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Longitudinal trajectories of quality of life among people with mild-to-moderate dementia: a latent growth model approach with IDEAL cohort study data
Clare, L. Gamble, L.D. Martyr, A. Sabatini, S. Nelis, S.M. Pentecost, C. Victor, C. Jones, R.W. Jones, I.R.
Clare, L.
Gamble, L.D.
Martyr, A.
Sabatini, S.
Nelis, S.M.
Pentecost, C.
Victor, C.
Jones, R.W.
Jones, I.R.
Publication Date
2022-06
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© The Author(s) 2022. 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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Yes
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openAccess
Accepted for publication
2022-01-13
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Abstract
Objectives: We aimed to examine change over time in self-rated quality of life (QoL) in people with
mild-to-moderate dementia and identify sub-groups with distinct QoL trajectories.
Method: We used data from people with mild-to-moderate dementia followed up at 12 and 24 months
in the IDEAL cohort study (baseline n=1537). A latent growth model approach examined
mean change over time in QoL, assessed with the QoL-AD scale, and investigated
associations of baseline demographic, cognitive and psychological covariates with the
intercept and slope of QoL. We employed growth mixture modelling to identify multiple
growth trajectories.
Results: Overall mean QoL scores were stable and no associations with change over time were
observed. Four classes of QoL trajectories were identified: two with higher baseline QoL
scores, labelled Stable (74.9%) and Declining (7.6%), and two with lower baseline QoL
scores, labelled Stable Lower (13.7%) and Improving (3.8%). The Declining class had higher
baseline levels of depression and loneliness, and lower levels of self-esteem and optimism,
than the Stable class. The Stable Lower class was characterised by disadvantage related to
social structure, poor physical health, functional disability, and low psychological well-being The Improving class was similar to the Stable Lower class but had lower cognitive test scores.
Discussion: Understanding individual trajectories can contribute to personalised care planning. Efforts to
prevent decline in perceived QoL should primarily target psychological well-being. Efforts to
improve QoL for those with poorer QoL should additionally address functional impairment,
isolation, and disadvantage related to social structure.
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Published version
Citation
Clare L, Gamble LD, Martyr A et al (2022) Longitudinal trajectories of quality of life among people with mild-to-moderate dementia: a latent growth model approach with IDEAL cohort study data. Journals of Gerontology - Series B Psychological Sciences and Social Sciences. 77(6): 1037-1050.
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Article