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Open Access 13-05-2024 | Dementia

Quality of life in a high-risk group of elderly primary care patients: characteristics and potential for improvement

Authors: Juliane Döhring, Martin Williamson, Christian Brettschneider, Thomas Fankhänel, Melanie Luppa, Alexander Pabst, Marina Weißenborn, Isabel Zöllinger, David Czock, Thomas Frese, Jochen Gensichen, Wolfgang Hoffmann, Hans-Helmut König, Jochen René Thyrian, Birgitt Wiese, Steffi Riedel-Heller, Hanna Kaduszkiewicz

Published in: Quality of Life Research

Abstract

Purpose

Quality of Life (QoL) is associated with a bandwidth of lifestyle factors that can be subdivided into fixed and potentially modifiable ones. We know too little about the role of potentially modifiable factors in comparison to fixed ones. This study examines four aspects of QoL and its associations with 15 factors in a sample of elderly primary care patients with a high risk of dementia. The main objectives are (a) to determine the role of the factors in this particular group and (b) to assess the proportion of fixed and potentially modifiable factors.

Method

A high-risk group of 1030 primary care patients aged between 60 and 77 years (52.1% females) were enrolled in “AgeWell.de,” a cluster-randomized, controlled trial. This paper refers to the baseline data. The multi-component intervention targets to decrease the risk of dementia by optimization of associated lifestyle factors. 8 fixed and 7 modifiable factors potentially influencing QoL served as predictors in multiple linear regressions.

Results

The highest proportion of explained variance was found in psychological health and age-specific QoL. In comparison to health-related QoL and physical health, the modifiable predictors played a major role (corr. R²: 0.35/0.33 vs. 0.18), suggesting that they hold a greater potential for improving QoL.

Conclusion

Social engagement, body weight, instrumental activities of daily living, and self-efficacy beliefs appeared as lifestyle factors eligible to be addressed in an intervention program for improving QoL.

Trial registration

German Clinical Trials Register, reference number: DRKS00013555. Date of registration: 07.12.2017.

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WHOQoL Group. (1993). Study protocol for the World Health Organization project to develop a Quality of Life assessment instrument (WHOQOL). Quality of life Research, 2, 153–159. https://doi.org/10.1007/BF00435734CrossRef

Frisch, M. B. (2000). Improving mental and physical health care through quality of life therapy and assessment. In Advances in quality of life theory and research (pp. 207–241). Springer. https://doi.org/10.1007/978-94-011-4291-5_10

Patrick, D. L., & Deyo, R. A. (1989). Generic and disease-specific measures in assessing health status and quality of life. Medical Care. https://doi.org/10.1097/00005650-198903001-00018CrossRefPubMed

Gusi, N., Olivares, P. R., & Rajendram, R. (2010). The EQ-5D health-related quality of life questionnaire. In Handbook of disease burdens and quality of life measures. Springer, pp. 87–99. Doi:https://doi.org/10.1007/978-0-387-78665-0_5

Group, & T. E. (1990). EuroQol-a new facility for the measurement of health-related quality of life. Health Policy, 16(3), 199–208. https://doi.org/10.1016/0168-8510(90)90421-9CrossRef

Power, M., Quinn, K., & Schmidt, S. (2005). Development of the WHOQOL-old module. Quality of life research, 14(10), 2197–2214. https://doi.org/10.1007/s11136-005-7380-9CrossRefPubMed

Shukla, K. (2022). The conceptual frameworks on quality of life: A go-to handbook for quality of life research (1st ed.). Notion Press.

Livingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S., & Mukadam, N. (2020). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet, 396(10248), 413–446.CrossRef

Bonsaksen, T. (2012). Exploring gender differences in quality of life. Mental Health Review Journal. https://doi.org/10.1108/13619321211231815CrossRef

10.

Makovski, T. T., Schmitz, S., Zeegers, M. P., Stranges, S., & van den Akker, M. (2019). Multimorbidity and quality of life: Systematic literature review and meta-analysis. Ageing Research Reviews, 53, 100903. https://doi.org/10.1016/j.arr.2019.04.005CrossRefPubMed

11.

Read, S., Grundy, E., & Foverskov, E. (2016). Socio-economic position and subjective health and well-being among older people in Europe: A systematic narrative review. Aging & Mental Health, 20(5), 529–542. https://doi.org/10.1016/S0140-6736(20)30367-6CrossRef

12.

