Awareness of Mild Cognitive Impairment and Mild Alzheimer's Disease Dementia Diagnoses Associated With Lower Self-Ratings of Quality of Life in Older Adults

J Gerontol B Psychol Sci Soc Sci. 2017 Oct 1;72(6):974-985. doi: 10.1093/geronb/gbx100.

Abstract

Objective: This study examined how awareness of diagnostic label impacted self-reported quality of life (QOL) in persons with varying degrees of cognitive impairment.

Method: Older adults (n = 259) with normal cognition, Mild Cognitive Impairment (MCI), or mild Alzheimer's disease dementia (AD) completed tests of cognition and self-report questionnaires that assessed diagnosis awareness and multiple domains of QOL: cognitive problems, activities of daily living, physical functioning, mental wellbeing, and perceptions of one's daily life. We compared measures of QOL by cognitive performance, diagnosis awareness, and diagnostic group.

Results: Persons with MCI or AD who were aware of their diagnosis reported lower average satisfaction with daily life (QOL-AD), basic functioning (BADL Scale), and physical wellbeing (SF-12 PCS), and more difficulties in daily life (DEM-QOL) than those who were unaware (all p ≤ .007). Controlling for gender, those expecting their condition to worsen over time reported greater depression (GDS), higher stress (PSS), lower quality of daily life (QOL-AD, DEM-QOL), and more cognitive difficulties (CDS) compared to others (all p < .05).

Discussion: Persons aware of their diagnostic label-either MCI or AD-and its prognosis report lower QOL than those unaware of these facts about themselves. These relationships are independent of the severity of cognitive impairment.

Keywords: Cognitive decline; Cognitive impairment; Cognitive performance; Diagnosis awareness; Self-reported symptoms.

MeSH terms

  • Activities of Daily Living / classification
  • Activities of Daily Living / psychology
  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / diagnosis
  • Alzheimer Disease / psychology*
  • Awareness*
  • Cognitive Dysfunction / diagnosis
  • Cognitive Dysfunction / psychology*
  • Cohort Studies
  • Depressive Disorder / diagnosis
  • Depressive Disorder / psychology
  • Female
  • Humans
  • Illness Behavior
  • Interview, Psychological
  • Longitudinal Studies
  • Male
  • Neuropsychological Tests / statistics & numerical data
  • Psychometrics
  • Quality of Life / psychology*
  • Risk Factors
  • Stress, Psychological / diagnosis
  • Stress, Psychological / psychology
  • Surveys and Questionnaires