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The relationship between perceived functional difficulties and the ability to live well with mild-to-moderate dementia: Findings from the IDEAL programme
Martyr, A. Nelis, S.M. Rusted, J.M. Morris, R.G. Clare, L.
Martyr, A.
Nelis, S.M.
Rusted, J.M.
Morris, R.G.
Clare, L.
Publication Date
2019
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© 2019 The Authors. This is an Open Access article distributed under the Creative Commons CC-BY license (https://creativecommons.org/licenses/by/4.0/)
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Open Access status
openAccess
Accepted for publication
2019-04-19
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Abstract
Objectives: The objectives of the study are to investigate how different levels of
functional ability relate to quality of life, well‐being, and satisfaction with life,
conceptualised as reflecting capability to “live well” in people with dementia.
Methods/design: Participants were 1496 people with mild‐to‐moderate dementia
and 1188 informants who completed baseline assessments in the Improving the
experience of Dementia and Enhancing Active Life (IDEAL) cohort study. Total selfrated
and informant‐rated scores on the Functional Activities Questionnaire were
split into six ability levels to monitor how poorer functioning impacts the ability to live
well. We also investigated the potential influence of sociodemographic and diagnostic
variables, depression, cognition, and carer stress.
Results: Multivariate multiple regression models found that people with dementia
who had the greatest functional impairment according to self‐ratings and informant
ratings had poorer living well scores than those with the least functional impairment.
Sociodemographic and diagnostic factors and cognition had little impact on effect
sizes. For self‐ratings, depression attenuated the relationship between functional
ability and living well, whereas carer stress attenuated informant ratings.
Conclusions: People with dementia with the least functional impairments had
greater capability to live well than those with the most functional impairment. Even
subtle perceived difficulties in functional ability had a detrimental effect on the ability
of people with dementia to live well. Depression in people with dementia and carer
stress in informants influenced these associations, and therefore, these factors should
be routinely included in future research studies and clinical assessments.
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Published version
Citation
Martyr A, Nelis SM, Quinn C, Rusted JM, Morris RG and Clare L (2019) The relationship between perceived functional difficulties and the ability to live well with mild-to-moderate dementia: Findings from the IDEAL programme. International Journal of Geriatric Psychiatry. 34(8): 1251-1261.
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Article