Health and Quality of Life Outcomes

Over the past 10 years, several instruments developed specifically for the assessment of Quality of Life (QOL) in dementia have been introduced. The goal of the current review is to present, compare, and critique existing QOL measures for dementia populations to assist investigators and clinicians in selecting the optimal inventory for their specific needs. Nine measures are reviewed with a focus on conceptualizations of QOL, psychometric data, targeted patient population, and administration and scoring procedures. Critical discussion and comparison of the instruments is presented after the scales are described individually. Differences in definitions of QOL, assessment procedures, and methods that were used to establish the validity of instruments are highlighted. An important direction for future research on QOL scales for dementia is to establish their responsiveness to change over time. It will also be important to identify factors that affect reports of QOL, determine the how perceived QOL affects decisions regarding the care of dementia patients, and evaluate interventions to increase patient QOL. Introduction Quality of Life measures for dementia Over the past 10 years, experts in the field of dementia have increasingly turned their attention to consideration of patient Quality of Life (QOL). The importance of measuring QOL outcomes in clinical trials and for the clinical management of dementia was debated and discussed among leaders in dementia research and treatment, the pharmaceutical industry, and government agencies [1,2]. Efforts to define, quantify, and systematically measure QOL in dementia resulted in the development of several new measures. These measures vary widely across several important domains but a unifying theme is the influence that Lawton's model of QOL in dementia [3–5] had on conceptualization of QOL. This paper will review existing measures of QOL developed specifically for dementia populations. Conceptualizations, psychometric data, and administration and scoring procedures of the measures will be presented. After the instruments are individually described and reviewed, they will be compared and critiqued. Discussion will focus on several critical dimensions that vary between QOL instruments. For example, some authors employ definitions of QOL that include a broad range of signs and symptoms that impact daily life, such as cognitive functioning, performance of activities of daily living (ADLs), and social and psychological factors, whereas other investigators designed scales to be much more narrow in focus. Instruments also differ as to the type and severity of dementia populations that were used in validation and reliability studies, and whether or not patients themselves or a proxy responds to items on the inventory. Published: 23 April 2003 Health and Quality of Life Outcomes 2003, 1:11 Received: 20 March 2003 Accepted: 23 April 2003 This article is available from: http://www.hqlo. com/content/1/1/11 © 2003 Ready and Ott; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.