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Observational Study
. 2017 Mar;32(2):108-115.
doi: 10.1177/1533317516688297. Epub 2017 Jan 22.

A Path Analysis of Dependence and Quality of Life in Alzheimer's Disease

Josep Garre-Olmo  1   2   3 , Joan Vilalta-Franch  1   2   3   4 , Laia Calvó-Perxas  1 , Secundino López-Pousa  1   2   4 ; CoDep-AD Study Group
Affiliations
Observational Study

A Path Analysis of Dependence and Quality of Life in Alzheimer's Disease

Josep Garre-Olmo et al. Am J Alzheimers Dis Other Demen. 2017 Mar.

Abstract

Objective: To determine the direct and indirect relationships of cognitive, functional, and behavioral factors and other medical comorbidities with the quality of life (QoL) of patients with Alzheimer's disease (AD) according to the theoretical model of dependence.

Methods: Observational and cross-sectional study. Cognitive and functional status, behavior, dependence, medical comorbidities, and QoL were assessed by using standardized instruments. A path analysis was used to model the direct and indirect relationships among clinical indicators according to the theoretically based model of dependence.

Results: The sample consisted of 343 patients with AD (32.1% mild, 36.7% moderate, and 31.2% severe). Medical comorbidities, disease severity, and dependence level had a direct relationship with QoL. The functional disability and the behavior disturbances were indirectly related to QoL via dependence level, and the cognitive impairment was indirectly related to QoL via severity level.

Conclusion: Direct and indirect effects exist between clinical indicators, dependence, and QoL.

Keywords: Alzheimer’s disease; dementia; dependence; quality of life.

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Conflict of interest statement

The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Josep Garre-Olmo and Secundino López-Pousa are employees of Institut d’Assistència Sanitària and were paid contractors to Pfizer Inc and Janssen Alzheimer Immunotherapy Research & Development, LLC, in the development of this manuscript and the study design and data analysis.

Figures

Figure 1.
Figure 1.
Theoretical model for dependence in Alzheimer’s disease.
Figure 2.
Figure 2.
Path model for dependence and QoL. *P < .05; **P < .001. CIRS indicates Cumulative Illness Rating Scale; DAD, Disability Assessment for Dementia; DS, Dependence Scale; EQ-5D, European Quality of Life-5 Dimensions; MMSE, Mini-Mental State Examination; NPI, Neuropsychiatric Inventory; QoL, quality of life; r 2: coefficient of determination.
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