Mild cognitive impairment and quality of life in the oldest old: a closer look

Felix S Hussenoeder, Ines Conrad, Susanne Roehr, Angela Fuchs, Michael Pentzek, Horst Bickel, Edelgard Moesch, Siegfried Weyerer, Jochen Werle, Birgitt Wiese, Silke Mamone, Christian Brettschneider, Kathrin Heser, Luca Kleineidam, Hanna Kaduszkiewicz, Marion Eisele, Wolfgang Maier, Michael Wagner, Martin Scherer, Hans-Helmut König, Steffi G Riedel-Heller, Felix S Hussenoeder, Ines Conrad, Susanne Roehr, Angela Fuchs, Michael Pentzek, Horst Bickel, Edelgard Moesch, Siegfried Weyerer, Jochen Werle, Birgitt Wiese, Silke Mamone, Christian Brettschneider, Kathrin Heser, Luca Kleineidam, Hanna Kaduszkiewicz, Marion Eisele, Wolfgang Maier, Michael Wagner, Martin Scherer, Hans-Helmut König, Steffi G Riedel-Heller

Abstract

Purpose: Mild cognitive impairment (MCI) is a widespread phenomenon, especially affecting older individuals. We will analyze in how far MCI affects different facets of quality of life (QOL).

Methods: We used a sample of 903 participants (110 with MCI) from the fifth follow-up of the German Study on Ageing, Cognition, and Dementia in Primary Care Patients (AgeCoDe), a prospective longitudinal study, to analyze the effects of MCI on different facets of the WHOQOL-OLD. We controlled for age, gender, marital status, education, living situation, daily living skills, and the ability to walk, see, and hear.

Results: Univariate analyses showed that individuals with MCI exhibited lower QOL with regard to the facets autonomy; past, present, and future activities; social participation; and intimacy, but less fears related to death and dying. No significant difference was shown with regard to the facet sensory abilities. In multivariate analyses controlling for age, gender, marital status, education, living situation, daily living skills, and the ability to walk, see and hear, MCI-status was significantly associated with QOL in the facet autonomy.

Conclusion: Effects of MCI go beyond cognition and significantly impact the lives of those affected. Further research and practice will benefit from utilizing specific facets of QOL rather than a total score.

Keywords: MCI; Older people; Quality of life; WHOQOL-OLD.

