behavioral disturbances in dementia. Prim Care Companion J Clin Psychiatry. 2001;3(3):93. doi: 10.4088/pcc.v03n0301 15014607

59. Rababa M. Association of comorbid burden and patient outcomes of residents with dementia in jordanian nursing homes. J Gerontol Nurs. 2018;44(7):50–8. doi: 10.3928/00989134-20180614-08 29969140

60. Klapwijk MS, Caljouw MA, Pieper MJ, Putter H, van der Steen JT, Achterberg WP. Change in quality of life after a multidisciplinary intervention for people with dementia: A cluster randomized controlled trial. Int J Geriatr Psychiatry. 2018;33(9):1213–1219.

61. Woods RT, Nelis SM, Martyr A, Roberts J, Whitaker CJ, Markova I, et al. What contributes to a good quality of life in early dementia? Awareness and the QoL-AD: a cross-sectional study. Health Qual Life Outcomes. 2014;12(1):94.

62. Lima S, Gago M, Garrett C, Pereira MG. Predictors and Moderators of Quality of Life in Alzheimer’s Disease Patients. J Alzheimers Dis. 2016;54(3):1113–21. doi: 10.3233/JAD-160256 27567826

63. Luppa M, Sikorski C, Luck T, Ehreke L, Konnopka A, Wiese B, et al. Age-and gender-specific prevalence of depression in latest-life–systematic review and meta-analysis. J Affect Disord. 2012;136(3):212–21. doi: 10.1016/j.jad.2010.11.033 21194754

64. Umberson D, Chen MD, House JS, Hopkins K, Slaten E. The effect of social relationships on psychological well-being: Are men and women really so different? Am. Sociol Rev. 1996:837–57.

65. Kawachi I, Berkman LF. Social ties and mental health. J Urban health. 2001;78(3):458–67 doi: 10.1093/jurban/78.3.458 11564849

66. Seeman TE. Health promoting effects of friends and family on health outcomes in older adults. Am J Health Promot. 2000;14(6):362–70. doi: 10.4278/0890-1171-14.6.362 11067571

67. Avlund K, Lund R, Holstein BE, Due P, Sakari-Rantala R, Heikkinen RL. The impact of structural and functional characteristics of social relations as determinants of functional decline. J Gerontol B Psychol Sci Soc Sci. 2004;59(1):S44–S51. doi: 10.1093/geronb/59.1.s44 14722343

68. Robert P, Onyike C, Leentjens A, Dujardin K, Aalten P, Starkstein S, et al. Proposed diagnostic criteria for apathy in Alzheimer's disease and other neuropsychiatric disorders. Eur Psychiatry. 2009;24(2):98–104. doi: 10.1016/j.eurpsy.2008.09.001 19201579

69. Buckley T, Fauth EB, Morrison A, Tschanz J, Rabins PV, Piercy KW, et al. Predictors of quality of life ratings for persons with dementia simultaneously reported by patients and their caregivers: the Cache County (Utah) Study. Int Psychogeriatr. 2012;24(7):1094–102. doi: 10.1017/S1041610212000063 22414494

70. Chiu MJ, Chen TF, Yip PK, Hua MS, Tang LY. Behavioral and psychologic symptoms in different types of dementia. J Formos Med ASsoc. 2006;105(7):556–62. doi: 10.1016/S0929-6646(09)60150-9 16877235

71. Dichter MN, Quasdorf T, Schwab CGG, Trutschel D, Haastert B, Riesner C, et al. Dementia care mapping: effects on residents’ quality of life and challenging behavior in German nursing homes. A quasi-experimental trial. Int Psychogeriatr. 2015;27(11):1875–92. doi: 10.1017/S1041610215000927 26138674


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