The Relationship between Activity and Participation and the Quality of Life of People with Dementia in Care Facilities

Abstract

Background: Quality of life (QOL) for people with dementia is a concept that includes not only functional disability and ability to perform activities of daily living (ADL) but also engagement in activity/participation. Previous studies have not included all variables related to functional disability, ability to perform ADL, and activity/participation in their analyses, and it is unclear the extent to which these factors are associated with QOL. Thus, this study aimed to identify factors associated with the QOL of institutionalized people with dementia by including functional factors and activity/participation reported in previous studies as variables.

Methods: This was a cross-sectional study. Multiple regression analysis with the forward-backward stepwise selection method was performed to analyze factors associated with QOL of institutionalized people with dementia, including the number of items of activity/participation, cognitive function, ADL independence, behavioral and psychological symptoms of dementia (BPSD), pain, and overall muscle strength, all of which have been reported to be associated with QOL.

Results: The number of items of activity/participation and BPSD were significantly associated with subjective QOL, wheras BPSD, the number of items of activity/participation, and ADL independence were significantly associated with objective QOL.

Conclusion: Activity/participation may be one of the significant factors associated with QOL of institutionalized people with dementia. Additionally, BPSD and ADL independence are important factors associated with QOL. A comprehensive combination of approaches that increase activity/participation, reduce BPSD, and improve ADL independence has the potential to improve the QOL of institutionalized people with dementia.