Patient versus informant reported quality of life in the earliest phases of Alzheimer's disease.
OBJECTIVE
The study investigated if patient and informant reported Quality of Life (QoL) differed in early Alzheimer's disease (AD). In addition, we examined whether anosognosia had an impact on the agreement between patient and informant ratings of QoL and whether anosognosia, dementia severity, depression and behavioural symptoms were significantly correlated to QoL in early AD.


METHODS
From a prospective research program including newly referred patients (age >60 years and MMSE > or = 20), 48 patients with very early AD were included. QoL was assessed using the QoL-AD and EQ-5D scales. Anosognosia was rated on a categorical scale by an examiner. MMSE, Geriatric Depression Scale, Danish Adult Reading Test and Frontal Behavioural Inventory were also administered.


RESULTS
On most QoL measures patients rated their QoL higher than their informants. Anosognosia was not associated with QoL but significantly with an inverse impact on the agreement between patient and informant ratings of QoL. Self-reported QoL was significantly correlated to depression but not to age, dementia severity, behavioural symptoms or memory impairment. Informant ratings of QoL were significantly correlated to behavioural symptoms and informant ratings on the EQ-5D Visual Analogue Scale were significantly correlated to patient reported depression.


CONCLUSIONS
Patients with early AD generally reported higher QoL than their informants. This disagreement was associated with the presence of anosognosia. Self-reported QoL did not correlate with the MMSE score. Behavioural changes and depressive symptoms may be associated with low QoL.
Vogel
Asmus
A
Memory Disorders Research Group, Neuroscience Center, Copenhagen University Hospital, Rigshospitalet, Denmark. asmus.vogel@rh.hosp.dk
Mortensen
Erik Lykke
EL
Hasselbalch
Steen G
SG
Andersen
Birgitte B
BB
Waldemar
Gunhild
G
D000368:Aged; D000369:Aged, 80 and over; D000377:Agnosia / Q000523:psychology; D000544:Alzheimer Disease / Q000523:psychology*; D001364:Awareness; D017028:Caregivers / Q000523:psychology*; D005195:Family Relations; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D011788:Quality of Life; D012647:Self-Assessment