Stites, S. D., Harkins, K., Rubright, J. D., & Karlawish, J. (2018). Relationships between cognitive complaints and quality of life in older adults with mild cognitive impairment, mild Alzheimer’s disease dementia, and normal cognition. Alzheimer Disease and Associated Disorders, 32(4), 276. https://doi.org/10.1097/wad.0000000000000262CrossRefPubMedPubMedCentral

13.

Conrad, I., Uhle, C., Matschinger, H., Kilian, R., & Riedel-Heller, S. G. (2015). Lebensqualität von älteren Menschen mit leichten kognitiven Störungen. Psychiatrische Praxis, 42(03), 152–157. https://doi.org/10.1055/s-0034-1369831CrossRefPubMed

14.

Guo, H. J., & Sapra, A. (2020). Instrumental activity of daily living. StatPearls Publishing.

15.

Talarska, D., Tobis, S., Kotkowiak, M., Strugała, M., Stanisławska, J., & Wieczorowska-Tobis, K. (2018). Determinants of quality of life and the need for support for the elderly with good physical and mental functioning. Medical Science Monitor, 24, 1604. https://doi.org/10.12659/MSM.907032CrossRefPubMedPubMedCentral

16.

Herzog, A. R., Ofstedal, M. B., & Wheeler, L. M. (2002). Social engagement and its relationship to health. Clinics in Geriatric Medicine, 18(3), 593–609. https://doi.org/10.1016/S0749-0690(02)00025-3CrossRefPubMed

17.

Hajek, A., Brettschneider, C., Mallon, T., Ernst, A., Mamone, S., Wiese, B., & König, H. H. (2017). The impact of social engagement on health-related quality of life and depressive symptoms in old age-evidence from a multicenter prospective cohort study in Germany. Health and Quality of Life Outcomes, 15, 1–8. https://doi.org/10.1186/s12955-017-0715-8CrossRef

18.

Jeon, B. J., & Gwak, H. J. (2016). Relationship between Information use and quality of life by household types of elderly. Journal of the Korea Academia-Industrial cooperation Society, 17(10), 213–220. https://doi.org/10.5762/KAIS.2016.17.10.213CrossRef

19.

Vagetti, G. C., Barbosa, V. C., Moreira, N. B., Oliveira, V. D., Mazzardo, O., & Campos, W. D. (2014). Association between physical activity and quality of life in the elderly: A systematic review, 2000–2012. Brazilian Journal of Psychiatry, 36, 76–88. https://doi.org/10.1590/1516-4446-2012-0895CrossRefPubMed

20.

Yan, L. L., Daviglus, M. L., Liu, K., Pirzada, A., Garside, D. B., Schiffer, L., & Greenland, P. (2004). BMI and health-related quality of life in adults 65 years and older. Obesity Research, 12(1), 69–76. https://doi.org/10.1038/oby.2004.10CrossRefPubMed

21.

Rejeski, W. J., & Mihalko, S. L. (2001). Physical activity and quality of life in older adults. The Journals of Gerontology Series A, 56(2), 23–35. https://doi.org/10.1093/gerona/56.suppl_2.23CrossRef

22.

Borowiak, E., & Kostka, T. (2004). Predictors of quality of life in older people living at home and in institutions. Aging Clinical and Experimental Research, 16(3), 212–220. https://doi.org/10.1007/BF03327386CrossRefPubMed

23.

Schwarzer, R. (1999). Self-regulatory processes in the adoption and maintenance of health behaviors. Journal of Health Psychology, 4(2), 115–127. https://doi.org/10.1177/135910539900400208CrossRefPubMed

24.

McAuley, E., Konopack, J. F., Motl, R. W., Morris, K. S., Doerksen, S. E., & Rosengren, K. R. (2006). Physical activity and quality of life in older adults: Influence of health status and self-efficacy. Annals of behavioral Medicine, 31(1), 99–103. https://doi.org/10.1207/s15324796abm3101_14CrossRefPubMed

25.

Lee, M. K., & Oh, J. (2020). Health-related quality of life in older adults: Its association with health literacy, self-efficacy, social support, and health-promoting behavior. Healthcare, 8(4), 407. https://doi.org/10.3390/healthcare8040407CrossRefPubMedPubMedCentral

26.

Blacker, D., & Weuve, J. (2018). Brain exercise and brain outcomes: does cognitive activity really work to maintain your brain?. JAMA Psychiatry, 75(7), 703–704. https://doi.org/10.1001/jamapsychiatry.2018.0656

27.

