Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-27T14:25:04.441Z Has data issue: false hasContentIssue false
  • English
  • Français

What is the quality of life in the oldest old?

Published online by Cambridge University Press:  01 February 2011

Maria I. Lapid ,
Teresa A. Rummans ,
Bradley F. Boeve ,
Joan K. McCormick ,
V. Shane Pankratz ,
Ruth H. Cha ,
Glenn E. Smith ,
Robert J. Ivnik ,
Eric G. Tangalos  and
Ronald C. Petersen
Maria I. Lapid*
Affiliation:
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, U.S.A.
Teresa A. Rummans
Affiliation:
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, U.S.A.
Bradley F. Boeve
Affiliation:
Department of Neurology, Mayo Clinic, Rochester, Minnesota, U.S.A.
Joan K. McCormick
Affiliation:
Alzheimer's Disease Research Center, Department of Neurology, Mayo Clinic, Rochester, Minnesota, U.S.A.
V. Shane Pankratz
Affiliation:
Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, U.S.A.
Ruth H. Cha
Affiliation:
Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, U.S.A.
Glenn E. Smith
Affiliation:
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, U.S.A.
Robert J. Ivnik
Affiliation:
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, U.S.A.
Eric G. Tangalos
Affiliation:
Department of Medicine, Mayo Clinic, Rochester, Minnesota, U.S.A.
Ronald C. Petersen
Affiliation:
Department of Neurology, Mayo Clinic, Rochester, Minnesota, U.S.A.
*
Correspondence should be addressed to: Maria I. Lapid, Mayo Clinic Dept. of Psychiatry and Psychology, 200 First Street SW, Rochester, MN 55905, U.S.A. Phone: +1 507-255-7184; Fax: +1 507-255-7365. Email: lapid.maria@mayo.edu.
Get access

Abstract

Background: Maintaining and improving quality of life has become a major focus in geriatric medicine, but the oldest old have received limited attention in clinical investigations. We aimed to investigate the relationship between self-perceived and caregiver-perceived quality of life (QOL), cognitive functioning, and depressive symptoms in the oldest old.

Methods: This IRB-approved prospective study recruited community dwellers aged 90–99 years old. Collected data included neurological evaluation, DSM III-R criteria for dementia, Mini-Mental State Examination (MMSE), Dementia Rating Scale (DRS), Geriatric Depression Scale (GDS), Record of Independent Living (ROIL), and QOL assessment using the Linear Analogue Self Assessment (LASA).

Results: Data on 144 subjects (56 cognitively normal (normal), 13 mild cognitive impairment (MCI), 41 dementia (DEM), 34 dementia with stroke and parkinsonism (DEMSP)) over a three-year period were analyzed. Mean ages ranged from 93 to 94 years, and the majority were female with at least high school education. Overall functional ability was higher in groups without dementia (p < 0.0001). All subjects reported high overall QOL (range 6.76–8.3 out of 10), regardless of cognitive functioning. However, caregivers perceived the subjects’ overall QOL to be lower with increasing severity of cognitive impairment (p < 0.0001). Lower GDS scores correlate with higher self-perceived overall QOL (ρ = −0.38, p < 0.0001).

Conclusions: In our community sample of the oldest old, there was a fairly high level of overall QOL, whether or not cognitive impairment exists. Individuals perceive their QOL better than caregivers do, and the difference in subjects’ and caregivers’ perception is more pronounced for the groups with dementia. QOL is more strongly correlated with depressive symptoms than with dementia severity.

