Patient‐ and proxy‐reported quality of life in advanced dementia with Lewy bodies

Author:

Armstrong Melissa J.12,LaBarre Brian3,Sovich Kaitlin1,Maixner Susan M.4,Paulson Henry L.5,Manning Carol6,Fields Julie A.7,Lunde Angela8,Forsberg Leah8,Boeve Bradley F.8,Galvin James E.9,Taylor Angela S.10,Li Zhigang3

Affiliation:

1. Department of Neurology University of Florida College of Medicine Gainesville Florida USA

2. Norman Fixel Institute for Neurological Diseases Gainesville Florida USA

3. Department of Biostatistics University of Florida College of Medicine Gainesville Florida USA

4. Department of Psychiatry University of Michigan Ann Arbor Michigan USA

5. Department of Neurology University of Michigan Ann Arbor Michigan USA

6. Department of Neurology University of Virginia Charlottesville Virginia USA

7. Department of Psychiatry and Psychology Mayo Clinic Rochester Minnesota USA

8. Department of Neurology Mayo Clinic Rochester Minnesota USA

9. Comprehensive Center for Brain Health Department of Neurology University of Miami Miller School of Medicine Miami Florida USA

10. Lewy Body Dementia Association Lilburn Georgia USA

Abstract

AbstractINTRODUCTIONLittle is known regarding quality of life (QoL) in dementia with Lewy bodies (DLB), particularly in advanced stages.METHODSDyads of individuals with moderate–advanced DLB and their primary caregivers were recruited from specialty clinics, advocacy organizations, and research registries. The study collected demographics, disease‐related measures, and measures of patient/caregiver experiences.RESULTSThe Quality of Life in Alzheimer's Disease (QoL‐AD) was completed by the person with DLB and the caregiver (proxy) in 61 dyads; 85 dyads had only a proxy‐completed QoL‐AD. Patient‐ and proxy‐reported scores were moderately correlated (r = 0.57, P < 0.0001). Worse patient‐reported QoL correlated with daytime sleepiness, autonomic symptom burden, and behavioral symptoms. Proxy ratings correlated with dementia severity, daytime sleepiness, behavioral symptoms, dependence in activities of daily living, and caregiver experience measures.DISCUSSIONPatient‐ and proxy‐reported quality of life (QoL) should be assessed separately in advanced DLB. Some symptoms associated with QoL have available therapeutic options. Research is needed regarding strategies to optimally improve QoL in DLB.Highlights Patient and proxy quality of life (QoL) ratings had moderate correlation in advanced dementia with Lewy bodies. Daytime sleepiness affected patient‐ and proxy‐reported QoL. Behavioral symptoms affected patient‐ and proxy‐reported QoL. Autonomic symptom burden affected patient‐reported QoL. Dementia severity, dependence, and caregiver experiences affected proxy ratings.

Publisher

Wiley

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