• Hanneke C Beerens, Caroline Sutcliffe, Anna Renom-Guiteras, Maria E Soto, Riitta Suhonen, Adela Zabalegui, Christina Bökberg, Kai Saks, Jan P H Hamers, and RightTimePlaceCare Consortium.
• Department of Health Services Research, Faculty of Health, Medicine and Life Sciences, CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands. Electronic address: h.beerens@maastrichtuniversity.nl.
• J Am Med Dir Assoc. 2014 Jan 1; 15 (1): 54-61.

ObjectivesTo explore how quality of life (QoL) and quality of care (QoC) for people with dementia (PwD) vary across 8 European countries; to explore how QoL and QoC for PwD vary across living arrangements; and to assess the association between QoL and QoC.DesignCross-sectional survey.SettingInstitutional long term care and home care in 8 European countries (England, Estonia, Finland, France, Germany, the Netherlands, Spain, and Sweden).ParticipantsPwD receiving formal home care but at risk for admission to an institutional setting, and PwD who were recently admitted.MeasurementsQoL was assessed by the PwD and by their best informed proxies using the Quality of Life-Alzheimer's Disease scale (QoL-AD) (range 13-52). QoC was measured using quality of care indicators (eg, the presence of depressive symptoms, the presence of pressure ulcers).ResultsA total of 1123 PwD living at home (mean age 82.2, 63%women) and 791 PwD living in institutional care (mean age 84.1, 74% women) participated. QoL of PwD was most often rated highest in Sweden and England and lowest in Estonia and Spain. No differences in QoL were detected among the settings. For the QoC indicators, no consistent patterns were visible in such a way that certain countries or settings scored "higher" or "lower." The presence of depressive symptoms was most consistently associated with lower QoL (P ≤ .001).ConclusionThere is great variation in QoL and QoC scores among European countries and settings. To gain insight into the underlying causes of these differences, more knowledge is needed about the effect of different national health care systems and dementia strategies on QoL and QoC indicators. Depressive symptoms were associated with QoL, and executing longitudinal studies investigating which factors are associated with change in QoL is highly recommended.Copyright © 2014 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

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