Quality of Life and the Eye of the Beholder: A Multidimensional Approach to Assessing Quality of Life for Persons with Dementia

Abstract

Formally assessing quality of life for persons with dementia presents a number of challenges due to the inherently subjective nature of the construct and the varying deficits observed in the progression of dementia. Caregiver judgments about affected individuals' functioning and quality of life can directly influence crucial care decisions for this vulnerable population. The current study employed a multi-trait multi-method paradigm to examine the discrepancies and congruencies between proxy, direct observation, and self-report measures of quality of life for persons with dementia. Results indicated that care recipients, professional caregivers, and family caregivers have distinctly different perspectives on the quality of life of persons with dementia with care recipients rating their quality of life significantly higher than family caregivers. Depressive symptoms, cognitive impairment, functional status and neuropsychiatric symptoms were variably associated with quality of life judgments across the three participant groups. Additionally, the validity of the QoL-AD, the dementia specific QoL measure was examined through assessment of the measure's convergent and divergent validity. The study results and directions for further research are discussed.