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Comorbidity, health status, and quality of life in institutionalized older people with and without dementia

Published online by Cambridge University Press:  11 April 2013

Salomé Martín-García ,
Carmen Rodríguez-Blázquez ,
Iluminada Martínez-López ,
Pablo Martínez-Martín  and
Maria João Forjaz
Salomé Martín-García
Affiliation:
EULEN Socio-sanitary services, Madrid, Spain
Carmen Rodríguez-Blázquez*
Affiliation:
National Center of Epidemiology, Institute of Health Carlos III, Madrid, Spain CIBERNED, Madrid, Spain
Iluminada Martínez-López
Affiliation:
EULEN Socio-sanitary services, Madrid, Spain
Pablo Martínez-Martín
Affiliation:
Research Unit, CIEN Foundation, Institute of Health Carlos III, Alzheimer Center Reina Sofia Foundation, Madrid, Spain CIBERNED, Madrid, Spain
Maria João Forjaz
Affiliation:
National School of Public Health, Institute of Health Carlos III, Madrid, Spain REDISSEC, Bilbao, Spain
*
Correspondence should be addressed to: Carmen Rodriguez-Blazquez, National Center of Epidemiology, Institute of Health Carlos III, Monforte de Lemos 5, 28029 Madrid, Spain. Phone: +34-91-822-2657; Fax: +34-91-387-7815. Email: crodb@isciii.es.
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Abstract

Background: Comorbidity in older adults may lead to lower perceived health status and a decrease in quality of life (QoL). The objective of this study is to analyze the relationship between comorbidity, health status, QoL, and dementia in institutionalized older adults.

Methods: Cross-sectional, multicenter study in residential care settings in Spain. Two groups of institutionalized older adults of 60 years of age and older were compared: 234 persons with normal cognitive function and 525 with dementia according to DSM-IV-TR criteria. Assessments included: sociodemographic questionnaire, EQ-5D index for health-related QoL, Visual Analogue Scale (EQ-VAS) for health status, number of chronic medical conditions (comorbidity), Barthel Index for functional independence, and Short Portable Mental Status Questionnaire.

Results: The group with dementia presented significantly worse QoL, health, and functional status than people without dementia. The most prevalent chronic medical conditions were musculoskeletal (72.3%), followed by genito-urinary disorders (60.2%). Controlling for age and sex, people with dementia and higher comorbidity exhibited lower EQ-VAS scores; however, no significant difference was found for the EQ-5D index. The health conditions that contributed the most to the EQ-VAS differences between the dementia and non-dementia groups were sight, oral, and genito-urinary problems.

Conclusions: When compared to older adults with no dementia, people with dementia and high comorbidity reported the most compromised health status, especially in those with sight, oral, and genito-urinary problems. These differences should be taken into consideration when selecting strategies to maintain and improve the health status of older adults in residential care settings.

Keywords

comorbidityhealth statusquality of lifeolder adultsdementia
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 7 , July 2013 , pp. 1077 - 1084
Copyright
Copyright © International Psychogeriatric Association 2013 

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