Optimizing Quality of Life With Cognitive Impairment: A Study of End-of-Life Care in Assisted Living.
Laura Arneson, Alexis A Bender, Maggi N Robert and 1 others
PMID 31784190WHAT IT FOUND
In assisted living residents with cognitive impairment near end of life, cognition did not track quality of life.
Psychological distress and fatigue did, and greater daily dependence also correlated.
Key findings
01Quality of life was not significantly associated with cognitive impairment, but it was significantly lower with more psychological distress, more fatigue, and more functional limitation.
02In the final model, psychological distress and fatigue remained significantly associated with quality of life, while cognitive impairment, pain, and functional limitation were removed; race was retained but not significant.
03The retained model variables accounted for 27% of the variation in quality of life.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a cross-sectional study, so it cannot show that distress, fatigue, or functional limitation caused lower quality of life. The analysis included 67 residents, which is small and limited complex analyses. Of 86 enrolled residents, 67 completed assessments, and 9 were excluded because of advanced cognitive impairment, so the most impaired residents are underrepresented. The study used 7 assisted living communities in metropolitan Atlanta, so it may not apply to all assisted living settings. The race association was not statistically significant and was kept in the model as a notable finding, so it should not be treated as established.
Declared interests
The authors reported no conflicts of interest. The study was supported by the National Institutes of Health's National Institute on Aging.
The easy way to misread this
Do not conclude that treating distress or fatigue will improve quality of life. This cross-sectional study of 67 residents measured associations at one time only, so it cannot show cause.