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Diagnosis and disclosure of a memory problem is associated with quality of life in community based older Australians with dementia

Published online by Cambridge University Press:  04 July 2012

Karen E. Mate ,
Constance D. Pond ,
Parker J. Magin ,
Susan M. Goode ,
Patrick McElduff  and
Nigel P. Stocks
Karen E. Mate*
Affiliation:
School of Medicine & Public Health, University of Newcastle, Newcastle, NSW, Australia School of Biomedical Science and Pharmacy, University of Newcastle, Newcastle, NSW, Australia
Constance D. Pond
Affiliation:
School of Medicine & Public Health, University of Newcastle, Newcastle, NSW, Australia
Parker J. Magin
Affiliation:
School of Medicine & Public Health, University of Newcastle, Newcastle, NSW, Australia
Susan M. Goode
Affiliation:
School of Medicine & Public Health, University of Newcastle, Newcastle, NSW, Australia
Patrick McElduff
Affiliation:
Clinical Research Design, IT & Statistical Support Unit, Hunter Medical Research Institute, School of Medicine & Public Health, University of Newcastle, Newcastle, NSW, Australia
Nigel P. Stocks
Affiliation:
Discipline of General Practice, School of Population Health and Clinical Practice, The University of Adelaide, Adelaide, SA, Australia
*
Correspondence should be addressed to: Dr. Karen Mate, School of Biomedical Science & Pharmacy, University of Newcastle, Newcastle, NSW 2308, Australia. Phone: +61 2 49215983; Fax: +61 2 49217903. Email: [email protected].
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Abstract

Background: Identification of factors associated with quality of life (QoL) in people having dementia will help develop strategies for maintenance and improvement of patient QoL. This study examined the predictors of QoL in a community-dwelling population aged 75 years and over, with or without dementia.

Methods: This was a cross-sectional study involving 169 GPs and 2,028 patients. Patients were interviewed to collect information on personal circumstances. Several instruments were administered including the WHOQOL-BREF (quality of life outcome measure), Geriatric Depression Scale, GPAQ (satisfaction with GP care), and the CAMCOG-R (cognitive function). Patients with a CAMCOG-R score < 80 were allocated to the dementia group. GPs provided an independent clinical judgment of cognitive function for each of their participating patients.

Results: The dementia group had significantly lower QoL scores in all four domains of the WHOQOL-BREF (all p ≤ 0.002). The GDS score was negatively correlated with all four domains in the non-dementia group and with physical, psychological, and environmental QoL in the dementia group (all p < 0.001). Satisfaction with GP communication was positively associated with psychological QoL in the dementia group and all domains in the non-dementia group. Participants in the dementia group who had been given a diagnosis of a memory problem had significantly higher physical (2.05, 95% CI 0.36 to 3.74) and environmental (2.18, 95% CI 0.72 to 3.64) QoL.

Conclusions: Satisfaction with GP communication is associated with a higher QoL in their older patients. Diagnosis and disclosure of memory problems is associated with better QoL in people with dementia. Clinicians should not be deterred from discussing a memory diagnosis and plans for the future with patients.

Keywords

WHOQOL-BREFgeneral practitionerdiagnosiscommunication
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 12 , December 2012 , pp. 1962 - 1971
Copyright
Copyright © International Psychogeriatric Association 2012