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Process of sample selection

References

    1. Barberger-Gateau P, Commenges D, Gagnon M, Letenneur L, Sauvel C, Dartigues JF. Instrumental activities of daily living as a screening tool for cognitive impairment and dementia in elderly community dwellers. Journal of the American Geriatrics Society. 1992;40(11):1129–1134. doi: 10.1111/j.1532-5415.1992.tb01802.x.
    1. Campbell NL, Unverzagt F, LaMantia MA, Khan BA, Boustani MA. Risk factors for the progression of mild cognitive impairment to dementia. Clinics in Geriatric Medicine. 2013;29(4):873–893. doi: 10.1016/j.cger.2013.07.009.
    1. Clement-Carbonell V, Ferrer-Cascales R, Ruiz-Robledillo N, Rubio-Aparicio M, Portilla-Tamarit I, Cabañero-Martínez MJ. Differences in autonomy and health-related quality of life between resilient and non-resilient individuals with mild cognitive impairment International. Journal of Environmental Research and Public Health. 2019 doi: 10.3390/ijerph16132317.
    1. Conrad I, Matschinger H, Kilian R, Riedel-Heller SG. WHOQOL-OLD und WHOQOL-BREF : Manual : Handbuch für die deutschsprachigen Versionen der WHO-Instrumente zur Erfassung der Lebensqualität im Alter. 1. Göttingen: Hogrefe; 2016.
    1. Conrad I, Matschinger H, Riedel-Heller S, von Gottberg C, Kilian R. The psychometric properties of the German version of the WHOQOL-OLD in the German population aged 60 and older. Health and Quality of Life Outcomes. 2014;12:105. doi: 10.1186/s12955-014-0105-4.
    1. Daig I, Lehmann A. Verfahren zur Messung der Lebensqualität. Zeitschrift für medizinische Psychologie. 2007;16:5–23.
    1. Dalton DS, Cruickshanks KJ, Klein BEK, Klein R, Wiley TL, Nondahl DM. The impact of hearing loss on quality of life in older adults. The Gerontologist. 2003;43(5):661–668. doi: 10.1093/geront/43.5.661.
    1. Froot KA. Consistent covariance matrix estimation with cross-sectional dependence and heteroskedasticity in financial data. The Journal of Financial and Quantitative Analysis. 1989;24(3):333. doi: 10.2307/2330815.
    1. Fusco O, Ferrini A, Santoro M, Lo Monaco MR, Gambassi G, Cesari M. Physical function and perceived quality of life in older persons. Aging Clinical and Experimental Research. 2012;24(1):68–73. doi: 10.1007/BF03325356.
    1. Hu C, Yu D, Sun X, Zhang M, Wang L, Qin H. The prevalence and progression of mild cognitive impairment among clinic and community populations: A systematic review and meta-analysis. International Psychogeriatrics. 2017;29(10):1595–1608. doi: 10.1017/S1041610217000473.
    1. Hughes TF, Flatt JD, Fu B, Chang C-CH, Ganguli M. Engagement in social activities and progression from mild to severe cognitive impairment: The MYHAT study. International Psychogeriatrics. 2013;25(4):587–595. doi: 10.1017/S1041610212002086.
    1. Hussenoeder FS, Riedel-Heller SG. Primary prevention of dementia: From modifiable risk factors to a public brain health agenda? Social Psychiatry and Psychiatric Epidemiology. 2018;53(12):1289–1301. doi: 10.1007/s00127-018-1598-7.
    1. Joensen LE, Almdal TP, Willaing I. Type 1 diabetes and living without a partner: Psychological and social aspects, self-management behaviour, and glycaemic control. Diabetes Research and Clinical Practice. 2013;101(3):278–285. doi: 10.1016/j.diabres.2013.07.001.
    1. Kameyama K, Tsutou A, Fujino H. The relationship between health-related quality of life and higher-level functional capacity in elderly women with mild cognitive impairment. Journal of Physical Therapy Science. 2016;28(4):1312–1317. doi: 10.1589/jpts.28.1312.
    1. Lapid MI, Rummans TA, Boeve BF, McCormick JK, Pankratz VS, Cha RH, et al. What is the quality of life in the oldest old? International Psychogeriatrics. 2011;23(6):1003–1010. doi: 10.1017/S1041610210002462.
    1. Lips P, van Schoor NM. Quality of life in patients with osteoporosis. Osteoporosis International. 2005;16(5):447–455. doi: 10.1007/s00198-004-1762-7.
    1. Liu H-Y, Tsai W-C, Chiu M-J, Tang L-Y, Lee H-J, Shyu Y-IL. Mild cognitive impairment in combination with comorbid diabetes mellitus and hypertension is negatively associated with health-related quality of life among older persons in Taiwan. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation. 2019;28(5):1281–1291. doi: 10.1007/s11136-019-02101-3.
    1. Luck T, Riedel-Heller SG, Kaduszkiewicz H, Bickel H, Jessen F, Pentzek M, et al. Mild cognitive impairment in general practice: Age-specific prevalence and correlate results from the German study on ageing, cognition and dementia in primary care patients (AgeCoDe) Dementia and Geriatric Cognitive Disorders. 2007;24(4):307–316. doi: 10.1159/000108099.
