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What is the quality of life in the oldest old?

Published online by Cambridge University Press:  01 February 2011

Maria I. Lapid ,
Teresa A. Rummans ,
Bradley F. Boeve ,
Joan K. McCormick ,
V. Shane Pankratz ,
Ruth H. Cha ,
Glenn E. Smith ,
Robert J. Ivnik ,
Eric G. Tangalos  and
Ronald C. Petersen
Maria I. Lapid*
Affiliation:
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, U.S.A.
Teresa A. Rummans
Affiliation:
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, U.S.A.
Bradley F. Boeve
Affiliation:
Department of Neurology, Mayo Clinic, Rochester, Minnesota, U.S.A.
Joan K. McCormick
Affiliation:
Alzheimer's Disease Research Center, Department of Neurology, Mayo Clinic, Rochester, Minnesota, U.S.A.
V. Shane Pankratz
Affiliation:
Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, U.S.A.
Ruth H. Cha
Affiliation:
Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, U.S.A.
Glenn E. Smith
Affiliation:
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, U.S.A.
Robert J. Ivnik
Affiliation:
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, U.S.A.
Eric G. Tangalos
Affiliation:
Department of Medicine, Mayo Clinic, Rochester, Minnesota, U.S.A.
Ronald C. Petersen
Affiliation:
Department of Neurology, Mayo Clinic, Rochester, Minnesota, U.S.A.
*
Correspondence should be addressed to: Maria I. Lapid, Mayo Clinic Dept. of Psychiatry and Psychology, 200 First Street SW, Rochester, MN 55905, U.S.A. Phone: +1 507-255-7184; Fax: +1 507-255-7365. Email: lapid.maria@mayo.edu.
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Abstract

Background: Maintaining and improving quality of life has become a major focus in geriatric medicine, but the oldest old have received limited attention in clinical investigations. We aimed to investigate the relationship between self-perceived and caregiver-perceived quality of life (QOL), cognitive functioning, and depressive symptoms in the oldest old.

Methods: This IRB-approved prospective study recruited community dwellers aged 90–99 years old. Collected data included neurological evaluation, DSM III-R criteria for dementia, Mini-Mental State Examination (MMSE), Dementia Rating Scale (DRS), Geriatric Depression Scale (GDS), Record of Independent Living (ROIL), and QOL assessment using the Linear Analogue Self Assessment (LASA).

Results: Data on 144 subjects (56 cognitively normal (normal), 13 mild cognitive impairment (MCI), 41 dementia (DEM), 34 dementia with stroke and parkinsonism (DEMSP)) over a three-year period were analyzed. Mean ages ranged from 93 to 94 years, and the majority were female with at least high school education. Overall functional ability was higher in groups without dementia (p < 0.0001). All subjects reported high overall QOL (range 6.76–8.3 out of 10), regardless of cognitive functioning. However, caregivers perceived the subjects’ overall QOL to be lower with increasing severity of cognitive impairment (p < 0.0001). Lower GDS scores correlate with higher self-perceived overall QOL (ρ = −0.38, p < 0.0001).

Conclusions: In our community sample of the oldest old, there was a fairly high level of overall QOL, whether or not cognitive impairment exists. Individuals perceive their QOL better than caregivers do, and the difference in subjects’ and caregivers’ perception is more pronounced for the groups with dementia. QOL is more strongly correlated with depressive symptoms than with dementia severity.

Keywords

geriatricwell beingcognitiondepressiondementiastrokeparkinsonismMCI

Information

Type
Research Article
Information
International Psychogeriatrics , Volume 23 , Issue 6 , August 2011 , pp. 1003 - 1010
Copyright
Copyright © International Psychogeriatric Association 2011

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