Quality of life and associated factors in older people with dementia living in long-term institutional care and home care

BackgroundPrevalence of dementia in developed countries is high. Optimising the quality of life (QoL) of both patient and caregiver is the most important treatment goal. The main objective is to measure the QoL of people with dementia living at home or in long-term care institutions (LTCI) and identify related factors.MethodsCross-sectional study. Data of people with dementia who lived at home or who had been recently admitted to an LTCI in Spain was included. QoL was assessed by people with dementia themselves and their proxies using the 'Quality of Life-Alzheimer's Disease scale' (QoL-AD). Clinical, cognitive and neuropsychiatric data were collected.ResultsIn total, 287 PwD were included; 113 from LTCIs (39.4%) and 174 from home care (HC) (60.6%). Mean age was 83.2 (7.1) years; 201 (70%) patients were women and mean of the MMSE score was 15.1 (5.6). A total of 160 (55.7%) PwD had completed data for both QoL self-reported and proxy-reported (35.4% from LTCI and 69% from HC; P < 0.001). Self-reported QoL was 33.1 (4.9) points and proxy-reported was 26.5 (5.0) points. The multivariate regression model showed that the Cornell index score (b: -0.534, P = 0.001) and neuropsychiatric symptoms (b: -0.223, P = 0.004) were independently associated with self-reported QoL. The Charlson index (b: -0.637, P = 0.032), Katz (b: 0.481, P = 0.019) and Cornell index score (b: -0.367, P = 0.001) were independently associated with proxy-reported QoL.ConclusionsLow depressive and neuropsychiatric symptoms were independently associated with better self-reported QoL. On the other hand, low comorbidity, better functional status and low depressive symptoms were independently associated with QoL reported by the informer caregivers.