School of Nursing, Oregon Health & Science University, Portland.
Benjamin Rose Institute on Aging, Center for Research and Education, Cleveland, Ohio.
Gerontologist. 2021 Apr 3;61(3):383-391. doi: 10.1093/geront/gnaa086.
Greater everyday decision-making involvement by persons living with dementia (PLWD) and congruent appraisal between PLWDs and their caregivers have been associated with a better quality of life (QOL) for both members of the dyad. However, no study has examined the association between the appraisals of everyday decision-making involvement of PLWDs and their QOL among African Americans.
A secondary analysis of cross-sectional data from 62 African American dementia dyads was conducted. Multilevel and latent class mixture modeling was used to characterize dyadic appraisal of the decision-making involvement of African American PLWDs and identify distinct patterns thereof.
Three distinct patterns were observed. "Incongruent, PLWD Low Involvement" labeled 19.4% of the sample, 53.2% were labeled "Incongruent, PLWD Moderate Involvement," and 27.4% were labeled "Congruent, PLWD High Involvement." The Congruent, PLWD High Involvement pattern consisted of PLWDs who were significantly younger and had significantly less cognitive impairment than PLWDs in the other patterns. In the Incongruent, PLWD Moderate Involvement pattern, PLWDs had significantly better QOL than PLWDs in the Incongruent, PLWD Low Involvement pattern, but QOL did not significantly differ from PLWDs in the Congruent, PLWD High Involvement pattern.
There is a need to tailor strategies to optimize QOL in African American dementia dyads. While increasing everyday decision-making involvement for PLWDs in the Incongruent, PLWD Low Involvement pattern is an important goal, other strategies may be needed to improve the QOL of PLWDs in the remaining patterns.
让痴呆症患者（PLWD）更多地参与日常决策，并使 PLWD 及其照护者之间的评估相契合，这与双方的生活质量（QOL）提高有关。然而，目前还没有研究调查 PLWD 对日常决策参与的评估与非洲裔美国人 QOL 之间的关系。
对 62 对非洲裔美国家庭痴呆症患者进行了横断面数据的二次分析。使用多层次和潜在类别混合模型来描述非洲裔美国 PLWD 日常决策参与的对偶评估，并确定其不同模式。
观察到三种不同的模式。19.4%的样本被标记为“不一致，PLWD 低度参与”，53.2%的样本被标记为“不一致，PLWD 中度参与”，27.4%的样本被标记为“一致，PLWD 高度参与”。“一致，PLWD 高度参与”模式中的 PLWD 比其他模式中的 PLWD 年龄更小，认知障碍程度更低。在“不一致，PLWD 中度参与”模式中，PLWD 的 QOL 明显优于“不一致，PLWD 低度参与”模式中的 PLWD，但与“一致，PLWD 高度参与”模式中的 PLWD 相比，QOL 没有显著差异。
需要制定策略来优化非洲裔美国家庭痴呆症患者的 QOL。虽然在“不一致，PLWD 低度参与”模式中增加 PLWD 的日常决策参与度是一个重要目标，但对于其余模式中的 PLWD，可能需要其他策略来提高其 QOL。
