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. 2019 Aug;34(8):1251-1261.
doi: 10.1002/gps.5128. Epub 2019 May 20.

The relationship between perceived functional difficulties and the ability to live well with mild-to-moderate dementia: Findings from the IDEAL programme

Anthony Martyr  1 , Sharon M Nelis  1 , Catherine Quinn  1   2 , Jennifer M Rusted  3 , Robin G Morris  4 , Linda Clare  1   5 ; IDEAL programme team
Affiliations

The relationship between perceived functional difficulties and the ability to live well with mild-to-moderate dementia: Findings from the IDEAL programme

Anthony Martyr et al. Int J Geriatr Psychiatry. 2019 Aug.

Abstract

Objectives: The objectives of the study are to investigate how different levels of functional ability relate to quality of life, well-being, and satisfaction with life, conceptualised as reflecting capability to "live well" in people with dementia.

Methods/design: Participants were 1496 people with mild-to-moderate dementia and 1188 informants who completed baseline assessments in the Improving the experience of Dementia and Enhancing Active Life (IDEAL) cohort study. Total self-rated and informant-rated scores on the Functional Activities Questionnaire were split into six ability levels to monitor how poorer functioning impacts the ability to live well. We also investigated the potential influence of sociodemographic and diagnostic variables, depression, cognition, and carer stress.

Results: Multivariate multiple regression models found that people with dementia who had the greatest functional impairment according to self-ratings and informant ratings had poorer living well scores than those with the least functional impairment. Sociodemographic and diagnostic factors and cognition had little impact on effect sizes. For self-ratings, depression attenuated the relationship between functional ability and living well, whereas carer stress attenuated informant ratings.

Conclusions: People with dementia with the least functional impairments had greater capability to live well than those with the most functional impairment. Even subtle perceived difficulties in functional ability had a detrimental effect on the ability of people with dementia to live well. Depression in people with dementia and carer stress in informants influenced these associations, and therefore, these factors should be routinely included in future research studies and clinical assessments.

Keywords: Alzheimer's disease; activities of daily living; carer stress; depression; quality of life.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
Self‐rated functional ability level by standardised scores on self‐rated living well measures. FAQ, Functional Activities Questionnaire; QoL‐AD, Quality of Life in Alzheimer's Disease; SwLS, Satisfaction with Life Scale; WHO‐5, World Health Organization‐Five Well‐being Index [Colour figure can be viewed at wileyonlinelibrary.com]
Figure 2
Figure 2
Informant‐rated functional ability level by standardised scores on informant‐rated living well measures. FAQ, Functional Activities Questionnaire; QoL‐AD, Quality of Life in Alzheimer's Disease; SwLS, Satisfaction with Life Scale; WHO‐5, World Health Organization‐Five Well‐being Index
See this image and copyright information in PMC

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