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A comprehensive model of factors associated with subjective perceptions of living well with dementia: findings from the IDEAL study

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posted on 2023-06-09, 16:25 authored by Linda Clare, Yu-Tzu Wu, Ian Rees Jones, Christina R Victor, Sharon M Nelis, Anthony Martyr, Catherine Quinn, Rachael Litherland, James Pickett, John Vincent Hindle, Roy W Jones, Martin Richard John Knapp, Michael Kopelman, Robin G Morris, Jennifer Rusted, Jeanette M Thom, Ruth A. Lamont, Catherine Henderson, Isla Rippon, Alexandra Hillman, Fiona Matthews
Background: The concept of ‘living well’ is increasingly used to indicate that it is, or should be, possible for a person living with dementia to experience a subjective sense of ‘comfort, function and contentment with life.’ We used a theoretically-derived conceptual framework to investigate capability to ‘live well’ with dementia through identifying the relative contribution of domains associated with the subjective experience of living well. Methods: We analysed data from 1550 community-dwelling individuals with mild to moderate dementia participating in the baseline wave of the Improving the experience of Dementia and Enhancing Active Life (IDEAL) cohort study. Subjective perceptions of ability to live well were obtained by generating a living well latent factor from responses on the Quality of Life in Alzheimer’s disease (QoL-AD), Satisfaction with Life and WHO-5 Well-being scales. Multivariate modelling and structural equation modelling was used to investigate variables potentially associated with living well. Variables were grouped into five domains, latent variables were constructed representing Social Location, Capitals, Assets and Resources, Psychological Characteristics and Psychological Health, Physical Fitness and Health, and Managing Everyday Life with Dementia, and associations with living well were examined. All models were adjusted for age, sex and dementia sub-type. Results: Considering the domains singly, the Psychological Characteristics and Psychological Health domain was most strongly associated with living well (3.56; 95% CI: 2.25, 4.88), followed by Physical Fitness and Physical Health (1.10, 95% CI: -2.26, 4.47). Effect sizes were smaller for Capitals, Assets and Resources (0.53; 95% CI: -0.66, 1.73), Managing Everyday Life with Dementia (0.34; 95% CI: 0.20, 0.87), and Social Location (-0.12; 95% CI: -5.72, 5.47). Following adjustment for the Psychological Characteristics and Psychological Health domain, other domains did not show independent associations with living well. Conclusions: Psychological resources are central to subjective perceptions of living well and offer important targets for immediate intervention. Availability of social and environmental resources, and physical fitness, underpin these positive psychological states, and also offer potential targets for interventions and initiatives aimed at improving the experience of living with dementia.

History

Publication status

  • Published

File Version

  • Accepted version

Journal

Alzheimer's and Dementia

ISSN

1552-5260

Publisher

Elsevier

Issue

7

Volume

14

Page range

Supplement P1422-P1423

Department affiliated with

  • Psychology Publications

Research groups affiliated with

  • Dementia Research Group Publications

Full text available

  • Yes

Peer reviewed?

  • Yes

Legacy Posted Date

2019-01-08

First Open Access (FOA) Date

2019-10-22

First Compliant Deposit (FCD) Date

2019-01-03

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