Determinants of quality of life in people with dementia in a Sri Lankan setting

Abstract

Background: Dementia has become a public health priority along with population ageing worldwide. Owing to its chronic progressive nature in the absence of a cure, maintaining the best possible quality of life (QOL) have become the desired outcome for people with dementia.
Objectives: To determine the factors associated with good QOL in people with dementia in Sri Lankan setting.
Methods: An unmatched case-control study was conducted to identify the factors associated with ‘good’ QOL. Cases were patients with ‘good’ QOL and controls were those with ‘poor/average’ QOL, accompanied by informal primary caregivers of last six months. They were identified using the validated DEMQOL tool, adhering to strict eligibility criteria, from state hospital tertiary care psychiatric clinics in the Colombo district. There were 64 cases and 208 controls. An interviewer-administered questionnaire was used to assess the associated factors. Bivariate analysis followed by logistic regression modelling determined the associated factors adjusted for confounders using odds ratio (OR) and 95% confidence interval (CI).

Results: After adjusting for confounders, the significant factors associated with ‘good QOL’ were; education up to GCE O/Level and above (OR=4.02; 95% CI=2.97, 12.0), ever employed

(OR=3.21; 95% CI=1.59, 11.06), good social functioning (OR=4.14; 95% CI=3.39, 16.46), mild functional impairment (OR=1.77; 95% CI=1.13, 9.67), little or no caregiver burden (OR=2.96; 95% CI=1.86, 10.94), absence of apathy (OR=2.22; 95% CI=1.27, 12.48) and absence of irritability (OR=2.17; 95% CI=1.72, 10.34).60% of the variance of ‘good’ QOL among patients with dementia was explained by the factors in the final model.
Conclusions: The identified associated factors indicate that QOL improvement programmes should primarily focus on patients’ activities of daily living, social functioning and caregiver burden.