Assessing quality of life on Taiwanese patients with Alzheimer's disease

Objective: To measure differences in patients with Alzheimer's disease (AD) and caregiver assessments of the patients' quality of life (QOL) and to identify the patient characteristics, caregiver characteristics, or patient-caregiver interactions responsible for these differences. Methods: We recruited consecutive patients with AD and their caregivers from an outpatient clinic of a teaching hospital in Taiwan. Each patient and caregiver rated the patient's quality of life (QOL) using the Quality of Life-Alzheimer's Disease (QOL-AD) questionnaire. Additional measures included the Mini-Mental State Examination (MMSE), Clinical Dementia Rating, Blessed Activities of Daily Living assessment, and the Neuropsychiatric Inventory. Only patients with MMSE score ≧ 10 were enrolled. Results: Of the 94 patients enrolled, 81 with reliable caregivers were included. The internal consistency was good within both patient and caregiver reports (α = 0.83 and 0.79, respectively). The agreement between patient and caregiver QOL-AD reports was moderate (absolute intraclass correlation coefficient: 0.41). Regression analyses indicated that caregiver distress was the most consistent predictor of QOL rating discrepancy between the patient and caregiver, and patient depressive disorder was the most significant predictor of QOL. Conclusions: Similar to previous studies in different ethnic groups, the QOL perception differed between the Taiwanese patients with AD and their caregivers. Medical professionals should be cautious if they try to use a caregiver-reported QOL to replace the patient-reported QOL among AD patients of mild to moderate severity.