The Course of Quality of Life and Its Predictors in Nursing Home Residents With Young-Onset Dementia.

Autor:	Pu L; Department of Primary and Community Care, Medical Center, Radboud University Nijmegen, Nijmegen, the Netherlands; Menzies Health Institute Queensland & School of Nursing and Midwifery, Griffith University, Queensland, Australia., Bakker C; Department of Primary and Community Care, Medical Center, Radboud University Nijmegen, Nijmegen, the Netherlands; Radboudumc Alzheimer Center, Nijmegen, the Netherlands; Groenhuysen, Center for Specialized Geriatric Care, Roosendaal, the Netherlands. Electronic address: christian.bakker@radboudumc.nl., Appelhof B; Department of Primary and Community Care, Medical Center, Radboud University Nijmegen, Nijmegen, the Netherlands; Radboudumc Alzheimer Center, Nijmegen, the Netherlands; Archipel, Landrijt, Knowledge Center for Specialized Care, Eindhoven, the Netherlands., Zwijsen SA; Department of General Practice and Elderly Care Medicine/EMGO + Institute for Health and Care Research, Amsterdam UMC, Amsterdam, the Netherlands., Teerenstra S; Section Biostatistics, Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands., Smalbrugge M; Department of General Practice and Elderly Care Medicine/EMGO + Institute for Health and Care Research, Amsterdam UMC, Amsterdam, the Netherlands., Verhey FRJ; Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands., de Vugt ME; Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands., Zuidema SU; Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands., Koopmans RTCM; Department of Primary and Community Care, Medical Center, Radboud University Nijmegen, Nijmegen, the Netherlands; Radboudumc Alzheimer Center, Nijmegen, the Netherlands; De Waalboog 'Joachim en Anna,' Center for Specialized Geriatric Care, Nijmegen, the Netherlands.
Jazyk:	angličtina
Zdroj:	Journal of the American Medical Directors Association [J Am Med Dir Assoc] 2021 Jul; Vol. 22 (7), pp. 1456-1464.e1. Date of Electronic Publication: 2020 Nov 19.
DOI:	10.1016/j.jamda.2020.09.040
Abstrakt:	Objective: To explore the course of quality of life (QoL) and possible resident-related predictors associated with this course in institutionalized people with young-onset dementia (YOD). Design: An observational longitudinal study. Setting and Participants: A total of 278 residents with YOD were recruited from 13 YOD special care units in the Netherlands. Methods: Secondary analyses were conducted with longitudinal data from the Behavior and Evolution in Young-ONset Dementia (BEYOND)-II study. QoL was assessed with proxy ratings, using the Quality of Life in Dementia (QUALIDEM) questionnaire at 4 assessment points over 18 months. Predictors included age, gender, dementia subtype, length of stay, dementia severity, neuropsychiatric symptoms, and psychotropic drug use at baseline. Multilevel modeling was used to adjust for the correlation of measurements within residents and clustering of residents within nursing homes. Results: The total QUALIDEM score (range: 0-111) decreased over 18 months with a small change of 0.65 (95% confidence interval -1.27, -0.04) points per 6 months. An increase in several domains of QoL regarding care relationship, positive self-image, and feeling at home was seen over time, whereas a decline was observed in the subscales positive affect, social relations, and having something to do. Residents with higher levels of QoL and more advanced dementia at baseline showed a more progressive decline in QoL over time. Sensitivity analyses indicated a more progressive decline in QoL for residents who died during the follow-up. Conclusion and Implications: This study shows that although overall QoL in nursing home residents with YOD was relatively stable over 18 months, there were multidirectional changes in the QoL subscales that could be clinically relevant. Higher levels of QoL and more advanced stages of dementia at baseline predicted a more progressive decline in QoL over time. More longitudinal studies are needed to verify factors influencing QoL in YOD. (Copyright © 2020 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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