期刊
AGING & MENTAL HEALTH
卷 24, 期 1, 页码 162-170出版社
ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD
DOI: 10.1080/13607863.2018.1517727
关键词
Dementia; carers; quality of life; proxy-rating; intervention development
资金
- Germany, Ministry of Education and Research
- Ireland, Health Research Board
- Italy, Ministry of Health
- Netherlands, The Netherlands organization for Health Research and Development
- Sweden, The Swedish Research Council for Health, Working Life and Welfare
- Norway, The Research Council of Norway
- Portugal, Foundation for Science and Technology, (Fundacao para a Ciencia e Tecnologia) [FCT -JPND HC/0001/2012]
- United Kingdom, Economic and Social Research Council
- ESRC [ES/L008831/1] Funding Source: UKRI
Objectives: To identify correlates of self-rated and proxy-rated quality of life (QoL) in people with dementia on (i) a dementia-specific and (ii) a capability-wellbeing QoL measure at baseline and 12-month follow-up, and to consider such factors in the context of QoL intervention development. Method: Prospective clinical and demographic data were collected from 451 community-dwelling dyads (mild-moderate dementia) across eight European countries. QoL was measured using the QOL-AD and the ICECAP-O. Multivariate modelling identified correlates of self- and proxy-rated QoL at baseline and at 12-month follow-up. Results: Carer's proxy-ratings of QoL were significantly lower than self-ratings at all time-points for both measures. Proxy-ratings declined over time, but self-ratings remained stable. Baseline predictors of greater self-rated QoL were education, and greater functional ability and relationship quality. Greater proxy-rated QoL was associated with education and greater functional ability, relationship quality, carer social support and carer QoL, lower carer anxiety/depression and less severe neuropsychiatric symptoms in people with dementia. At follow-up, greater self-rated QoL was predicted by greater functional ability, relationship quality, carer social support and having a spousal carer. Greater proxy-rated QoL at follow-up was associated with the same factors as at baseline; however, the dyad living together was an additional predictive factor. Conclusion: Both proxy-ratings and self-ratings of QoL should be interpreted with caution and in the context of each individual caregiving relationship. Different functional, psychosocial, relational and contextual factors influence self- and proxy-ratings, and both sets of factors should be considered in the context of QoL intervention development for the dyad.
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