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A comprehensive model of factors associated with subjective perceptions of living well with dementia: findings from the IDEAL study
journal contribution
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 MatthewsBackground: 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 DementiaISSN
1552-5260Publisher
ElsevierExternal DOI
Issue
7Volume
14Page range
Supplement P1422-P1423Department affiliated with
- Psychology Publications
Research groups affiliated with
- Dementia Research Group Publications
Full text available
- Yes
Peer reviewed?
- Yes
Legacy Posted Date
2019-01-08First Open Access (FOA) Date
2019-10-22First Compliant Deposit (FCD) Date
2019-01-03Usage metrics
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