Objectives. Quality of life (QOL) assessment in dementia has been drawing great attention in research and also in health care policies and is being included as one of the efficacy variables in many recent therapeutic intervention studies. The goal of the present study is to present the cross-cultural adaptation and the internal validity of the Brazilian version of the QOL-AD proposed by Logsdon et al. (1999).
Design. The scale was translated and adapted to Portuguese according to a rigorous method, which included translation and back-translation by two independent investigators, followed by a semantic, idiomatic, conceptual and cultural equivalence assessment performed by an expert committee. The scale is composed by 13 items semi-quantitatively evaluated. Higher scores indicate better QOL. The scale allows the composition of QOL indicators through the patients’ report and the caregiver/family’s report about the patient’s QOL and the caregiver/family member QOL.
Material and Methods. The final version was administered to a sample of 40 patients with probable AD, with mild (n=20) and moderate (n=20) dementia, according to the NINCDS-ADRDA and DSM-III-R criteria, respectively, and to their caregivers/family members. The scale stability was evaluated through test-retest, intra (n=17) and inter-examiner (n=13) reliability, after a two-week interval. The Pearson’s correlation coefficient and Kappa’s statistical tests were used in the test-retest analysis. In the internal consistency analysis of the adapted instrument the Cronbach’s alpha coefficient was used, correlating each of the items with the total score and each of the items with the item “Life as a whole”.
Results. The scale proved to be easy and fast to administer (average time of six minutes for patients and five minutes for the version of the caregiver/family). The stability of the instrument was excellent, both in the intra and in the inter-examiner reliability. The correlation coefficients for the intra-examiner assessment were 0.87/0.95/0.95 (p<0.001)) for the patient’s, family’s and caregiver’s versions, respectively. The correlation coefficients for the inter-examiner assessment were 0.76/0.96/0.93 (p<0.001) for the patient’s, family’s and caregiver’s versions, respectively. The reliability was excellent for both the patient's and the relative’s versions in relation to the patient's QOL (alpha=0.81 and 0.85, respectively) and in relation to the caregiver’s QOL (alpha=0.84). The average score for the mild AD patients was 34.95 and 35.90 for the moderate cases. The average score for the caregivers/family members of patients with mild AD was 36.95 and for caregivers of patients with moderate AD, 33.85. Conclusion. The Brazilian version of the QOL-AD proved to be easy and brief to administer, presenting excellent stability and reliability.
Key words – Quality of life, Alzheimer’s disease, caregivers and cross-cultural adaptation.
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