| Title | Decision-making involvement and quality of life in people with dementia: the mediating role of psychological needs |
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| Type | Journal article |
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| Authors | Colclough, C., Perach, R., Harris, P., Rusted, J., Banerjee, S. and Miles, E. |
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| Abstract | Objectives: Decision-making involvement is important for maintaining a sense of self and quality of life in people with dementia. To date, few studies have explored the factors behind this relationship. We explored whether decision-making benefits quality of life by enabling fulfilment of basic psychological needs: autonomy, competence, and relatedness. Method: We analysed one-year longitudinal data from 787 people recently diagnosed with dementia from the DETERMIND cohort. Path analysis examined cross-sectional and longitudinal associations between decision-making involvement and quality of life. Parallel mediation analysis tested whether psychological needs explained this relationship. Cognitive impairment was tested as a moderator of longitudinal associations. Results: At baseline, decision-making involvement was positively associated with quality of life, fully mediated by satisfaction of all three psychological needs. Despite declines in cognitive function, decision-making involvement remained high and quality of life stable over one year. No significant longitudinal associations were found between decision-making involvement and quality of life. Conclusion: Decision-making involvement may support quality of life through psychological needs fulfilment. Stability in decision-making and quality of life suggests resilience among people with dementia in early stages. Supporting psychological needs through tailored interventions and decision-aid tools may have the potential to enhance quality of life as dementia progresses. |
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| Keywords | Dementia |
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| decision-making |
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| quality of life |
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| psychological needs |
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| longitudinal |
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| Journal | Aging & Mental Health |
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| ISSN | 1360-7863 |
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| 1364-6915 |
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| Year | 2025 |
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| Publisher | Routledge |
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| Publisher's version | License CC BY 4.0 File Access Level Open (open metadata and files) |
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| Digital Object Identifier (DOI) | https://doi.org/10.1080/13607863.2025.2541188 |
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| Web address (URL) | https://www.tandfonline.com/doi/full/10.1080/13607863.2025.2541188 |
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| Publication dates |
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| Published online | 16 Aug 2025 |
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| Funder | ESRC (Economic & Social Research Council) |
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