Quality of life in patients with mild dementia. Validation of the Italian version of the quality of life Alzheimer’s disease (QoL-AD) Scale

Background and aims: to investigate possible clinical determinants of quality of life (QoL) in mild dementiaMethods: 200 dementia outpatients assessed with the Quality of Life-AD (QoL-AD) scale administered to patientsand their caregivers and combined into a QoL-AD composite score (QoL-AD CS). Patients were dividedinto tertiles according to high, intermediate and low QoL levels. Cognitive status was assessed with the MiniMental State Examination (MMSE) and depressive symptoms with the Geriatric Depression Scale (GDS). Basic(BADL) and instrumental (IADL) activities of daily living scales were used to assess functional domain. TheNeuropsychiatric Inventory (NPI) measured neuropsychiatric symptoms.Results: a strong correlation was found between patient-rated QoL-AD scores and caregiver-rated QoL-ADscores (Pearson correlation coefficient: .353; p = .000). High QoL group patients displayed better functionalstatus in BADL and IADL, had lower comorbidity and number of medications. Insight level and cognition werecomparable among the three groups. The group with higher QoL had significantly lower depressive and neuropsychiatricsymptoms compared to the intermediate and low QoL groups. On linear regression analysis usingthe QoL-AD CS as the depended variable, the model including GDS, IADL, number of medications and NPIexplains nearly 50% of QoL-CS variance (R2 = .495; adjusted R2 = .485).Conclusions: QoL in mild dementia is a broad dominion that goes beyond the cognitive impairment itselfand is determined by for the presence of depression, impairment in instrumental activities of daily living, behaviouraldisturbances and number of medications.