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See detailQuality of Life in Older Belgian People: Comparison between People with Dementia, Mild Cognitive Impairment, and Controls
Missotten, Pierre ULg; Squelard, Gilles ULg; Ylieff, Michel ULg et al

in International Journal of Geriatric Psychiatry (2008), 23(11), 1103-1109

OBJECTIVES: To assess the sensitivity of the 'Alzheimer's Disease Related Quality of Life' instrument (ADRQL) applied to Belgian people with dementia (n = 357), mild cognitive impairment (MCI) (n = 36 ... [more ▼]

OBJECTIVES: To assess the sensitivity of the 'Alzheimer's Disease Related Quality of Life' instrument (ADRQL) applied to Belgian people with dementia (n = 357), mild cognitive impairment (MCI) (n = 36), and controls (n = 72). We also determined the clinical parameters that influence the quality of life (QOL) of people with dementia. METHOD: Each subject was evaluated with the ADRQL, the Mini Mental State Examination (MMSE), the cognitive scale of the Cambridge Examination for Mental Disorders of the Elderly (CAMCOG), the Katz's ADL classification (ADL), the Instrumental Activities of Daily Living (IADL), the Behavior Rating Scale for Dementia (CERAD/BRSD), and the Clinical Dementia Rating/Modified (CDR-M). RESULTS: The ADRQL showed that QOL of the dementia group (65.77 +/- 17.04) was significantly inferior to that of the MCI (82.11 +/- 13.31) and control groups (79.75 +/- 15.82). There were no significant differences between the MCI and control groups. Within the dementia group, the five ADRQL subscale results were similar to those reported in other studies. Gender, age and place of residence had no significant influence on ADRQL scores. In contrast, ADRQL scores correlated significantly with MMSE, CAMCOG, IADL, ADL, CERAD/BRSD, and CDR-M. The MMSE and CERAD/BRSD were significant predictors of ADRQL variability. CONCLUSIONS: QOL of people with dementia is inferior to that of people with MCI and controls. This demonstrates the ADRQL instrument is sufficiently sensitive for evaluating the QOL of people with dementia. Longitudinal studies are needed to specifically examine the rate of QOL evolution throughout the entire dementia process. Copyright (c) 2008 John Wiley [less ▲]

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See detailQuality of life in dementia: a 2-year follow-up study
Missotten, Pierre ULg; Ylieff, Michel ULg; Di Notte, David et al

in International Journal of Geriatric Psychiatry (2007), 22(12), 1201-1207

Objectives To examine the evolution of quality of life (QOL) in demented subjects at base-line, one and 2 years later and to determine clinical variables associated with QOL. Method Longitudinal study of ... [more ▼]

Objectives To examine the evolution of quality of life (QOL) in demented subjects at base-line, one and 2 years later and to determine clinical variables associated with QOL. Method Longitudinal study of a cohort of 127 subjects living at home or in a long-term care institution. A QOL measure (Alzheimer Disease Related Quality of Life; ADRQL) was administered three times. In addition, several clinical instruments (MMSE, IADL, ADL and CDR/M) were also administered. Results ADRQL data analysis did not reveal significant modifications of QOL over the 2-year period, whereas results from clinical instruments showed a significant deterioration. On the group, the variations of ADRQL scores were limited, with some improvement after the first year followed by some deterioration after the second year. On the other hand, ADRQL scores fluctuated every year by at least 10 points for more than 50% of subjects. With dementia evolution, it was observed that the clinical variables were more strongly correlated with ADRQL scores and were more significant predictors. This varied from 5.9% (MMSE) in 2002 to 40.01 % in 2004 (MMSE and CDR/M). Conclusions QOL did not develop in a strictly linear manner following the deterioration of clinical state. This suggests that the evolution of QOL is also determined by other variables relating to the physical and social environment of the patients. Their role seems particularly important for the mild to moderate stages of dementia. Copyright (c) 2007 John Wiley [less ▲]

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See detailThe need for a consensus in the use of assessment tools for Alzheimer's disease: The Feasibility Study (assessment tools for dementia in Alzheimer Centres across Europe), a European Alzheimer's Disease Consortium's (EADC) survey
Diaz, S. P. R.; Gregorio, P. G.; Casado, J. M. R. et al

in International Journal of Geriatric Psychiatry (2005), 20(8), 744-748

Aims To ensure that all Alzheimer centres across Europe are capable of using a similar method of data collection. Information about the patient assessment tools used by each participating centre was ... [more ▼]

Aims To ensure that all Alzheimer centres across Europe are capable of using a similar method of data collection. Information about the patient assessment tools used by each participating centre was obtained and normal clinical practice in each EADC centre was documented by collecting data from routine new patient consultation. Methods Twenty new consecutive patients with objective memory impairment were recruited in each Alzheimer centre over 6 months. Each patient consultation was carried out according to routine clinical practice. Patient data were recorded using the anonymous patient protocol (demographic, diagnosis, MMSE score, patient assessment scales, and most prominent behavioural problem). Information about neuropsychological assessment tools used in each centre was take to account to harmonise research practice for future multicentre collaboration. Results Seven hundred and four patients from 36 memory clinics in 13 countries across Europe participated in the study. [M:F ratio 0.67. Mean age 75.4 SD 9.3 (51-102) Mean MMSE 21 SD 6 (0-30)] Five hundred and fifty-five patients had a clinical diagnosis of dementia [Alzheimer's disease (68.5%), vascular dementia (10.3%), frontal lobe dementia (5.6%), Lewy body dementia (4.1%), mixed dementia (5.6%)]. Duration of symptoms: 0-6 months 6.5%; 6-12 months 16.1%; 1-2 years 30.5%; 2-5 years 46.9%. Assessment scales used: Clinical Dementia Rating (CDR) 48.9%, Reisberg's Global Deterioration Scale (GDS) 38.6%, ADL/IADL (Lawton and Brody, 1969) 37.5%, Neuropsychological Inventory (NPI) 28.6%, Geriatric Depression Scale 22%, ADL (Katz et al., 1963) 19.2%, ADAS-Cog 14.9%, Cornell Scale for Depression 12.9%, Grober and Bushke Selective Reminding Test 11.5%, ADCS/ADL 7.7%. 64.8% of the patients experienced behavioural symptoms: apathy 13.6%; anxiety 12.8%; dysphoria 9.9%; irritability 7.8%; agitation 5.5%; hallucinations 3.6%; delusions 3.6%, sleep disorder 2.4%; desinhibition 2%. Conclusions The most common type of cognitive decline was Alzheimer's disease followed by mild cognitive impairment and vascular dementia. CDR, GDS Reisberg, and ADL/IADL were used widely (40-50%). The NPI, geriatric depression scale and ADL (Katz, 1963) were only used in 20% of the centres. We verified large differences in the tools use in the EADC centres to evaluate patients with dementia across Europe. There is a need for a consensus in the use of assessment tools for dementia in Alzheimer's centres in Europe. Copyright (c) 2005 John Wiley [less ▲]

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See detailA new approach to the qualitative evaluation of functional disability in dementia
Kurz, Xavier; Scuvée-Moreau, Jacqueline ULg; Rive, B. et al

in International Journal of Geriatric Psychiatry (2003), 18

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