Premium
Effects of anosognosia and neuropsychiatric symptoms on the quality of life of patients with Alzheimer's disease: a 24‐month follow‐up study
Author(s) -
CondeSala Josep L.,
TurróGarriga Oriol,
PiñánHernández Sara,
PortellanoOrtiz Cristina,
ViñasDiez Vanesa,
GascónBayarri Jordi,
ReñéRamírez Ramón
Publication year - 2016
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.4298
Subject(s) - anosognosia , apathy , dementia , quality of life (healthcare) , depression (economics) , psychology , disease , psychiatry , alzheimer's disease , caregiver burden , severity of illness , rating scale , clinical psychology , medicine , cognition , developmental psychology , economics , psychotherapist , macroeconomics
Objectives Neuropsychiatric symptoms and anosognosia are known to influence the perceived quality of life of patients (QoL‐p) with Alzheimer's disease (AD). This study analysed their impact on patient and caregiver ratings of QoL‐p and how these ratings changed in relation to the severity of dementia. Methods A baseline sample of 221 patients and caregivers was followed up over 24 months. Instruments: Neuropsychiatric Inventory (NPI), Anosognosia Questionnaire—Dementia (AQ‐D), Quality of life—Alzheimer's Disease (QoL‐AD) and the Global Deterioration Scale (GDS). Longitudinal data were analysed using generalized linear models. Results In the multivariate analysis, greater anosognosia was always associated with higher ratings of QoL‐p among patients, especially at 24 months ( p < 0.001), and with more negative ratings among caregivers, especially at baseline ( p < 0.001). A higher total NPI score was associated with a more negative rating of QoL‐p among caregivers ( p < 0.001), and it also had a smaller negative effect on patients' self‐ratings ( p = 0.001). The neuropsychiatric symptoms (NPI) associated with a more negative view of QoL‐p were depression, for patients' self‐ratings, and apathy and agitation for caregiver ratings. The discrepancy between patient and caregiver ratings increased in line with the severity of dementia. Conclusion Neuropsychiatric symptoms had a similarly negative effect on the QoL‐p ratings of both patients and caregivers, whereas the effect of anosognosia differed according to the rater (positive for patients, negative for caregivers). Copyright © 2015 John Wiley & Sons, Ltd.