Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan.
Department of Cardiovascular, Respiratory, Nephrological, Anesthesiologic, and Geriatric Sciences, Policlinico Umberto I, "La Sapienza" University of Rome, Rome, Italy.
Geriatr Gerontol Int. 2019 Oct;19(10):999-1005. doi: 10.1111/ggi.13759. Epub 2019 Aug 21.
Quality of life (QOL) in older adults can be affected by many factors, such as dementia, sarcopenia and frailty. This study sought to identify factors that can lead to global deterioration in QOL among older outpatients, including factors stated in caregiver reports. This study also evaluated the discrepancy between QOL ratings reported by the patients and those by their family or professional caregivers.
The sample comprised 141 patients with a Mini-Mental State Examination score ≥20 and a Clinical Dementia Rating of 0.5-1, indicating mild cognitive impairment to mild dementia. QOL was assessed using both components of the EQ-5D scale, namely, the index score and visual analog scale. In addition, cognitive, neuropsychological, nutritional and physical function tests were carried out, and body measurements were taken.
Patients' self-reported QOL was significantly associated with basic activities of daily living, Mini Nutritional Assessment score and Geriatric Depression Scale-15. QOL rated by caregivers was significantly associated with basic activities of daily living. EQ-5D index scores reported by caregivers were lower than those reported by patients. Furthermore, patients achieved a better score for self-care, usual activities, pain/discomfort and anxiety/depression than those assigned by caregivers.
As far as the patient's ratings are concerned, the presence of depressive symptoms and a worse nutritional status were indicative of lower QOL, whereas a better functional status was associated with a higher QOL. For caregivers, however, the most relevant factor negatively affecting QOL was basic activities of daily living. Geriatr Gerontol Int 2019; 19: 999-1005.
老年人的生活质量（QOL）可能受到多种因素的影响，如痴呆、肌肉减少症和衰弱。本研究旨在确定哪些因素会导致老年门诊患者的整体 QOL 下降，包括照护者报告中提到的因素。本研究还评估了患者自评 QOL 与家庭或专业照护者报告的 QOL 之间的差异。
本研究的样本包括 141 名简易精神状态检查评分≥20 分且临床痴呆评定为 0.5-1 分的患者，提示存在轻度认知障碍到轻度痴呆。使用 EQ-5D 量表的两个维度（即指数评分和视觉模拟评分）评估 QOL。此外，还进行了认知、神经心理学、营养和身体功能测试，并进行了身体测量。
患者自评的 QOL 与日常生活基本活动、微型营养评估评分和老年抑郁量表-15 显著相关。照护者评定的 QOL 与日常生活基本活动显著相关。照护者报告的 EQ-5D 指数评分低于患者报告的评分。此外，患者在自我护理、日常活动、疼痛/不适和焦虑/抑郁方面的自评得分优于照护者的评分。
就患者的评分而言，存在抑郁症状和较差的营养状况提示 QOL 较低，而功能状态较好与 QOL 较高相关。然而，对于照护者而言，对 QOL 产生负面影响的最相关因素是日常生活基本活动。
老年医学与老年病学国际杂志 2019; 19: 999-1005.
