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Am J Geriatr Psychiatry. 2014 Feb;22(2):138-47. doi: 10.1016/j.jagp.2012.07.001. Epub 2013 Jan 9.

Severity of dementia, anosognosia, and depression in relation to the quality of life of patients with Alzheimer disease: discrepancies between patients and caregivers.

Author information

  • 1Faculty of Psychology, University of Barcelona, Barcelona, Spain. Electronic address: jllconde@ub.edu.
  • 2Dementia Unit, Department of Neurology, Bellvitge University Hospital, Hospitalet de Llobregat, Spain.
  • 3Research Unit, Santa Caterina Hospital, Institut d'Assistència Sanitària, Salt, Spain.
  • 4Department of Psychology, University of Girona, Girona, Spain; Research Unit, Santa Caterina Hospital, Institut d'Assistència Sanitària, Salt, Spain.



To investigate the factors associated with discrepancies between patient and caregiver reports of the quality of life of patients (QoLp) with Alzheimer disease.


Cross-sectional analytic study of 141 patients and their caregivers. The instruments used were the Quality of Life in AD, the Global Deterioration Scale (GDS), the Geriatric Depression Scale, and the Anosognosia Questionnaire-Dementia. Differences were analyzed according to GDS stage. A linear regression analysis was conducted using the difference between the absolute QoLp scores of patients and caregivers. A cluster analysis involving patient variables was then performed.


The discrepancy between patient and caregiver QoLp ratings increased in line with GDS stages (χ(2) (2) = 8.7, p = 0.013). In the regression model (F [7,133] = 16.6, p <0.001; R(2) = 0.477), discrepancies in QoLp reports were associated with greater anosognosia, less depression, and a better cognitive status in patients and with female gender among caregivers. The cluster analysis showed that patients with the lowest ratings of QoLp had a better cognitive status, more depression, and less anosognosia. Conversely, the highest ratings were given by patients with a poorer cognitive status, less depression, and greater anosognosia.


The factors associated with greater discrepancies between patient and caregiver ratings of QoLp were severity of dementia, anosognosia, depression, and cognitive status in patients and female gender in caregivers. In patients with advanced dementia, greater anosognosia leads to more positive ratings in QoLp and complementary observations are required.

Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.


Quality of life; anosognosia; caregivers; depression; patients; severity of dementia

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