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Vol. 21, No. 3, 2006
Issue release date: February 2006

Determinants of the Quality of Life in Alzheimer’s Disease Patients as Assessed by the Japanese Version of the Quality of Life – Alzheimer’s Disease Scale

Matsui T. · Nakaaki S. · Murata Y. · Sato J. · Shinagawa Y. · Tatsumi H. · Furukawa T.A.
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Abstract

Background: Although QOL is an important indicator to assess multiple facets of life, the QOL of Alzheimer’s disease (AD) subjects with impaired cognitive ability due to dementia has not yet been fully investigated. In this study, we developed the Japanese version of the Quality of Life – Alzheimer’s disease (QOL-AD) scale by means of back-translation, and ascertained its reliability and validity for evaluating the quality of life in AD subjects. We also hypothesized that the presence of neuropsychiatric symptoms may determine the characteristics and determinants of both the patients’ and the caregivers’ responses to the patients’ QOL questionnaire. Methods: We administered the QOL-AD questionnaire to subjects with mild or moderate AD (n = 140). The test-retest reliability was evaluated by the same interviewer after a month’s interval. Data from the following tests were also collected to ascertain the validity of the questionnaire: Short Memory Questionnaire (SMQ), Neuropsychiatry Inventory (NPI), Hyogo Activities of Daily Living Scale (HADL) and Mini-Mental State Examination (MMSE). Results: The Japanese version of the QOL-AD questionnaire demonstrated good internal reliability for both the patients’ (Cronbach’s α = 0.84) and the caregivers’ responses (Cronbach’s α = 0.82) and good test-retest reliability for both the patients’ (intraclass correlation coefficient = 0.84) and caregivers’ reports (intraclass correlation coefficient = 0.91). The concordance between the patients’ self-report and the caregivers’ observation was moderate (Pearson correlation coefficient = 0.60). The score for the ‘mood factor’ (apathy, depression/dysphoria) in NPI predicted the overall QOL score as determined from both the patients’ and the caregivers’ responses for subjects with mild (MMSE≧21, n = 88) and moderate (MMSE<21, n = 52) AD. The score for the ‘psychosis factor’ (delusions, hallucinations, anxiety, agitation, disinhibition, irritability, aberrant motor activity) in NPI predicted the total QOL score as determined by the patients and the caregivers among subjects with moderate AD only. Conclusions: As hypothesized, the presence of neuropsychiatric symptoms may be an important predictor of both the patients’ and caregivers’ responses to the patients’ QOL questionnaire. QOL-AD appears to be a promising measure of the QOL of subjects with mild to moderate AD in Japan.



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References

  1. Rabins PV, Kasper JD, Kleinman L, Black BS, Patrick DL: Concepts and methods in the development of the ADRQL: an instrument for assessing health-related quality of life in persons with Alzheimer’s disease. J Ment Health Aging 1999;5:33–48.
  2. Lawton MP, Van Haitsma K, Perkinson M, Ruckdeschel K: Observed affect and quality of life in dementia: further affirmations and problems. J Ment Health Aging 1999;5:69–82.
  3. Logsdon RG, Gibbons LE, McCurry SM, Teri L: Quality of life in Alzheimer’s disease: patient and caregiver reports. J Ment Health Aging 1999;5:21–32.
  4. Logsdon RG, Gibbons LE, McCurry SM, Teri L: Assessing quality of life in older adults with cognitive impairment. Psychosom Med 2002;64:510–519.
  5. Selai CE, Trimble MR, Rossor M, Harvey RJ: Assessing quality of life in dementia: preliminary psychometric testing of the Quality of Life Assessment Schedule (QOLAS). NeuroRehabilitation 2001;11:219–243.
  6. Novella JL, Jochum C, Jolly D, Morrone I, Ankri J, Bureau, F, Blanchard, F: Agreement between patients’ and proxies’ reports of quality of life in Alzheimer’s disease. Qual Life Res 2001;10:443–452.
  7. Thorgrimsen L, Selwood A, Spector A, Royan L, Lopez M, Woods RT, Orrell M: Whose quality of life is it anyway? The validity and reliability of the Quality of Life-Alzheimer’s Disease (QoL-AD) scale. Alzheimer Dis Assoc Disord 2003;17:201–208.
  8. Selai C, Vaughan A, Harvey RJ, Logsdon R: Using the QOL-AD in the UK. Int J Geriatr Psychiatry 2001;16:537–538.
  9. Doudoumi S, Tsolaki M, Sagiadinou M, Deoudi P, Kazis A, Kioseoglou G: Quality of life of caregivers of people with Alzheimer’s disease in Greece. Encephalos. 2003;40(3).
  10. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan E M: Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology 1984;34:939–944.
  11. Folstein MF, Folstein SE, McHugh PR: ‘Mini-mental state’. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189–198.
  12. Brislin RW: Back-translation for cross-cultural research. J Cross Cult Psychol 1970;1:185–216.

