Trajectories and Determinants of Quality of Life in Dementia with Lewy Bodies and Alzheimer's Disease.

Content Provider	Europe PMC
Author	van de Beek, Marleen van Steenoven, Inger Ramakers, Inez H.G.B. Aalten, Pauline Koek, Huiberdina L. Olde Rikkert, Marcel G.M. Manniën, Judith Papma, Janne M. de Jong, Frank Jan Lemstra, Afina W. van der Flier, Wiesje M.
Copyright Year	2019
Abstract	Background:Quality of Life (QoL) is an important outcome measure in dementia, particularly in the context of interventions. Research investigating longitudinal QoL in dementia with Lewy bodies (DLB) is currently lacking.Objective:To investigate determinants and trajectories of QoL in DLB compared to Alzheimer’s disease (AD) and controls.Methods:QoL was assessed annually in 138 individuals, using the EQ5D-utility-score (0–100) and the health-related Visual Analogue Scale (VAS, 0–100). Twenty-nine DLB patients (age 69±6), 68 AD patients (age 70±6), and 41 controls (age 70±5) were selected from the Dutch Parelsnoer Institute-Neurodegenerative diseases and Amsterdam Dementia Cohort. We examined clinical work-up over time as determinants of QoL, including cognitive tests, neuropsychiatric inventory, Geriatric Depression Scale (GDS), and disability assessment of dementia (DAD).Results:Mixed models showed lower baseline VAS-scores in DLB compared to AD and controls (AD: β±SE = -7.6±2.8, controls: β±SE = -7.9±3.0, p < 0.05). An interaction between diagnosis and time since diagnosis indicated steeper decline on VAS-scores for AD patients compared to DLB patients (β±SE = 2.9±1.5, p < 0.1). EQ5D-utility-scores over time did not differ between groups. Higher GDS and lower DAD-scores were independently associated with lower QoL in dementia patients (GDS: VAS β±SE = -1.8±0.3, EQ5D-utility β±SE = -3.7±0.4; DAD: VAS = 0.1±0.0, EQ5D-utility β±SE = 0.1±0.1, p < 0.05). No associations between cognitive tests and QoL remained in the multivariate model.Conclusion:QoL is lower in DLB, while in AD QoL shows steeper decline as the disease advances. Our results indicate that non-cognitive symptoms, more than cognitive symptoms, are highly relevant as they impact QoL.
ISSN	13872877
Journal	Journal of Alzheimer's Disease
Volume Number	70
PubMed Central reference number	PMC6839497
Issue Number	2
PubMed reference number	31177218
e-ISSN	18758908
DOI	10.3233/JAD-190041
Language	English
Publisher	IOS Press
Publisher Date	2019-01-01
Publisher Place	Amsterdam, The Netherlands
Access Restriction	Open
Rights License	This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. © 2019 – IOS Press and the authors. All rights reserved
Subject Keyword	Alzheimer’s disease dementia dementia with Lewy Bodies quality of Life
Content Type	Text
Resource Type	Article
Subject	Neuroscience Clinical Psychology Psychiatry and Mental Health Geriatrics and Gerontology