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Using structural equation modeling to detect response shift in quality of life in patients with Alzheimer's disease

Published online by Cambridge University Press:  03 May 2018

Xuxia Wang ,
Xiaomeng Xu ,
Hongjuan Han ,
Runlian He ,
Liye Zhou ,
Ruifeng Liang  and
Hongmei Yu
Xuxia Wang
Affiliation:
Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
Xiaomeng Xu
Affiliation:
Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
Hongjuan Han
Affiliation:
Department of Mathematics, School of Basic Medical Sciences, Shanxi Medical University, Taiyuan, China
Runlian He
Affiliation:
Department of Nursing, Taiyuan Central Hospital, Taiyuan, China
Liye Zhou
Affiliation:
Department of Mathematics, School of Basic Medical Sciences, Shanxi Medical University, Taiyuan, China
Ruifeng Liang
Affiliation:
Department of Environmental Health, School of Public Health, Shanxi Medical University, Taiyuan, China
Hongmei Yu*
Affiliation:
Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
*
Correspondence should be addressed to: Hongmei Yu, Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 South XinJian Road, Taiyuan 030001, China. Phone: +86-351-4135049; Fax: +86-351-2027943. Email: [email protected].
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Abstract

Background:

Our study aims to detect different types of response shifts (RS) and true changes of quality of life (QOL) measurement in patients with Alzheimer's disease (AD) using structural equation modeling (SEM) in domain level.

Methods:

Patients with AD aged over 60 years old were collected from the Department of Neurology and Geriatrics in Taiyuan Central Hospital, China. The 12-item Short Form (SF-12) Health Survey was measured in 238 patients with AD prior to hospitalization and one month following discharge. RS was detected by SEM approach. The statistical process consisted of four steps and fitted four models. We interpreted changes of parameters in models to detect RS and to assess true change.

Results:

The results showed reprioritization of social functioning (SF) (χ2 = 4.13, p < 0.05), reconceptualization of role limitations due to emotional problems (RE) (χ2 = 17.03, p < 0.001), uniform recalibration of bodily pain (BP) (χ2 = 12.24, p < 0.001), and non-uniform recalibration of mental health (MH) (χ2 = 4.41, p < 0.05), respectively. The true changes of common factors were deteriorated in general physical health (PHYS) (−0.10, χ2 = 8.30, p < 0.005) and improved in general mental health (MENT) (+0.29, χ2 = 20.95, p < 0.001). The effect-sizes of RS were only small.

Conclusion:

This study showed that patients with AD occurred three types of RS and true changes one month following discharge. RS had effects on the QOL of patients. Better understanding of potential changes in QOL in patients with AD is crucial.

Keywords

response shiftstructural equation modelingAlzheimer's diseasequality of life
Type
Original Research Article
Information
International Psychogeriatrics , Volume 31 , Issue 1: Issue Theme: Parkinson's Disease , January 2019 , pp. 123 - 132
Copyright
Copyright © International Psychogeriatric Association 2018 

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