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A Comprehensive Model of Factors Associated With Subjective Perceptions of “Living Well” With Dementia

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Introduction:

We aimed to better understand what predicts the capability to “live well” with dementia by identifying the relative contribution of life domains associated with the subjective experience of living well.

Methods:

We analyzed data from 1547 individuals with mild-to-moderate dementia in the IDEAL cohort. We generated a “living well” latent factor from measures of quality of life, satisfaction with life, and well-being. We used multivariate modeling to identify variables related to living well measures and structural equation modeling to derive latent variables for 5 life domains and to examine the associations of these domains with living well.

Results:

All 5 domains were individually associated with living well. When modeled together, the psychological characteristics and psychological health domain was the only independent predictor of living well [effect size, 3.55; 95% confidence interval (CI): 2.93-4.17], and effect sizes were smaller for physical fitness and physical health (1.23, 95% CI: −0.10 to 2.58), social capitals, assets and resources (0.67; 95% CI: −0.04 to 1.38), managing everyday life with dementia (0.33; 95% CI: −0.06 to 0.71), and social location (0.08; 95% CI: −2.10 to 2.26).

Discussion:

Psychological resources, and the social, environmental, and physical factors that underpin positive psychological states, are potentially important targets for interventions and initiatives that aim to improve the experience of living with dementia.
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Keywords: Alzheimer; quality of life; satisfaction with life; well-being

Document Type: Research Article

Affiliations: 1: Centre for Research in Ageing and Cognitive Health (REACH), School of Psychology, PenCLAHRC, University of Exeter Medical School, Wellcome Centre for Cultures and Environments of Health, University of Exeter 2: Centre for Research in Ageing and Cognitive Health (REACH), School of Psychology, PenCLAHRC, University of Exeter Medical School 3: Wales Institute for Social and Economic Research, Data and Methods, Cardiff University, Cardiff 4: College of Health and Life Sciences, Brunel University London 5: Innovations in Dementia, Exeter 6: Alzheimer’s Society 7: Department of Care for the Elderly, Betsi Cadwaladr University Health Board, Llandudno, School of Psychology, Bangor University, Bangor 8: RICE (The Research Institute for the Care of Older People), Bath 9: Personal Social Services Research Unit, London School of Economics and Political Science 10: Departments of Psychological Medicine 11: Psychology, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London 12: School of Psychology, University of Sussex, Brighton 13: School of Medical Sciences, University of New South Wales, Sydney, Australia 14: Institute for Health and Society, Newcastle University, Newcastle upon Tyne, UK

Publication date: January 1, 2019

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