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Assessing quality of life of nursing home residents with dementia: feasibility and limitations in patients with severe cognitive impairment

  • María Crespo (a1), Carlos Hornillos (a1) and M. Mar Gómez (a1)

The Quality of Life-Alzheimer's Disease Scale (QOL-AD) is a reliable and valid self-report measure for assessing quality of life (QoL) in people with dementia in long-term care settings, but little is known yet about the number of patients with severe cognitive impairment who are able to complete this measure, and the characteristics of those unable to do so. The aim of the study is to advance knowledge of these issues.


Data on residents with dementia were collected from 11 nursing homes. The QOL-AD residential version was directly applied to residents with dementia diagnosis and Mini-Mental State Examination scores under 27, randomly selected in each center. Residents’ QoL was further assessed from the perspective of some close relative and some staff member. Altogether, 102 data sets from residents, 184 from relatives, and 197 from staff members were collected. An analysis of the characteristics of completers versus non-completers regarding levels of cognitive impairment was carried out.


People with dementia in long-term care are able to report their QoL. The QOL-AD completion rate decreases as the cognitive impairment level increases; non-completion is associated with greater overall impairment. About 30% of residents with severe cognitive impairment could self-report on their QoL with acceptable reliability.


QoL self-rating should be the first-line option when assessing residents with severe cognitive impairment. For those that are not able to complete self-report measures, proxies’ report could be an alternative, although the development of other assessment procedures (e.g. observational) should be considered.

Corresponding author
Correspondence should be addressed to: María Crespo, PhD, Facultad de Psicología, Universidad Complutense de Madrid, Campus de Somosaguas s/n, 28223, Madrid, Spain. Phone: +34-913943122; Fax: +34 91-394-31-89. Email:
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G. A. Alexopoulos , R. C. Abrams , R. C. Young and C. A. Shamoian (1988). Cornell Scale for depression in dementia. Biological Psychiatry, 23, 271284. doi:10.1016/0006-3223(88)90038-8.

C. Beer et al. (2010). Factors associated with self and informant ratings of the quality of life of people with dementia living in care facilities: a cross sectional study. PLoS One, 5, e15621. doi:10.1371/journal.pone.001562.

J. Cohen-Mansfield (1986). Agitated behaviors in the elderly II. Preliminary results in the cognitively deteriorated. Journal of the American Geriatrics Society, 34, 722727.

J. L. Conde-Sala , J. Garre-Olmo , O. Turró-Garriga , S. López-Pousa and J. Vilalta-Franch (2009). Factors related to perceived quality of life in patients with Alzheimer's disease: the patient's perception compared with that of caregivers. American Journal of Geriatric Psychiatry, 24, 585594. doi:10.1002/gps.216.

M. Crespo , M. Bernaldo de Quirós , M. M. Gómez and C. Hornillos (2012). Quality of life of nursing home residents with dementia: comparison of perspectives of residents, family and staff. The Gerontologist, 52, 5665. doi:10.1093/geront/gnr080.

M. Crespo , C. Hornillos and M. Bernaldo de Quirós (2013). Factors associated with quality of life in dementia patients in long-term care. International Pyschogeriatrics, 25, 577585. doi:10.1017/S1041610212002219.

J. Hoe , C. Katona , B. Roch and G. Livingston (2005). Use of the QOL-AD for measuring quality of life in people with severe dementia – the LASER-AD study. Age and Ageing, 34, 130135. doi:10.1093/ageing/afi030.

J. Hoe , G. Hancock , G. Livingston and M. Orrell (2006). Quality of life in people with dementia in residential care homes. British Journal of Psychiatry, 188, 460464. doi: 10.1192/bjp.bp.104.007658.

J. Hoe , C. Katona , M. Orrell and G. Livingston (2007). Quality of life in dementia: care recipient and caregiver perceptions of quality of life in dementia: the LASER-AD study. International Journal of Geriatric Psychiatry, 22, 10311036. doi: 10.1002/gps.1786.

J. Hoe et al. (2009). Changes in the quality of life of people with dementia living in care homes. Alzheimer Disease and Associated Disorders, 23, 285290. doi:10.1097/WAD.0b013e318194fc1e.

C. Katona et al. (2007). International Psychogeriatric Association consensus statement on defining and measuring treatment benefits in dementia. International Psychogeriatrics, 19, 345354. doi:10.1017/S1041610207005145.

B. León-Salas , R. G. Logsdon , J. Olazarán , P. Martínez-Martín and MSU-ADRU. The (2011a). Psychometric properties of the Spanish QoL–AD with institutionalized dementia patients and their family caregivers in Spain. Aging and Mental Health, 15, 775783. doi:10.1080/13607863.2011.562183.

B. León-Salas , J. Olazarán , R. Muñiz , M. T. González- Salvador and P. Martínez-Martín (2011b). Caregivers’ estimation of patients’ quality of life (QoL) in Alzheimer's disease (AD): an approach using the ADRQL. Archives of Gerontology and Geriatrics, 53, 1318. doi:10.1016/j.archger.2010.05.021.

R. G. Logsdon , L. E. Gibbons , S. M. McCurry and L. Teri (2002). Assessing quality of life in older adults with cognitive impairment. Psychosomatic Medicine, 64, 510519.

J. L. Mack and P. J. Whitehouse (2001). Quality of life in dementia: state of the art – report of the International Working Group for Harmonization of Dementia Drug Guidelines and the Alzheimer's Society satellite meeting. Alzheimer Disease and Associated Disorders, 15, 6971. doi:10.1097/00002093-200104000-00005.

E. Moniz-Cook et al. (2008). A European consensus on outcome measures for psychological intervention research in dementia care. Aging and Mental Health, 12, 1429. doi:10.1080/13607860801919850.

C. E. Selai , M. R. Trimble , M. N. Rossor and R. J. Harvey (2001). Assessing quality of life in dementia: preliminary psychometric testing of the Quality of Life Assessment Schedule (QOLAS). Neuropsychological Rehabilitation, 11, 219243. doi:10.1080/09602010042000033.

A. Spector and M. Orrell (2006). Quality of life (QoL) in dementia: a comparison of the perceptions of people with dementia and care staff in residential homes. Alzheimer Disease and Associated Disorders, 20, 160165. doi:10.1097/00002093-200607000- 00007.

L. Thorgrimsen et al. (2003). Whose quality of life is it anyway? The validity and reliability of the Quality of Life-Alzheimer's Disease (QoL-AD) Scale. Alzheimer Disease and Associated Disorders, 17, 201208. doi:10.1097/00002093-200310000-00002.

P. J. Whitehouse and P. V. Rabins (1992). Quality of life in dementia. Alzheimer Disease and Associated Disorders, 6, 135137. doi:10.1097/00002093-199206030- 00001.

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International Psychogeriatrics
  • ISSN: 1041-6102
  • EISSN: 1741-203X
  • URL: /core/journals/international-psychogeriatrics
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