Impact of dementia on the trajectories of quality of life in older adults

Aim: To assess the quality of life (QoL) and the factors affecting QoL in patients with dementia (PwD) and without dementia, and if dignity belongs to these factors. To define predictors of QoL change over 2 years. Participants and Methods: The set consisted of 294 PwD (37.1% males; age 79.6 +/- 7.5 years; MMSE 22.7 +/- 1.7) and 329 patients without dementia (30.1% males; age 72.7 +/- 7.0 years; MMSE 29.2 +/- 1.3). Prospective longitudinal design (three measurements over 2 years) was used. The questionnaire set included Czech versions of standardized tools for QoL, depression, dignity, attitudes towards aging, physical fi tness, self-sufficiency, pain, and a set of socio-demographic data. Paired t-test, chi-square test, Shapiro-Wilk test, Durbin-Watson test, and multivariate linear regression were used for the statistical analysis. Results: Depression influenced QoL in both groups of respondents. PwD had a higher QoL also associated with a more positive assessment of dignity, better self-sufficiency (all P < 0.001), and a more positive attitude towards aging (P = 0.011). QoL got worse during 2 years only in PwD (P < 0.001). Predictors of deterioration in QoL were male gender (P = 0.021), loneliness >= 8 h per day (P = 0.001), partner-free life (P < 0.001), lower frequency of visits (P = 0.039), and higher QoL at baseline (P < 0.001). Conclusion: Dignity belongs to significant factors of QoL in PwD. Social relationships and social engagement are essential for maintaining the QoL long-term.