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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

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    Publication date
    2022-06
    Author
    Clare, L.
    Gamble, L.D.
    Martyr, A.
    Sabatini, S.
    Nelis, S.M.
    Quinn, Catherine
    Pentecost, C.
    Victor, C.
    Jones, R.W.
    Jones, I.R.
    Knapp, M.
    Litherland, R.
    Morris, R.G.
    Rusted, J.M.
    Thom, J.M.
    Collins, R.
    Henderson, C.
    Matthews, F.E.
    IDEAL study team
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    Keyword
    Alzheimer's
    Caregivers
    Longitudinal
    Rights
    © The Author(s) 2022. Published by Oxford University Press on behalf of The Gerontological Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
    Peer-Reviewed
    Yes
    Open Access status
    Gold
    
    Metadata
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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.
    URI
    http://hdl.handle.net/10454/18762
    Version
    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.
    Link to publisher’s version
    https://doi.org/10.1093/geronb/gbac022
    Type
    Article
    Collections
    Health Studies Publications

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