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Psychol Med. 2018 Oct;48(13):2130-2139. doi: 10.1017/S0033291718000405. Epub 2018 May 8.

Living well with dementia: a systematic review and correlational meta-analysis of factors associated with quality of life, well-being and life satisfaction in people with dementia.

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School of Psychology, University of Exeter,EX4 4QG,UK.
Personal Social Services Research Unit,London School of Economics and Political Science,WC2A 2AE,UK.
School of Psychology, University of Sussex,BN1 9RH,UK.
School of Psychology, Bangor University,LL57 2AS,UK.
School of Medical Sciences, University of New South Wales,NSW 2052,Australia.
Wales Institute of Social and Economic Research, Data and Methods, Cardiff University,CF10 3BB,UK.
Department of Psychology,King's College London Institute of Psychiatry, Psychology and Neuroscience,London, SE5 8AF,UK.
Department of Clinical Sciences,Brunel University,UB8 3PH,UK.


Current policy emphasises the importance of 'living well' with dementia, but there has been no comprehensive synthesis of the factors related to quality of life (QoL), subjective well-being or life satisfaction in people with dementia. We examined the available evidence in a systematic review and meta-analysis. We searched electronic databases until 7 January 2016 for observational studies investigating factors associated with QoL, well-being and life satisfaction in people with dementia. Articles had to provide quantitative data and include ⩾75% people with dementia of any type or severity. We included 198 QoL studies taken from 272 articles in the meta-analysis. The analysis focused on 43 factors with sufficient data, relating to 37639 people with dementia. Generally, these factors were significantly associated with QoL, but effect sizes were often small (0.1-0.29) or negligible (<0.09). Factors reflecting relationships, social engagement and functional ability were associated with better QoL. Factors indicative of poorer physical and mental health (including depression and other neuropsychiatric symptoms) and poorer carer well-being were associated with poorer QoL. Longitudinal evidence about predictors of QoL was limited. There was a considerable between-study heterogeneity. The pattern of numerous predominantly small associations with QoL suggests a need to reconsider approaches to understanding and assessing living well with dementia.


Alzheimer's disease; dementia; depression; neuropsychiatric symptoms; quality of life


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