Keywords

geriatricwell beingcognitiondepressiondementiastrokeparkinsonismMCI
Type
Research Article
Information
International Psychogeriatrics , Volume 23 , Issue 6 , August 2011 , pp. 1003 - 1010
Copyright
Copyright © International Psychogeriatric Association 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition. Washington, DC: American Psychiatric Press.Google Scholar
Bergdahl, E. et al. (2005). Depression among the oldest old: the Umeå 85+ Study. International Psychogeriatrics, 17, 557–575.CrossRefGoogle ScholarPubMed
Blazer, D. G. (2000). Psychiatry and the oldest old. American Journal of Psychiatry, 157, 1915–1924.CrossRefGoogle ScholarPubMed
Boeve, B. et al. (2003). Mild cognitive impairment in the oldest old. Neurology, 60, 477–480.CrossRefGoogle ScholarPubMed
Bretscher, M. et al. (1999). Quality of life in hospice patients: a pilot study. Psychosomatics, 40, 309–313.CrossRefGoogle ScholarPubMed
Ceroni, G., Rucci, P., Berardi, D., Berti Ceroni, F. and Katon, W. (2002). Case review vs. usual care in primary care patients with depression: a pilot study. General Hospital Psychiatry, 24, 71–80.CrossRefGoogle ScholarPubMed
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences. Hillsdale, NJ: Lawrence Erlbaum Associates.Google Scholar
De Leo, D. et al. (1998). LEIPAD, an internationally applicable instrument to assess quality of life in the elderly. Behavioral Medicine, 24, 17–27.CrossRefGoogle ScholarPubMed
Doraiswamy, P. M., Khan, Z. M., Donahue, R. M. J. and Richard, N. E. (2002). The spectrum of quality-of-life impairments in recurrent geriatric depression. Journal of Gerontology: Medical Sciences, 57A, M134–M137.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Grunberg, S., Groshen, S., Steingass, S., Zaretsky, S. and Meyerowitz, B. (1996). Comparison of conditional quality of life terminology and visual analogue scale measurements. Quality of Life Research, 5, 65–72.CrossRefGoogle ScholarPubMed
Gudex, C., Dolan, P., Kind, P. and Williams, A. (1996). Health state valuations from the general public using the visual analogue scale. Quality of Life Research, 5, 521–531.CrossRefGoogle ScholarPubMed
Kokmen, E., Naessens, J. M. and Offord, K. P. (1987). A short test of mental status: description and preliminary results. Mayo Clinic Proceedings, 62, 281–288.CrossRefGoogle Scholar
Kokmen, E., Smith, G. E., Petersen, R. C., Tangalos, E. and Ivnik, R. C. (1991). The short test of mental status: correlations with standardized psychometric testing. Archives of Neurology, 48, 725–728.CrossRefGoogle ScholarPubMed
Liao, Y., McGee, D. L., Cao, G. and Cooper, R. S. (2000). Quality of the last year of life of older adults: 1986 vs 1993. JAMA, 283, 512–518.CrossRefGoogle ScholarPubMed
Locke, D. E. et al. (2007). Validation of single-item linear analog scale assessment of quality of life in neuro-oncology patients. Journal of Pain and Symptom Management, 34, 628–638.CrossRefGoogle ScholarPubMed
Mattis, S. (1988). Dementia Rating Scale. Professional Manual. Odessa: Psychological Assessment Resources.Google Scholar
McKenna, S. P. et al. (2001). International development of the Quality of Life in Depression Scale (QLDS). Journal of Affective Disorders, 63, 189–199.CrossRefGoogle ScholarPubMed
Melton, L. J. III (1996). History of the Rochester Epidemiology Project. Mayo Clinic Proceedings, 71, 266–274.CrossRefGoogle ScholarPubMed
Nakajima, G. and Wenger, N. S. (2007). Quality indicators for the care of depression in vulnerable elders. Journal of the American Geriatrics Society, 55, S302–S311.CrossRefGoogle ScholarPubMed
O'Boyle, C. A. (1997). Measuring the quality of later life. Philosophical Transactions of the Royal Society of London, Series B: Biological Sciences, 352, 1871–1879.CrossRefGoogle ScholarPubMed
Penninx, B. W., Geerlings, S. W., Deeg, D. J., van Eijk, J. T., van Tilburg, W. and Beekman, A. T. (1999a). Minor and major depression and the risk of death in older persons. Archives of General Psychiatry, 56, 889–895.CrossRefGoogle ScholarPubMed
Penninx, B. W., Leveille, S., Ferrucci, L., van Eijk, J. T. and Guralnik, J. M. (1999b). Exploring the effect of depression on physical disability: longitudinal evidence from the established populations for epidemiologic studies of the elderly. American Journal of Public Health, 89, 1346–1352.CrossRefGoogle ScholarPubMed
Rummans, T. A. et al. (2006). Impacting quality of life for patients with advanced cancer with a structured multidisciplinary intervention: a randomized controlled trial. Journal of Clinical Oncology, 24, 635–642.CrossRefGoogle ScholarPubMed
Sarvimaki, A. and Stenbock-Hult, B. (2000). Quality of life in old age described as a sense of well-being, meaning and value. Journal of Advanced Nursing, 32, 1025–1033.CrossRefGoogle ScholarPubMed
Ventry, I. M. and Weinstein, B. E. (1983). Identification of elderly people with hearing problems. ASHA, 25, 37–42.Google ScholarPubMed
Warner, J. P. (1998). Quality of life and social issues in older depressed patients. International Clinical Psychopharmacology, 13 (Suppl.), S19–S24.CrossRefGoogle ScholarPubMed
Weintraub, S. (1986). The record of independent living: an informant completed measure of activities of daily living and behavior in elderly patients with cognitive impairment. American Journal of Alzheimer Care and Related Disorders, 7, 35–39.CrossRefGoogle Scholar
Yesavage, J. A. et al. (1982). Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatric Research, 17, 37–49.CrossRefGoogle Scholar