Journal
INTERNATIONAL PSYCHOGERIATRICS
Volume 24, Issue 7, Pages 1094-1102Publisher
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S1041610212000063
Keywords
caregiver; dementia; proxy-report; quality of life; self-report
Funding
- National Institute on Aging [R01AG21136, R01AG1183, R01AG18712]
- National Institutes of Health [R01AG11380, P50AG05146]
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Background: Quality of life (QOL) is frequently assessed in persons with dementia (PWD) through self- and/or proxy-report. Determinants of QOL ratings are multidimensional and may differ between patients and caregiver proxies. This study compared self-and proxy-reported QOL ratings in a population-based study of PWD and their caregivers, and examined the extent to which discrepancies in reports were associated with characteristics of the PWD. Methods: The sample consisted of 246 patient/caregiver dyads from the initial visit of the Cache County Dementia Progression Study, with both members of the dyad rating PWD QOL. PWD age, gender, cognitive impairment (Mini-Mental State Examination), neuropsychiatric symptoms (Neuropsychiatric Inventory; NPI), dementia severity (Clinical Dementia Rating), medical comorbidities (General Medical Health Rating), and functional impairment (Dementia Severity Rating Scale) were examined as correlates of self-and proxy-reported QOL ratings and the differences between the QOL reports. Results: Self-and proxy-reported PWD QOL ratings were only modestly correlated. Medical comorbidity was associated with self-report whereas NPI was associated with proxy-report. Dementia severity was associated with discrepancies in self-and proxy-report, with worse patient cognition associated with poorer proxy-reported QOL ratings. Conclusions: PWD self-and proxy-reported QOL ratings are associated with different variables. Discrepancies between PWD and caregiver perceptions of PWD QOL should be recognized, particularly in cases of more severe dementia.
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