Norwegian Centre for Dementia Research, Centre for Aging and Health, Oslo University Hospital, Ullevaal, Oslo, Norway.
Dement Geriatr Cogn Disord. 2011;31(6):435-42. doi: 10.1159/000328969. Epub 2011 Jul 15.
To study quality of life among the elderly with dementia in institutions.
Patients above 60 years with dementia, 82 in nursing home and 74 in departments of geriatric psychiatry, were included. They were assessed with the Quality of Life in Late-Stage Dementia (QUALID); the Self-Maintenance scale, Mini Mental State Examination (MMSE) and Clinical Dementia Rating scale. Patient's age, gender, previous medical and psychiatric history were recorded. Dementia was diagnosed according to ICD-10 criteria for research. Based on information in an interview with the patient and a carer and information in the patient's record, a geriatric psychiatrist made a diagnosis of major depression according to DSM-IV, if present.
The patients' mean (± SD) age was 82.9 ± 7.7 years, 103 (66%) were women. A factor analysis of the QUALID scale resulted in two factors: 'discomfort' and 'comfort'. Three linear regression analyses were performed. Variables associated with lower quality of life (total QUALID score) were: a diagnosis of major depression (p < 0.001), lower score on MMSE (p = 0.032), impaired function in activities of daily living (p = 0.007) and female gender (p = 0.046). Variables associated with the 'discomfort' subscale score were: major depression (p < 0.001), lower score on MMSE (p = 0.006) and living in a department of geriatric psychiatry (p = 0.041). The 'comfort' subscale score was associated with impaired function in activities of daily living (p < 0.001). Explained variance for the three models was 34, 33 and 23%, respectively.
Quality of life is diminished among elderly patients in institutions and the most marked correlates were a diagnosis of major depression, worse performance in activities of daily living and worse cognitive function.
研究机构中痴呆老年人的生活质量。
纳入 82 名养老院和 74 名老年精神病科的 60 岁以上痴呆患者，用晚期痴呆生活质量问卷（QUALID）、自我护理量表、简易精神状态检查（MMSE）和临床痴呆评定量表进行评估。记录患者的年龄、性别、既往内科和精神科病史。痴呆诊断根据国际疾病分类第 10 版（ICD-10）研究标准。根据患者和护理者访谈以及患者病历中的信息，老年精神病医生根据 DSM-IV 标准作出重性抑郁障碍的诊断。
患者的平均（± SD）年龄为 82.9 ± 7.7 岁，103 名（66%）为女性。QUALID 量表的因子分析产生了两个因子：“不适”和“舒适”。进行了 3 次线性回归分析。与生活质量（总 QUALID 评分）较低相关的变量是：重性抑郁障碍诊断（p < 0.001）、MMSE 评分较低（p = 0.032）、日常生活活动功能受损（p = 0.007）和女性（p = 0.046）。与“不适”分量表评分相关的变量是：重性抑郁障碍诊断（p < 0.001）、MMSE 评分较低（p = 0.006）和住在老年精神病科（p = 0.041）。“舒适”分量表评分与日常生活活动功能受损相关（p < 0.001）。三个模型的解释方差分别为 34%、33%和 23%。
机构中痴呆老年患者的生活质量下降，最显著的相关因素是重性抑郁障碍诊断、日常生活活动功能更差和认知功能更差。