Banerjee, S., Samsi, K., Petrie, C. D., Alvir, J., Treglia, M., Schwam, E. M., & del Valle, M. (2009). What do we know about quality of life in dementia? A review of the emerging evidence on the predictive and explanatory value of disease specific measures of health related quality of life in people with dementia. International Journal of Geriatric Psychiatry, 24(1), 15–24. https://doi.org/10.1002/gps.2090CrossRefPubMed

28.

Landeiro, F., Mughal, S., Walsh, K., Nye, E., Morton, J., Williams, H., & Gray, A. M. (2020). Health-related quality of life in people with predementia Alzheimer’s disease, mild cognitive impairment or dementia measured with preference-based instruments: a systematic literature review. Alzheimer’s Research & Therapy, 12(1), 1–14. https://doi.org/10.1186/s13195-020-00723-1CrossRef

29.

Röhr, S., Zülke, A., Luppa, M., Brettschneider, C., Weißenborn, M., Kühne, F., & Riedel-Heller, S. G. (2021). Recruitment and baseline characteristics of participants in the AgeWell de study: A pragmatic cluster-randomized controlled lifestyle trial against cognitive decline. International Journal of Environmental Research and Public Health, 18(2), 408. https://doi.org/10.3390/ijerph18020408CrossRefPubMedPubMedCentral

30.

Kivipelto, M., Ngandu, T., Laatikainen, T., Winblad, B., Soininen, H., & Tuomilehto, J. (2006). Risk score for the prediction of dementia risk in 20 years among middle aged people: A longitudinal, population-based study. The Lancet Neurology, 5(9), 735–741. https://doi.org/10.1016/S1474-4422(06)70537-3CrossRefPubMed

31.

Lampert, T., & Kroll, L. E. (2009). Die Messung des sozioökonomischen Status in sozialepidemiologischen Studien. In Gesundheitliche Ungleichheit (pp. 309–334). VS Verlag für Sozialwissenschaften. Doi:https://doi.org/10.1007/978-3-531-91643-9_18

32.

Ludwig, K., Graf von der Schulenburg, J. M., & Greiner, W. (2018). German value set for the EQ-5D-5L. PharmacoEconomics, 36, 663–674. https://doi.org/10.1007/s40273-018-0615-8CrossRefPubMedPubMedCentral

33.

Nasreddine, Z. S., Phillips, N. A., Bédirian, V., Charbonneau, S., Whitehead, V., Collin, I., Cummings, J. L., & Chertkow, H. (2005). Montreal cognitive assessment (MoCA) [Database record]. APA PsycTests. https://doi.org/10.1037/t27279-000CrossRef

34.

Moms, J. C., Heyman, A., Mohs, R. C., Hughes, J. P., van Belle, G., Fillenbaum, G., & Clark, C. (1989). The consortium to establish a registry for Alzheimer’s disease (CERAD): part I: Clinical and neuropsychological assessment of Alzheimer’s disease. Neurology, 39(9), 1159–1159. https://doi.org/10.1212/WNL.39.9.1159CrossRef

35.

Graf, C. (2008). The Lawton instrumental activities of daily living scale. The American Journal of Nursing, 108(4), 52–63. https://doi.org/10.1097/01.NAJ.0000314810.46029.74CrossRefPubMed

36.

Lubben, J., & Gironda, M. (2004). Measuring social networks and assessing their benefits. Social Networks and Social Exclusion, 4, 20–34.

37.

Yesavage, J. A., Brink, T. L., Rose, T. L., Lum, O., Huang, V., Adey, M., & Leirer, V. O. (1982). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research, 17(1), 37–49. https://doi.org/10.1016/0022-3956(82)90033-4CrossRefPubMed

38.

Schwarzer, R. (1999). Skala zur allgemeinen Selbstwirksamkeitserwartung.

39.

Cohen, J. (1992). Statistical power analysis. Current Directions in Psychological Science, 1(3), 98–101. https://doi.org/10.1111/1467-8721.ep10768783CrossRef

40.

Feng, Y. S., Kohlmann, T., Janssen, M. F., & Buchholz, I. (2021). Psychometric properties of the EQ-5D-5L: A systematic review of the literature. Quality of Life Research, 30, 647–673. https://doi.org/10.1007/s11136-020-02688-yCrossRefPubMed

41.

Whoqol Group. (1998). Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychological Medicine, 28(3), 551–558. https://doi.org/10.1017/S0033291798006667CrossRef

42.

Long, D., Polinder, S., Bonsel, G. J., & Haagsma, J. A. (2021). Test–retest reliability of the EQ-5D-5L and the reworded QOLIBRI-OS in the general population of Italy, the Netherlands, and the United Kingdom. Quality of Life Research, 30, 2961–2971.CrossRefPubMedPubMedCentral

43.

