Unterschiede in der Selbst- und Fremdbeurteilung gesundheitsbezogener Lebensqualität bei Patienten mit leichter kognitiver Beeinträchtigung und Demenz vom Alzheimer-Typ

Zusammenfassung

Ziel Patienten mit einer Alzheimer-Demenz (AD) und leichten kognitiven Beeinträchtigungen (LKB) beurteilen ihre gesundheitsbezogene Lebensqualität (LQ) häufig besser als ihre Angehörigen. Einflussfaktoren dieses Beurteilungsunterschieds werden evaluiert.

Methodik Die LQ von 241 zu Hause lebenden Patienten wurde anhand des krankheitsspezifischen Quality of Life-Alzheimer’s Disease-Fragebogens (QoL-AD) erhoben.

Ergebnisse Das Verwandtschaftsverhältnis, depressive Symptome und die Alltagsfunktionalität stellen relevante Einflussfaktoren bei Beurteilungsunterschieden der LQ dar.

Schlussfolgerung Soziodemografische und klinische Variablen können Bewertungsunterschiede der LQ von Patienten mit AD und LKB teilweise erklären.

Abstract

Objective The self-assessment of health-related quality of life (HrQoL) in patients with Alzheimer’s disease (AD) and mild cognitive impairment is commonly higher than the proxy-assessment by caregivers. This study aims at evaluating sociodemographic and clinical factors to explain this difference.

Methods HrQoL of 241 community-dwelling patients was analysed using the dementia-specific Quality of Life-Alzheimer’s Disease questionnaire (QoL-AD). Behavioural and psychological symptoms and functional capacity were evaluated using the Geriatric Depression Scale (GDS), the Neuropsychiatric Inventory (NPI) and the Alzheimer’s Disease Cooperative Study-Activities of Daily Living scale (ADCS-ADL).

Results The self-assessment of patients’ HrQoL was significantly higher than the caregiver-ratings (mean difference: 7.4 ± 5.6, p < 0.001). Considerable influencing factors were the extent of depressive symptoms (GDS), the degree of impairment in functional performance (ADCS-ADL) and the relationship between patients and caregivers.

Conclusion Independent variables explained 23 % of the variance in the difference between self- and proxy-assessment of HrQoL. Future studies should include further influencing factors such as caregivers’ mental health.

Schlüsselwörter

gesundheitsbezogene Lebensqualität - Demenz vom Alzheimer-Typ - Selbst- und Fremdbeurteilung

Keywords

Alzheimer’s disease - quality of life - self-assessment - proxy bias

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