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Quality of life in nursing home residents with advanced dementia


Cordner, Zachary, Blass, David M., Rabins, Peter V., Black, Betty S.


Journal Of The American Geriatrics Society, Volume: 58, No.: 12, Pages.: 2394-2400

Year of Publication



Objectives: To examine quality of life (QOL) in nursing home (NH) residents with advanced dementia and identify correlates of QOL near the end of life.; Design: Cross-sectional data derived from NH records, interviews with residents’ surrogate decision-makers, QOL ratings by NH caregivers, and assessment of residents’ cognitive function.; Setting: Three NHs in Maryland.; Participants: A cohort of NH residents with dementia (n=119) who were receiving hospice or palliative care or met hospice criteria for dementia and their surrogates.; Measurements: QOL based on the proxy-rated Alzheimer’ Disease-Related Quality of Life (ADRQL) scale administered to NH staff and validated against a single-item surrogate-rated measure of QOL, the Severe Impairment Rating Scale, to measure cognitive function and dichotomous indicators of neuropsychiatric symptoms (behavior problems, mood disorders, psychosis, delusions).; Results: Total ADRQL scores, ranging from 12.4 to 95.1 out of 100, were normally distributed and positively correlated (P<.001) with surrogate-rated QOL. Multiple regression analysis of ADRQL scores showed that residents with higher cognitive function (P<.001, 95% confidence interval (CI)=0.97-1.65) and those receiving pain medication (P=.006, 95% CI=3.30-19.59) had higher QOL, whereas residents with behavior problems (P=.01, 95% CI=-11.60 to -1.30) had lower QOL.; Conclusion: The ADRQL is a valid indicator of QOL in NH residents with advanced dementia. QOL in this population may be improved near the end of life using appropriate assessment and treatment of pain and effective management of behavior problems.; © 2010, Copyright the Authors. Journal compilation © 2010, The American Geriatrics Society.

Bibtex Citation

@article{Cordner_2010, doi = {10.1111/j.1532-5415.2010.03170.x}, url = {}, year = 2010, month = {nov}, publisher = {Wiley-Blackwell}, volume = {58}, number = {12}, pages = {2394--2400}, author = {Zachary Cordner and David M. Blass and Peter V. Rabins and Betty S. Black}, title = {Quality of Life in Nursing Home Residents with Advanced Dementia}, journal = {Journal of the American Geriatrics Society} }


aged, aged, 80 and over, cohort studies, data interpretation statistical, dementia, diagnosis, female, homes for the aged, hospice care, humans, male, management, maryland, medication, neuropsychological tests, nursing homes, pain, palliative care, proxy, psychiatric status rating scales, psychology, quality of life, severity of illness index, unspecified

Countries of Study


Types of Study

Cohort Study

Type of Outcomes

Cognition, Quality of Life of Person With Dementia


Nursing Homes

Type of Interventions

End of Life Care, Pharmaceutical Interventions

Pharmaceutical Interventions


End of Life Care

Palliative Care