TY - JOUR
T1 - Trajectories and Determinants of Quality of Life in Dementia with Lewy Bodies and Alzheimer's Disease
AU - van de Beek, Marleen
AU - van Steenoven, Inger
AU - Ramakers, Inez H. G. B.
AU - Aalten, Pauline
AU - Koek, Huiberdina L.
AU - Rikkert, Marcel G. M. Olde
AU - Mannien, Judith
AU - Papma, Janne M.
AU - de Jong, Frank Jan
AU - Lemstra, Afina W.
AU - van der Flier, Wiesje M.
N1 - Funding Information:
This research was supported by the Parelsnoer Initiative, Parel Neurodegenerative Diseases, which is part of and funded by the Netherlands Federation of University Medical Centers and has received initial funding from the Dutch Government. Research of Alzheimer Center Amsterdam is part of the neurodegeneration research program of Amsterdam Neuroscience. The Alzheimer Center Amsterdam is supported by Alzheimer Nederland and Sticht-ing VUmc funds. A.L. has received funding from
Funding Information:
This research was supported by the Parelsnoer Initiative, Parel Neurodegenerative Diseases, which is part of and funded by the Netherlands Federation of University Medical Centers and has received initial funding from the Dutch Government. Research of Alzheimer Center Amsterdam is part of the neurodegeneration research program of Amsterdam Neuroscience. The Alzheimer Center Amsterdam is supported by Alzheimer Nederland and Stichting VUmc funds. A.L. has received funding from stichting Dioraphte en from ZonMW Memorabel (project #733050509).
Publisher Copyright:
© 2019 - IOS Press and the authors. All rights reserved.
PY - 2019
Y1 - 2019
N2 - 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: beta +/- SE = - 7.6 +/- 2.8, controls: beta +/- 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 (beta +/- 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 beta +/- SE = -1.8 +/- 0.3, EQ5D-utility beta +/- SE = -3.7 +/- 0.4; DAD: VAS = 0.1 +/- 0.0, EQ5D-utility beta +/- 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.
AB - 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: beta +/- SE = - 7.6 +/- 2.8, controls: beta +/- 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 (beta +/- 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 beta +/- SE = -1.8 +/- 0.3, EQ5D-utility beta +/- SE = -3.7 +/- 0.4; DAD: VAS = 0.1 +/- 0.0, EQ5D-utility beta +/- 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.
KW - Alzheimer's disease
KW - dementia
KW - dementia with Lewy Bodies
KW - quality of Life
KW - NURSING-HOME ADMISSION
KW - CAREGIVER BURDEN
KW - PEOPLE
KW - DIAGNOSIS
KW - PREVALENCE
KW - PREDICTORS
KW - SYMPTOMS
KW - MANAGEMENT
KW - STRESS
U2 - 10.3233/JAD-190041
DO - 10.3233/JAD-190041
M3 - Article
C2 - 31177218
SN - 1387-2877
VL - 70
SP - 387
EP - 395
JO - Journal of Alzheimer's Disease
JF - Journal of Alzheimer's Disease
IS - 2
ER -