Self-reported quality of life ratings of people with dementia: the role of attitudes to aging.

Background: Attitudes to aging have not previously been assessed in people with dementia. The possession of positive life attitudes into older age has the potential to induce resilience to health changes and may explain the discrepancy between self-reported and proxy ratings of quality of life (QoL). The aim of this study was to explore the attitudes of people with dementia to determine the main factors that predict these attitudes and any relationship that exists with self-reported QoL.

Methods: Fifty-six participants with dementia were recruited from a memory clinic setting. The Bath Assessment of Subjective Quality of Life in Dementia, Attitudes to Aging Questionnaire (AAQ), Memory Functioning Scale, Alzheimer's Disease Cooperative Study Activities of Daily Living Inventory, and Mini-Mental State Examination were administered. The AAQ was also completed by 86 community-dwelling older adults without dementia.

Results: Participants with dementia displayed a significantly stronger endorsement of the negative attitude that aging is a time of psychosocial loss than those without dementia. Regression analyses suggest this negative attitude acts as a partial mediator in the relationship between the person's level of insight and self-reported QoL.

Conclusions: Negative attitudes to aging had a direct impact on the self-reported QoL ratings of people with dementia. The view of aging as a time of psychosocial loss was most significant for people with dementia and suggests that negative stereotypes of dementia need to be challenged. In order to promote QoL, care should focus on abilities that the person retains rather than what has been lost.