Assessing quality of life in Alzheimer disease research

Quality of life (QOL) is defined both conceptually and operationally in terms of essential characteristics of evaluational stance, multidimensionality, and subjective-versus-objective aspects. Necessary dimensions for QOL assessment include both subjective and objective components, specifically attributes falling into sectors of behavioral competence, self-assessed quality of domains of everyday life, environment, and generalized psychological well-being. None of these QOL facets should be excluded from assessment in people with dementia, but many such people require the use of indicators that do not depend on self-report. Existing measures and assessment techniques are discussed as grouped into attribute ratings (single ratings provided by someone who observes the person over some extended period of time) and direct observational methods (only behavior as it is observed in ongoing fashion). Attribute ratings are the domains of time use quality, social interaction, and affect states, and direct observation in domains of behavior, affect display, and environmental quality are discussed.