    External Resources

  13. Cummings JL, Mega M, Gray K, Rosenberg-Thompson S, Caruso DA, Hornbeam J: The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology 1994;44:2308–2314.
  14. Hirono N, Yamadori A, Mori E, Yamashita H, Tokimasa A: Daily living activities of patients with Alzheimer’s disease. Jpn J Neuropsychol 1995;11:186–195.
  15. Hirono N, Mori E, Yamashita H, Tokimasa A, Yamadori A: A novel scoring system of activities of daily living for patients with Alzheimer’s disease: Hyogo Activities of Daily Living Scale (HADLS). Jpn J Neuropsychol 1997;13:260–269.
  16. Koss E, Patterson MB, Ownby R, Stuckey JC, Whitehouse PJ: Memory evaluation in Alzheimer’s disease. Caregivers’ appraisals and objective testing. Arch Neurol 1993;50:92–97.
  17. Maki N, Ikeda M, Hokoishi K, Nebu A, Komori K, Hirono N, Tanabe H: The validity of the MMSE and SMQ as screening tests for dementia in the elderly general population – a study of one rural community in Japan. Dement Geriatr Cogn Disord 2000;11:193–196.
  18. SPSS Inc. 2001: SPSS for windows Version 11.5. Chicago, SPSS Inc.
  19. Nunnally JC: Psychometrics Theory, ed 2. New York, McGraw Hill, 1978.
  20. Frisoni GB, Rozzini L, Gozzetti A, Zanetti O: Behavioral syndromes in Alzheimer’s disease: description and correlates. Dement Geriatr Cogn Disord 1999;10:130–138.
  21. Aalten P, Marjolein E, Lousberg R, Korten E, Jaspers N, Senden B, Jolles J, Verhey FRJ: Behavioral problems in dementia: a factor analysis of the Neuropsychiatric Inventory. Dement Geriatr Cogn Disord 2003;15:99–105.
  22. Pedhazur EJ: Multiple Regression in Behavioral Research: Explanation and prediction, ed 3. Fort Worth, Harcourt Brace, 1997.
  23. Levy ML, Cummings JL, Fairbanks LA, Bravi D, Calvani M, Carta A: Longitudinal assessment of symptoms of depression, agitation, and psychosis in 181 patients with Alzheimer’s disease. Am J Psychiatry 1996;153:1438–1443.
  24. Levy ML, Cummings JL, Fairbanks LA, Masterman D, Miller BL, Craig, AH, Paulsen JS, Litvan I: Apathy is not depression. J Neuropsychiatry Clin Neurosci 1998;10:314–319.
  25. Lyketsos CG, Lee HB: Diagnosis and treatment of depression in Alzheimer’s disease. A practical update for the clinician. Dement Geriatr Cogn Disord 2004;17:55–64.
  26. Boyle PA, Malloy PF, Salloway S, Deborah A, Cahn-Weiner DA, Cohen R, Cummings JL: Executive dysfunction and apathy predict functional impairment in Alzheimer disease. Am J Geriatr Psychiatry 2003;11:214–221.
  27. Green J, Goldstein FC, Sirockman BE: Variable awareness of deficits in Alzheimer’s disease. Neuropsychiatry Neuropsychol Behav Neurol 1993;6:159–165.

    External Resources

  28. Vasterling JJ, Seltzer B, Foss JW, Vanderbrook V: Unawareness of deficit in Alzheimer’s disease: domain-specific differences and disease correlates. Neuropsychiatry Neuropsychol Behav Neurol 1995;8:26–32.

    External Resources

  29. Seltzer B, Vasterling JJ, Hale MA, Khurana R: Unawareness of memory deficit in Alzheimer’s disease: relation to mood and other disease variables. Neuropsychiatry Neuropsychol Behav Neurol 1995;8:176–181.

    External Resources

  30. Migliorelli R, Teson A, Sabe L, Petracca G, Petracchi M, Leiguarda R, Starkstein SE: Anosognosia in Alzheimer’s disease: a study of associated factors. J Neuropsychiatry Clin Neurosci 1995;7:338–344.
  31. Sainfort F, Becker M, Diamond R: Judgments of quality of life of individuals with severe mental disorders: patient self-report versus provider perspectives. Am J Psychiatry 1996;153:497–502.
  32. Karlawish JH, Casarett D, Klocinski J, Clark CM: The relationship between caregivers’ global ratings of Alzheimer’s disease patients’ quality of life, disease severity, and the caregiving experience. J Am Geriatr Soc 2001;49:1066–1070.
  33. Sands LP, Ferreira P, Stewart AL, Brod M, Yaffe K: What explains differences between dementia patients’ and their caregivers’ ratings of patients’ quality of life? Am J Geriatr Psychiatry 2004;12:272–280.
  34. Ready RE, Ott BR, Grace J: Patient versus informant perspectives of Quality of Life in Mild Cognitive Impairment and Alzheimer’s disease. Int J Geriatr Psychiatry 2004;19:256–265.
  35. Vogel A, Stokholm J, Gade A, Andersen BB, Hejl AM, Waldemar G: Awareness of deficits in mild cognitive impairment and Alzheimer’s disease: do MCI Patients have impaired insight? Dement Geriatr Cogn Disord 2004;17:181–187.
  36. Lawton MP: Quality of life in Alzheimer disease. Alzheimer Dis Assoc Disord 1994;8 (suppl 3):138–150.

    External Resources

  37. Brod M, Stewart AL, Sands L, Walton P: Conceptualization and measurement of quality of life in dementia: the dementia quality of life instrument (DQoL). Gerontologist 1999;39:25–35.
  38. Jonker C, Gerritsen DL, Bosboom PR, Van Der Steen JT: A model for quality of life measures in patients with dementia: Lawton’s next step. Dement Geriatr Cogn Disord 2004;18:159–164.
  39. Cummings JL, Vinters H, Felix J: The Neuropsychiatry of Alzheimer’s Disease and Related Dementias. London, Taylor & Francis, 2002.


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