Variables associated with self- and proxy-perceived difficulties in independent living for patients with bipolar disorder and comorbid dementia.

backgroundIdentifying variables associated with difficulties in independent living may help optimize intervention, as only 50% of individuals with bipolar disorder alone achieve residential independence. This proportion may be further reduced when bipolar disorder is complicated by comorbid dementia. However, evidence in this complex population remains limited, and existing studies have primarily focused on variables associated with independent living ability or performance, leaving those of perceived difficulties unknown.

aimThis study examined variables associated with perceived difficulties in independent living using data reported by patients with bipolar disorder and comorbid dementia and by proxies.

methodsThe dependent variable was a World Health Organization Disability Assessment Schedule 2.0 item asking the perceived difficulty in living independently for a few days, where the remaining items were the independent variables. Patient- and proxy-reported data (n = 43 and 47) were analyzed separately and extracted from a nationwide database.

resultsAfter controlling for demographic and clinical characteristics, the patient- and proxy-reported regression models identified four variables in each and explained approximately 80% of the variance in perceived difficulties in independent living. The identified variables differed substantially between the two models.

conclusionThese variables may help clinicians identify clinically relevant domains for intervention planning. Incorporating associated variables for both patients and proxies is recommended because they serve as each other's environment and influence one another, and the associated variables for them seem inconsistent.