Objective: A number of tools for assessing dementia-specific quality of life (QOL) have recently become available. These measures, which have used different methods for obtaining data, must be compared and contrasted to understand their validity and usefulness as QOL measures for people with dementia.
Design: Data were collected at a single point in time in each of eight settings using six measures of dementia-specific QOL. Pearson correlations, hierarchical multiple regression, reliability analyses, factor analyses,and Rasch analyses were conducted to assess the psychometric structure of the instruments and similarity among instruments in terms of measurement of dementia-specific QOL.
Materials and Methods: Researcher observations, i.e., Dementia Care Mapping, Affect Rating Scale; staff proxies (Quality of Life-AD Staff Questionnaire and Alzheimer's Disease Related Quality of Life); and resident interviews (Quality of Life-AD Resident Interview and Dementia Quality of Life instrument) were used to assess the QOL of people with dementia (N=166) in three adult day centers, two assisted living and three special care facilities. Covariates,including measures of cognitive status (MMSE), functional status (ADLs), depression (Cornell Depression Score) and comorbidities (Cumulative Illness Rating Scale) were collected by interview and record review.
Results: Moderate to high correlations were found between the two resident interviews, between two staff proxies, between two observational measures, and between each of two staff measures and DCM. In multivariate analyses, a staff questionnaire, an observational measure and a resident interview each accounted for unique variance in DCM. A staff questionnaire and resident interview were found to be equivalent measures via Rasch analyses.
Conclusion: Depending upon the purpose of the evaluation, each of the three types of measures may be an appropriate method for assessing dementia-specific QOL. A thorough assessment of dementia-specific QOL may require a profile of scores based on multiple measures that include multiple perspectives. Practical considerations regarding choosing the most appropriate tools must be consistent with organizational aims and resources. Identifying reliable and valid methods of assessing the QOL of people with dementia in various settings is crucial, because without them, determinants of desirable outcomes for people with dementia cannot be identified and efforts of administrators, program directors, and frontline staff to improve QOL in care settings will be hampered.
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