Peel, N. M., Bartlett, H. P., & Marshall, A. L. (2007). Measuring quality of life in older people: Reliability and validity of WHOQOL-OLD. Australasian Journal on Ageing, 26(4), 162–167. https://doi.org/10.1007/s11136-021-02893-3CrossRef

44.

Hunter, E. G., & Kearney, P. J. (2018). Occupational therapy interventions to improve performance of instrumental activities of daily living for community-dwelling older adults: A systematic review. The American Journal of Occupational Therapy, 72(4), 5. https://doi.org/10.5014/ajot.2018.031062CrossRef

45.

Gobbens, R. J. (2018). Associations of ADL and IADL disability with physical and mental dimensions of quality of life in people aged 75 years and older. PeerJ, 6, e5425. https://doi.org/10.7717/peerj.5425CrossRefPubMedPubMedCentral

46.

Korczak, D., Habermann, C., & Braz, S. (2013). The effectiveness of occupational therapy for persons with moderate and severe dementia. GMS Health Technology Assessment, 9, 7. https://doi.org/10.3205/hta000115CrossRef

47.

Carmel, S. (2019). Health and well-being in late life: Gender differences worldwide. Frontiers in Medicine, 6, 218. https://doi.org/10.3389/fmed.2019.00218CrossRefPubMedPubMedCentral

48.

Kahneman, D., & Deaton, A. (2010). High income improves evaluation of life but not emotional well-being. Proceedings of the National Academy of Sciences, 107(38), 16489–16493. https://doi.org/10.1073/pnas.1011492107CrossRef

49.

Fjeldstad, C., Fjeldstad, A. S., Acree, L. S., Nickel, K. J., & Gardner, A. W. (2008). The influence of obesity on falls and quality of life. Dynamic Medicine, 7(1), 1–6. https://doi.org/10.1186/1476-5918-7-4CrossRef

50.

Edgerton, J. D., Roberts, L. W., & von Below, S. (2011). Education and quality of life. Handbook of Social Indicators and Quality of Life Research, 5, 265–296. https://doi.org/10.1007/978-94-007-2421-1_12CrossRef

51.

Cummins, R. A. (1997). Assessing quality of life. Quality of Life for People with Disabilities, 2, 116–150.

52.

Netuveli, G., & Blane, D. (2008). Quality of life in older ages. British Medical Bulletin, 85(1), 113–126. https://doi.org/10.1093/bmb/ldn003CrossRefPubMed

53.

Taylor, V. H., Forhan, M., Vigod, S. N., McIntyre, R. S., & Morrison, K. M. (2013). The impact of obesity on quality of life. Best Practice & Research Clinical Endocrinology & Metabolism, 27(2), 139–146. https://doi.org/10.1016/j.beem.2013.04.004CrossRef

54.

55.

Sivertsen, H., Bjørkløf, G. H., Engedal, K., Selbæk, G., & Helvik, A. S. (2015). Depression and quality of life in older persons: A review. Dementia and Geriatric Cognitive Disorders, 40(5–6), 311–339. https://doi.org/10.1159/000437299CrossRefPubMed

56.

Cardona, M. I., Weißenborn, M., Zöllinger, I., Kroeber, E. S., Bauer, A., Luppa, M., & Thyrian, J. R. (2022). Physical activity determinants in older german adults at increased dementia risk with multimorbidity: Baseline results of the AgeWell.de study. International Journal of Environmental Research and Public Health, 19(6), 3164. https://doi.org/10.3390/ijerph19063164CrossRefPubMedPubMedCentral

Title: Quality of life in a high-risk group of elderly primary care patients: characteristics and potential for improvement
Authors: Juliane Döhring
Martin Williamson
Christian Brettschneider
Thomas Fankhänel
Melanie Luppa
Alexander Pabst
Marina Weißenborn
Isabel Zöllinger
David Czock
Thomas Frese
Jochen Gensichen
Wolfgang Hoffmann
Hans-Helmut König
Jochen René Thyrian
Birgitt Wiese
Steffi Riedel-Heller
Hanna Kaduszkiewicz
Publication date: 13-05-2024
Publisher: Springer International Publishing
Keywords: Dementia
Dementia
Published in: Quality of Life Research
Print ISSN: 0962-9343
Electronic ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-024-03647-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Quality of life in a high-risk group of elderly primary care patients: characteristics and potential for improvement

Abstract

Purpose

Method

Results

Conclusion

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Method

Results

Conclusion

Trial registration

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