Longitudinal trajectories of quality of life among people with mild-to-moderate dementia: a latent growth model approach with IDEAL cohort study data

Clare, Linda, Gamble, Laura D, Martyr, Anthony, Sabatini, Serena, Nelis, Sharon M, Quinn, Catherine, Pentecost, Claire, Victor, Christina, Jones, Roy W, Jones, Ian R, Knapp, Martin ORCID: 0000-0003-1427-0215, Litherland, Rachael, Morris, Robin G, Rusted, Jennifer M, Thom, Jeanette M, Collins, Rachel, Henderson, Catherine and Matthews, Fiona E (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. ISSN 1079-5014

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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 subgroups with distinct QoL trajectories. METHODS: We used data from people with mild-to-moderate dementia followed up at 12 and 24 months in the Improving the experience of Dementia and Enhancing Active Life (IDEAL) cohort study (baseline n = 1,537). 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 modeling 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: 2 with higher baseline QoL scores, labeled Stable (74.9%) and Declining (7.6%), and 2 with lower baseline QoL scores, labeled 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 characterized 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 personalized 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.

Item Type:	Article
Official URL:	https://academic.oup.com/psychsocgerontology
Additional Information:	© 2022 The Authors
Divisions:	Personal Social Services Research Unit
Subjects:	R Medicine > RA Public aspects of medicine
Date Deposited:	25 Mar 2022 10:12
Last Modified:	17 Apr 2024 20:51
URI:	http://eprints.lse.ac.uk/id/eprint/114468

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