Electronic versions

DOI

  • Clive Ballard
    King's College London
  • Martin Orrell
    University of Nottingham
  • Yongzhong Sun
  • Esme Moniz-Cook
    University of Hull
  • Jane Stafford
    King's College London
  • Rhiannon Whitaker
    Whitaker Research Ltd., Bangor
  • Robert Woods
  • Anne Corbett
    King's College London
  • Sube Banerjee
    Brighton and Sussex Medical School
  • Ingelin Testad
    King's College London
  • Lucy Garrod
    Oxford Health NHS Foundation Trust
  • Zunera Khan
    King's College London
  • B. Woodward-Carlton
    Alzheimer's Society London
  • Jennifer Wenborn
    University College London
  • Jane Fossey
    Oxford Health NHS Foundation Trust
Background

Very few interventional studies have directly examined the impact of treatment approaches on health-related quality of life (HRQL) in people with dementia. This is of particular importance in therapies to address behavioural symptoms, where HRQL is often severely affected.
Methods

Analysis within the WHELD cluster randomised factorial study in 16 UK care homes examining the impact of person-centred care in combination with antipsychotic review, social interaction and exercise interventions. This study analysed impact on HRQL through the DEMQOL-Proxy.
Results

Data on HRQL were available for 187 participants. People receiving antipsychotic review showed a significant worsening in two DEMQOL-Proxy domains (negative emotion: p = 0.02; appearance: p = 0.04). A best-case scenario analysis showed significant worsening for total DEMQOL-Proxy score. Social interaction intervention resulted in a significant benefit to HRQL (p = 0.04). There was no deterioration in HRQL in groups receiving both antipsychotic review and social interaction (p = 0.62).
Conclusions

This demonstrates an important detrimental impact of discontinuation of antipsychotics in dementia on HRQL, highlighting the need for careful review of best practice guidelines regarding antipsychotic use and emphasising the importance of providing evidence-based non-pharmacological interventions in conjunction with antipsychotic review

Keywords

  • Dementia, Care homes, Antipsychotic review, Psychosocial, Quality of Life
Original languageEnglish
Pages (from-to)1094-1103
JournalInternational Journal of Geriatric Psychiatry
Volume32
Issue number10
Early online date19 Sep 2016
DOIs
Publication statusPublished - Oct 2017
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