Introduction: In the absence of a cure, dementia is often managed by minimizing risk factors contributing to quality of life (QOL). Attitudes to dementia in older adults may differ from those in relatively younger adults. The aim was to conduct a systematic review of the literature to determine how QOL was assessed in adults, 65 years and older with dementia, and identify factors that influence the reported scores. Methods: A systematic review of full-text articles addressing QOL in older adults with dementia, published in English from January 1995 to September 2020, was conducted using PubMed and PsycINFO. We included studies that assessed QOL and involved participants 65 years and older. Studies were evaluated for inclusion by 2 independent pairs of reviewers. We assessed the quality of the studies using the Joanna Briggs Institute’s Critical Appraisal Checklist. Study characteristics and findings were summarized. Analysis was by narrative synthesis. We identified social and clinical factors influencing QOL scores. Results: Of the 1,010 articles identified, 19 met the inclusion criteria. These 19 studies involved 6,279 persons with dementia, with sample sizes from 32 to 1,366. Mean age of participants ranged from 77.1 to 86.6 years. Five measurement tools were identified; Quality of Life in Alzheimer Disease (QOL-AD), Alzheimer Disease-Related Quality of Life (ADRQL), Quality of Life in Late-Stage Dementia (QUALID), QUALIDEM (a dementia-specific QOL tool), and DEMQOL (health-related QOL for people with dementia). Self-ratings of QOL were higher than proxy ratings. Factors commonly influencing self-ratings of QOL included depression, functional impairment, and polypharmacy. Common factors that influenced proxy ratings included functional impairment, presence of neuropsychiatric symptoms, cognitive impairment, and caregiver burden. Conclusion: In evaluating QOL in dementia, self- and proxy reports may complement each other to ensure that all perspectives are addressed.
Dement Geriatr Cogn Disord

中文翻译：

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老年痴呆症的生活质量评估：系统评价

简介：在无法治愈的情况下，痴呆症通常通过尽量减少影响生活质量 (QOL) 的风险因素来管理。老年人对痴呆症的态度可能与相对年轻的成年人不同。目的是对文献进行系统回顾，以确定如何评估 65 岁及以上患有痴呆症的成年人的 QOL，并确定影响报告分数的因素。方法：使用 PubMed 和 PsycINFO 对 1995 年 1 月至 2020 年 9 月以英文发表的关于老年痴呆症 QOL 的全文文章进行了系统评价。我们纳入了评估 QOL 并涉及 65 岁及以上参与者的研究。研究由 2 对独立的评审员进行评估。我们使用乔安娜布里格斯研究所的批判性评估清单评估了研究的质量。总结了研究特征和结果。分析是通过叙事综合。我们确定了影响 QOL 评分的社会和临床因素。结果：在确定的 1,010 篇文章中，19 篇符合纳入标准。这 19 项研究涉及 6,279 名痴呆症患者，样本量从 32 到 1,366。参与者的平均年龄介于 77.1 至 86.6 岁之间。确定了五种测量工具；阿尔茨海默病的生活质量 (QOL-AD)、阿尔茨海默病相关的生活质量 (ADRQL)、晚期痴呆症的生活质量 (QUALID)、QUALIDEM（痴呆症特定的 QOL 工具）和 DEMQOL（健康-痴呆症患者的相关 QOL）。QOL 的自我评价高于代理评价。通常影响 QOL 自我评价的因素包括抑郁、功能障碍和多重用药。影响代理评级的常见因素包括功能障碍、神经精神症状的存在、认知障碍和照顾者负担。结论：在评估痴呆患者的 QOL 时，自我报告和代理报告可以相互补充，以确保所有观点都得到解决。
老年痴呆症认知障碍