Title: Quality of life in Alzheimer’ disease: do dementia-specific scales measure the same thing?
Background. QOL measures are increasingly used in the assessment of Alzheimer disease (AD) patients although little is known about their equivalence. This study aims at exploring the relationship between the QOL-AD and DQOL scales and among views of different observers.
Patients and methods. QoL-AD and DQoL scales were administered to 102 AD patients, their caregivers and 25 health staff recruited from day-centres. Patient-caregiver agreement was estimated using intraclass correlation coefficient (ICC). Correlation and multiple regression analyses were used to assess the relationships between QOL ratings. A p-value of ≤0.05 was considered statistically significant.
Results. Patient-reported QoL-AD was strongly correlated with caregiver-reported QoL-AD (r=0.563) and moderately correlated with the rest of the measures. Caregiver-reported QOL-AD was also correlated with caregiver-reported DQOL (r=0.505). Correlations between staff measures of QOL, and patient and caregiver reports were moderate. A very high correlation was found between patient and caregiver DQOL ratings (r=0.840). Patient-caregiver agreement was moderate for QoL-AD ratings (ICC-absolute=0.391) but high for DQOL ratings (ICC-absolute=0.887). DQOL scores were higher than QOL-AD scores in both patients (t=3.261) and caregivers (t=7.476). Caregiver-reported QoL-AD and DQOL predicted 40% of patient-reported QOL-AD (standardized-β=0.414 and 0.305, respectively). Patient-reported QoL-AD was the only predictor of caregiver-reported QOL-AD (standardized-β= 0.563; r2=31.7%) and staff-reported QOL-AD (standardized-β=0.42; r2=17)
Conclusions. QoL-AD and DQOL measure QOL-related aspects, which can be differently affected in AD patients. Caregivers have a more similar view of patients’ QOL than staff and could be considered valid informants when assessing patients’ psychological well-being.
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