    1. Missotten P, Squelard G, Ylieff M, Di Notte D, Paquay L, de Lepeleire J, et al. Quality of life in older Belgian people: Comparison between people with dementia, mild cognitive impairment, and controls. International Journal of Geriatric Psychiatry. 2008;23(11):1103–1109. doi: 10.1002/gps.1981.
    1. Muangpaisan W, Assantachai P, Intalapaporn S, Pisansalakij D. Quality of life of the community-based patients with mild cognitive impairment. Geriatrics & Gerontology International. 2008;8(2):80–85. doi: 10.1111/j.1447-0594.2008.00452.x.
    1. Parker PA, Baile WF, Moor CD, Cohen L. Psychosocial and demographic predictors of quality of life in a large sample of cancer patients. Psycho-Oncology. 2003;12(2):183–193. doi: 10.1002/pon.635.
    1. Pusswald G, Moser D, Pflüger M, Gleiss A, Auff E, Stögmann E, et al. The impact of depressive symptoms on health-related quality of life in patients with subjective cognitive decline, mild cognitive impairment, and Alzheimer's disease. International Psychogeriatrics. 2016;28(12):2045–2054. doi: 10.1017/S1041610216001289.
    1. Ready RE, Ott BR, Grace J. Patient versus informant perspectives of quality of life in mild cognitive impairment and Alzheimer's disease. International Journal of Geriatric Psychiatry. 2004;19(3):256–265. doi: 10.1002/gps.1075.
    1. Roberts RO, Knopman DS, Mielke MM, Cha RH, Pankratz VS, Christianson TJH, et al. Higher risk of progression to dementia in mild cognitive impairment cases who revert to normal. Neurology. 2014;82(4):317–325. doi: 10.1212/WNL.0000000000000055.
    1. Steinbüchel N, Lischetzke V, Gurny M, Winkler I. Erfassung gesundheitsbezogener Lebensqualität älterer Menschen mit dem WHOQOL-BREF-Fragebogen. Zeitschrift für Medizinische Psychologie. 2005;14(1):13–23.
    1. Stelmack J. Quality of life of low-vision patients and outcomes of low-vision rehabilitation. Optometry and Vision Science: Official Publication of the American Academy of Optometry. 2001;78(5):335–342. doi: 10.1097/00006324-200105000-00017.
    1. Stites SD, Karlawish J, Harkins K, Rubright JD, Wolk D. Awareness of mild cognitive impairment and mild alzheimer's disease dementia diagnoses associated with lower self-ratings of quality of life in older adults. The Journals Of Gerontology. Series B, Psychological Sciences and Social Sciences. 2017;72(6):974–985. doi: 10.1093/geronb/gbx100.
    1. Teng, E., Tassniyom, K., & Lu, P. (2012). Reduced quality of life ratings in mild cognitive impairment: Analyses of subject and informant responses (P04.208). Neurology, 78(Meeting Abstracts 1), P04.208–P04.208.
    1. Teng E, Tassniyom K, Lu PH. Reduced quality-of-life ratings in mild cognitive impairment: Analyses of subject and informant responses. The American Journal of Geriatric Psychiatry: Official Journal of the American Association for Geriatric Psychiatry. 2012;20(12):1016–1025. doi: 10.1097/JGP.0b013e31826ce640.
    1. Undén A-L, Elofsson S, Andréasson A, Hillered E, Eriksson I, Brismar K. Gender differences in self-rated health, quality of life, quality of care, and metabolic control in patients with diabetes. Gender Medicine. 2008;5(2):162–180. doi: 10.1016/j.genm.2008.05.003.
    1. Weiss EM, Papousek I, Fink A, Matt T, Marksteiner J, Deisenhammer EA. Lebensqualität bei älteren Personen mit unterschiedlichem Schweregrad von kognitiver Beeinträchtigung. Neuropsychiatrie: Klinik, Diagnostik, Therapie und Rehabilitation: Organ der Gesellschaft Osterreichischer Nervenarzte und Psychiater. 2012;26(2):72–77. doi: 10.1007/s40211-012-0016-8.
    1. Winblad B, Palmer K, Kivipelto M, Jelic V, Fratiglioni L, Wahlund L-O, et al. Mild cognitive impairment–beyond controversies, towards a consensus: Report of the International Working Group on Mild Cognitive Impairment. Journal of Internal Medicine. 2004;256(3):240–246. doi: 10.1111/j.1365-2796.2004.01380.x.
    1. World Medical Association World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. Journal of Postgraduate Medicine. 2002;48(3):206–208.
    1. Xu W, Wang H-X, Caracciolo B, Winblad B, Bäckman L, Qiu C, et al. Accelerated progression from mild cognitive impairment to dementia in people with diabetes. Alzheimer's & Dementia. 2010;6(4):S110–S111. doi: 10.1016/j.jalz.2010.05.342.
    1. Zaudig M, Hiller W. SIDAM-Handbuch : Strukturiertes Interview für die Diagnose einer Demenz vom Alzheimer Typ, Multiinfarkt- (oder vaskulären) Demenz und Demenzen anderer Ätiologie nach DSM-III-R, DSM-IV und ICD-10. Bern: Huber; 1996.

Source: PubMed

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