Validation of the Saint Louis University Quality of Life Questionnaire in Older Adults with Alzheimer's Disease

Background/Objectives Alzheimer's disease (AD) is the most common cause of dementia and negatively impacts individuals' quality of life (QOL). One essential component of disease management in older adults with AD is the maintenance and improvement of QOL. The QOL-AD is a tool that can be administered to evaluate QOL in AD patients, but it can take too long to administer in a patient visit. The purpose of this study was to investigate the validity of a more brief, 6-item QOL questionnaire, LIFEAD, comparing it to the QOL-AD in older adults with mild to moderate cognitive dysfunction. Design Prospective validation study. Setting Participants were patients presenting to internal medicine and geriatrics outpatient clinics and a nursing home. Participants 285 adults 65 and older with mild to moderate cognitive impairment. Measurements: QOL was assessed using LIFEAD and the QOL-AD. Demographic data were collected and level of depression was determined through a demographic questionnaire and the PHQ-8, respectively. Results QOL-AD mean item scores ranged from 2.27-3.32 with an average scale total of 36.28 +/- 6.48. LIFEAD mean item scores ranged from 2.26-2.51 with an average scale total of 14.28 +/- 2.87. A majority (68%) of patients rated all items on LIFEAD as either average or good. The correlation between LIFEAD and the QOL-AD was 0.71 (p<0.001). Both LIFEAD and the QOL-AD showed strong internal consistency with a Cronbach's alpha of 0.82 and 0.87, respectively. Conclusion This study validated LIFEAD and exhibited LIFEAD can assess QOL in older adults with mild to moderate cognitive dysfunction in the clinic or nursing home. LIFEAD is a short, practical questionnaire and is easily administered in approximately 1 minute. Further research on LIFEAD could be done with larger samples, in different clinical populations, and including persons of other ethnic backgrounds.