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Neuropsychiatric Symptoms and Quality of Life in Alzheimer Disease

Received October 9, 2003; revised March 31, June 17, 2004; accepted June 21, 2004. From the Dept. of Psychiatry (I-SS), Chonnam National University Medical School, Kwangju, Republic of Korea.; Dept. of Neurology (MC, DM, JLC), Dept. of Psychiatry and Biobehavioral Sciences (LF, JLC), David Geffen School of Medicine at UCLA, Los Angeles, CA. Send correspondence and reprint requests to Jeffrey L. Cummings, M.D., Reed Neurological Research Center 2-238, UCLA Alzheimer’s Disease Center, 710 Westwood Plaza, Los Angeles, CA 90095-1769. e-mail: cummings{at}ucla.edu
© 2005 American Association for Geriatric Psychiatry

Objective: Authors examined the impact of neuropsychiatric symptoms in Alzheimer disease (AD) patients’ and caregivers’ quality of life (QOL) and assessed the relationship of caregiver distress to neuropsychiatric symptoms and caregiver QOL. Methods: Sixty-two patients with probable or possible AD and their caregivers participated. Neuropsychiatric symptoms of patients were assessed with the Neuropsychiatric Inventory (NPI). QOL of both patients and caregivers was assessed using the QOL–Alzheimer’s Disease (QOL–AD) scale. Each patient and caregiver completed patient QOL ratings; caregivers also completed caregiver QOL assessments. Results: Caregiver QOL–AD was negatively correlated with agitation/aggression, anxiety, disinhibition, irritability/lability, and total NPI score. Patient QOL on both patient and caregiver ratings was negatively correlated with depression. Patient-reported QOL–AD ratings at different levels of cognitive functioning were not correlated with caregiver-reported ratings. The lack of relationship between patient and caregiver assessments of patient QOL was evident in both mildly and moderately affected patients. Caregiver QOL was negatively correlated with distress related to agitation/aggression, disinhibition, irritability/lability, and total NPI distress. Conclusion: Neuropsychiatric symptoms of AD patients adversely affect both patient and caregiver QOL. These results suggest that identifying and treating neuropsychiatric symptoms in AD may improve both patient and caregiver QOL.

Key Words: Quality of Life • Alzheimer Disease • Caregiver Factors

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