Research Paper Volume 12, Issue 11 pp 10754—10771
How non-drug interventions affect the quality of life of patients suffering from progressive cognitive decline and their main caregiver
- 1 Leenaards Memory Center, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- 2 Service of Old Age Psychiatry, Department of Psychiatry (SUPAA), Lausanne University Hospital (CHUV), Lausanne, Switzerland
- 3 Vaud Association for Help and Home Care (AVASAD, Association Vaudoise d’Aide et de Soins à Domicile), Lausanne, Switzerland
- 4 Memory Center of the Neuropsychology and Aphasiology Unit, Fribourg Hospital (HFR), Fribourg, Switzerland
- 5 Nord Broye Memory Center, Montagny-près-Yverdon, Switzerland
- 6 East Memory Center of Canton Vaud, Rennaz, Switzerland
- 7 La Côte Memory Center, Rolle, Switzerland
- 8 Memory Center of the Geneva University Hospitals (HUG), Geneva, Switzerland
- 9 CU ROMENS, Switzerland
- 10 Valais Hospital Memory Center, Sierre, Switzerland
- 11 Service of Geriatric Medicine and Geriatric Rehabilitation, Lausanne University Hospital (CHUV), Lausanne, Switzerland
Received: December 17, 2019 Accepted: April 27, 2020 Published: June 9, 2020
https://doi.org/10.18632/aging.103291How to Cite
Copyright © 2020 Leidi-Maimone et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Background: In the absence of cure for age-related neurodegenerative diseases, non-drug interventions (NDIs) represent useful options. Quality of life (QOL) is a multidimensional concept progressively affected by cognitive decline. How single or multiple NDIs impact QOL is unknown.
Results: We found no significant effect of multiple over single NDI on QOL. Socio-demographic variables influenced patients’ (age, gender, caregivers’ occupational status, management of patients’ financial affairs) and caregivers’ (gender, occupational status, patients’ severity of cognitive decline) QOL. When dyads interrupted interventions after 6 months, their QOL was lower and caregivers’ anxiety, depression and physical symptoms were higher at the end of the study.
Conclusions: While the type and number of interventions do not appear to be critical, the continuity of adapted interventions in the long-term might be important for maintaining QOL of patients and caregivers.
Methods: This is a multicenter (7 Swiss Memory Clinics), quasi-experimental, one-year follow-up study including 148 subjects (mild cognitive impairment or mild dementia patients and their caregivers). Primary outcome was the effect of multiple vs single NDIs on QOL. Secondary outcome included NDIs effect on patients’ cognitive impairment and functional autonomy, caregivers’ burden, severity of patients’ neuropsychiatric symptoms and dyads’ anxiety and depression.
Abbreviations
AD: Alzheimer’s disease; BPSD: Behavioral and psychological symptoms of dementia; CDR: Clinical dementia rate; CIRS-G: Modified Cumulative Illness Rating Scale for Geriatrics; DAD-6: Disability Assessment for Dementia; FTD: Fronto-temporal dementia; HAD: Hospital Anxiety and Depression; LBD: Lewy-body dementia; MCI: Mild cognitive impairment; MMSE: Mini mental state evaluation; MoCA: Montreal cognitive assessment; NDI: Non-drug intervention; NPIQ: Neuropsychiatric inventory questionnaire; PHQ-15: Patient Health Questionnaire; PPA: Primary progressive aphasia; QOL: Quality of life; QPC: Questionnaire of Cognitive Complaints; RFS: Raw facet score; RQ: Relationship Questionnaire; SEM: Standard error of the mean; TFS: Transformed facet score; WHO: World Health Organization.