Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Dec 22;14(1):e12389.
doi: 10.1002/dad2.12389. eCollection 2022.

Life satisfaction across the entire trajectory of Alzheimer's disease: A mediation analysis

Arenda Mank  1   2   3 , Ingrid S van Maurik  1   2   3 , Argonde C van Harten  1   2 , Hanneke F M Rhodius-Meester  1   4 , Charlotte E Teunissen  5 , Bart N M van Berckel  1   2   6 , Johannes Berkhof  3 , Wiesje M van der Flier  1   2   3 , Judith J M Rijnhart  3
Affiliations

Life satisfaction across the entire trajectory of Alzheimer's disease: A mediation analysis

Arenda Mank et al. Alzheimers Dement (Amst). .

Abstract

Introduction: We studied life satisfaction across Alzheimer's disease (AD) stages and studied mobility and meaningful activities as mediators of the associations between these AD stages and life satisfaction.

Methods: In this cross-sectional study, we included n = 269 amyloid-positive patients with subjective cognitive decline (SCD), mild cognitive impairment (MCI), and AD dementia from the Amsterdam Dementia Cohort. Life satisfaction was measured with the satisfaction with life scale. The mediating role of transportation, work, sports, and hobbies on life satisfaction was examined in single and multiple mediator models.

Results: Patients with dementia are less satisfied with life compared to SCD and MCI. These differences in life satisfaction are explained by reduced participation in meaningful activities, which in turn, was largely attributable to decreased transportation use.

Discussion: Our findings suggest that improving access to transportation, therewith allowing participation in meaningful activities help to maintain life satisfaction and may be an important target for intervention.

Keywords: Alhzeimer's disease; dementia; life satisfaction; mild cognitive impairment; mobility; subjective cognitive decline.

PubMed Disclaimer

Conflict of interest statement

Arenda Mank reports no financial disclosures or conflicts of interest. Ingrid S. van Maurik is consultant to Roche. All funding is paid to her institution. Argonde van Harten was supported by funding from Alzheimer Netherlands, The Alzheimer Drug Discovery Foundation and the VUmc fund. Argonde van Harten has a collaboration contract with Quanterix corp. Hanneke F.M. Rhodius‐Meester is recipient of the Memorabel Dementia Fellowship 2021 (ZonMw projectnumber 10510022110004). Hanneke F.M. Rhodius‐Meester performs contract research for Combinostics; all funding is paid to her institution. Research of Charlotte E. Teunissen is supported by the European Commission (Marie Curie International Training Network, grant agreement No 860197 (MIRIADE), and JPND), Health Holland, the Dutch Research Council (ZonMW), Alzheimer Drug Discovery Foundation, The Selfridges Group Foundation, Alzheimer Netherlands, Alzheimer Association. CT is recipient of ABOARD, which is a public‐private partnership receiving funding from ZonMW (#73305095007) and Health∼Holland, Topsector Life Sciences & Health (PPP‐allowance; #LSHM20106). More than 30 partners participate in ABOARD. ABOARD also receives funding from Edwin Bouw Fonds and Gieskes‐Strijbisfonds. CET has a collaboration contract with ADx Neurosciences, Quanterix and Eli Lilly, performed contract research or received grants from AC‐Immune, Axon Neurosciences, Biogen, Brainstorm Therapeutics, Celgene, EIP Pharma, Eisai, PeopleBio, Roche, Toyama, Vivoryon. CET serves on editorial boards of Medidact Neurologie/Springer, Alzheimer Research and Therapy, Neurology: Neuroimmunology & Neuroinflammation, and is editor of a Neuromethods book Springer. Bart van Berckel has received research support from EU‐FP7, CTMM, ZonMw, NWO and Alzheimer Nederland. BvB has performed contract research for Rodin, IONIS, AVID, Eli Lilly, UCB, DIAN‐TUI and Janssen. BvB was a speaker at a symposium organized by Springer Healthcare. BvB has a consultancy agreement with IXICO for the reading of PET scans. BvB is a trainer for GE. Johannes Berkhof reports no financial disclosures or conflicts of interest. Wiesje M. van der Flier: Research programs of Wiesje M. van der Flier have been funded by ZonMW, NWO, EU‐FP7, EU‐JPND, Alzheimer Nederland, Hersenstichting CardioVascular Onderzoek Nederland, Health∼Holland, Topsector Life Sciences & Health, stichting Dioraphte, Gieskes‐Strijbis fonds, stichting Equilibrio, Edwin Bouw fonds, Pasman stichting, stichting Alzheimer & Neuropsychiatrie Foundation, Philips, Biogen MA Inc, Novartis‐NL, Life‐MI, AVID, Roche BV, Fujifilm, Combinostics. Wiesje M. van der Flier holds the Pasman chair. Wiesje M. van der Flier is recipient of ABOARD, which is a public‐private partnership receiving funding from ZonMW (#73305095007) and Health∼Holland, Topsector Life Sciences & Health (PPP‐allowance; #LSHM20106). Wiesje M. van der Flier has performed contract research for Biogen MA Inc, and Boehringer Ingelheim. Wiesje M. van der Flier has been an invited speaker at Boehringer Ingelheim, Biogen MA Inc, Danone, Eisai, WebMD Neurology (Medscape), Springer Healthcare. Wiesje M. van der Flier is consultant to Oxford Health Policy Forum CIC, Roche, and Biogen MA Inc. Wiesje M. van der Flier participated in advisory boards of Biogen MA Inc and Roche. All funding is paid to her institution. Wiesje M. van der Flier was associate editor of Alzheimer, Research & Therapy in 2020/2021. Wiesje M. van der Flier is associate editor at Brain. Judith J. M. Rijnhart received a grant from the Amsterdam Public Health Research Institute, which was paid to the Amsterdam UMC. Author disclosures are available in the supporting information.

Figures

FIGURE 1
FIGURE 1
(A) Directed acyclic graph of the hypothesized mediation model. (B) The bold arrows highlight the indirect effect through transportation only from the single mediator model. (C) The bold arrows highlight the total indirect effect through transportation and sports from a multiple mediator model. Each multiple mediator model contained two mediators. For the total indirect effects for transportation and hobbies, we included path a3 instead of a2, and for the total indirect effects for transportation and (voluntary) work, we included path a4 instead of a2
See this image and copyright information in PMC

References

    1. Scheltens P, Blennow K, Breteler MM, et al. Alzheimer's disease. Lancet. 2016;388(10043):505‐517. - PubMed
    1. van Maurik IS, Slot RER, Verfaillie SCJ, et al. Personalized risk for clinical progression in cognitively normal subjects‐the ABIDE project. Alzheimers Res Ther. 2019;11(1):33. - PMC - PubMed
    1. van Maurik IS, Vos SJ, Bos I, et al. Biomarker‐based prognosis for people with mild cognitive impairment (ABIDE): a modelling study. Lancet Neurol. 2019;18(11):1034‐1044. - PubMed
    1. Patrick DL, Burke LB, Powers JH, et al. Patient‐reported outcomes to support medical product labeling claims: FDA perspective. Value Health. 2007;10(Suppl 2):S125‐S137. - PubMed
    1. Mank A, van Maurik IS, Bakker ED, et al. Identifying relevant outcomes in the progression of Alzheimer's disease; what do patients and care partners want to know about prognosis? Alzheimer's & dementia (N Y). 2021;7(1):e12189. - PMC - PubMed