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References

Andersen, C. K., Wittrup-Jensen, K. U., Lolk, A., Andersen, K. and Kragh-Sorensen, P. (2004). Ability to perform activities of daily living is the main factor affecting quality of life in patients with dementia. Health and Quality of Life Outcomes, 2, 52.CrossRefGoogle ScholarPubMed
Australian Bureau of Statistics (2003). ASGC Remoteness Classification: Purpose and Use (Census Paper No. 03/01). Canberra: Commonwealth of Australia. Available at: http://www.abs.gov.au/websitedbs/d3110122.nsf/0/f9c96fb635cce780ca256d420005dc02/$FILE/Remoteness_Paper_text_final.pdf.Google Scholar
Australian Bureau of Statistics (2006). Census of Population and Housing: Socio-Economic Indexes for Areas (SEIFA), Australia — data only (ABS Cat. No. 2033.0.55.001). Canberra: ABS. Available at: http://www.abs.gov.au/ausstats/[email protected]/mf/2033.0.55.001/.Google Scholar
Banerjee, S. et al. (2006). Quality of life in dementia: more than just cognition. An analysis of associations with quality of life in dementia. Journal of Neurology, Neurosurgery and Psychiatry, 77, 146–148.CrossRefGoogle ScholarPubMed
Banerjee, S. et al. (2009). What do we know about quality of life in dementia? A review of the emerging evidence on the predictive and explanatory value of disease specific measures of health related quality of life in people with dementia. International Journal of Geriatric Psychiatry, 24, 15–24.Google Scholar
Byszewski, A. M. et al. (2007) Dementia diagnosis disclosure: a study of patient and caregiver perspectives. Alzheimer Disease and Associated Disorders, 21, 107–114.CrossRefGoogle ScholarPubMed
Deeg, D. J. H. (2007). Health and quality of life. In Mollenkopf, H. and Walker, A. (eds.), Quality of Life in Old Age. International and Multi-Disciplinary Perspectives (pp. 195–213). Dordrecht, The Netherlands: Springer.CrossRefGoogle Scholar
Dröes, R.-M. et al. (2006). Quality of life in dementia in perspective. Dementia, 5, 533–558.CrossRefGoogle Scholar
Hawthorne, G., Herrman, H. and Murphy, B. (2006). Interpreting the WHOQOL-BREF: preliminary population norms and effect sizes. Social Indicators Research, 77, 37–59.CrossRefGoogle Scholar
Hoppmann, C. A., Gerstorf, D. and Luszcz, M. (2008). Spousal social activity trajectories in the Australian longitudinal study of ageing in the context of cognitive, physical, and affective resources. Journal of Gerontology, Series B: Psychological Sciences and Social Sciences, 63, P41–P50.Google Scholar
Huppert, F. A. et al. (1996). Psychometric properties of the CAMCOG and its efficacy in the diagnosis of dementia. Aging, Neuropsychology and Cognition, 3, 201–214.CrossRefGoogle Scholar
Hurt, C. S. et al. (2010). Insight, cognition and quality of life in Alzheimer's disease. Journal of Neurology, Neurosurgery and Psychiatry, 81, 331–336.Google Scholar
Katz, S., Ford, A. B., Moskowitz, R. W., Jackson, B. A. and Jaffe, M. W. (1963). Studies of illness in the aged. The index of ADL: a standardised measure of biological and psychological function. JAMA, 185, 914–919.Google Scholar
Lawton, M. P. and Brody, E. M. (1969). Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist, 9, 179–186.Google Scholar
Lichtenberg, P., Steiner, D., Marcopulos, B. & Tabscott, J. (1992). Comparison of the Hamilton Depression Rating Scale and the Geriatric Depression Scale: detection of depression in dementia patients. Psychological Reports, 70, 515–521.Google Scholar
Lucas-Carrasco, R., Skevington, S. M., Gomez-Benito, J., Rejas, J. and March, J. (2011). Using the WHOQOL-BREF in persons with dementia: a validation study. Alzheimer Disease and Associated Disorders, 25, 345–351.Google Scholar
Mead, N., Bower, P. and Roland, M. (2008). The General Practice Assessment Questionnaire (GPAQ) – development and psychometric characteristics. BMC Family Practice, 9, 13.CrossRefGoogle ScholarPubMed
Missotten, P. et al. (2008). Relationship between quality of life and cognitive decline in dementia. Dementia and Geriatric Cognitive Disorders, 25, 564–572.Google Scholar
Mollenkopf, H. and Walker, A. (2007). Quality of life in old age. Synthesis and future perspectives. In Mollenkopf, H. and Walker, A. (eds.), Quality of Life in Old Age. International and Multi-Disciplinary Perspectives (pp. 235–248). Dordrecht, The Netherlands: Springer.Google Scholar
Mougias, A. A., Politis, A., Lyketsos, C. G. and Mavreas, V. G. (2011). Quality of life in dementia patients in Athens, Greece: predictive factors and the role of caregiver-related factors. International Psychogeriatrics, 23, 395–403.CrossRefGoogle ScholarPubMed
Naumann, V. J. and Byrne, G. J. (2004). WHOQOL-BREF as a measure of quality of life in older patients with depression. International Psychogeriatrics, 16, 159–173.CrossRefGoogle ScholarPubMed
Netuveli, G. and Blane, D. (2008). Quality of life in older ages. British Medical Bulletin, 85, 113–126.CrossRefGoogle ScholarPubMed
Pearce, A., Clare, L. and Pistrang, N. (2002). Managing sense of self. Dementia, 1, 173–192.Google Scholar
Phillips, J., Pond, D. and Goode, S. (2011). Timely Diagnosis of Dementia: Can we do Better. Sydney, Australia: Alzheimer's Australia.Google Scholar
Pond, D. et al. (2012a). Ageing in general practice (AGP) trial: a cluster randomised trial to examine the effectiveness of peer education on GP diagnostic assessment and management of dementia. BMC Family Practice, 13, 12.Google Scholar
Pond, D. et al. (2012b). General practitioners’ view of the difficulties in disclosing the diagnosis of dementia. British Journal of General Practice, in press.Google Scholar
Roth, M., Huppert, F. A., Mountjoy, C. Q. and Tym, E. (1998). CAMDEX-R: The Cambridge Examination for Mental Disorders of the Elderly – Revised. Cambridge, UK: Cambridge University Press.Google Scholar
Rothermund, K. and Brandstadter, J. (2003). Coping with deficits and losses in later life: from compensatory action to accommodation. Psychology and Aging, 18, 896–905.Google Scholar
Schilling, O. (2006). Development of life satisfaction in old age: another view on the “paradox.” Social Indicators Research, 75, 241–271.Google Scholar
Selwood, A., Thorgrimsen, L. and Orrell, M. (2005). Quality of life in dementia – a one-year follow-up study. International Journal of Geriatric Psychiatry, 20, 232–237.Google Scholar
Sheikh, J. A. and Yesavage, J. A. (1986). Geriatric Depression Scale (GDA): recent findings and development of a shorter version. In Brink, T. L. (ed.), Clinical Gerontology: A Guide to Assessment and Intervention. New York: Howarth Press.Google Scholar
Vogel, B. A., Leonhart, R. and Helmes, A. W. (2009). Communication matters: the impact of communication and participation in decision making on breast cancer patients’ depression and quality of life. Patient Education and Counseling, 77, 391–397.Google Scholar
Webb, E., Blane, D., McMunn, A. and Netuveli, G. (2010). Proximal predictors of change in quality of life at older ages. Journal of Epidemiology and Community Health, 65, 542–547.Google Scholar
Zaninotto, P., Falaschetti, F. and Sacker, A. (2009). Age trajectories of quality of life among older adults: results from the English longitudinal study of ageing. Quality of Life Research, 18, 1301–1309.Google Scholar