title: Predictors of quality of life ratings for persons with dementia simultaneously reported by patients and their caregivers: the Cache County (Utah) Study.
abstract: BACKGROUND
  Quality of life (QOL) is frequently assessed in persons with dementia (PWD) through self- and/or proxy-report. Determinants of QOL ratings are multidimensional and may differ between patients and caregiver proxies. This study compared self- and proxy-reported QOL ratings in a population-based study of PWD and their caregivers, and examined the extent to which discrepancies in reports were associated with characteristics of the PWD.
  
  
  METHODS
  The sample consisted of 246 patient/caregiver dyads from the initial visit of the Cache County Dementia Progression Study, with both members of the dyad rating PWD QOL. PWD age, gender, cognitive impairment (Mini-Mental State Examination), neuropsychiatric symptoms (Neuropsychiatric Inventory; NPI), dementia severity (Clinical Dementia Rating), medical comorbidities (General Medical Health Rating), and functional impairment (Dementia Severity Rating Scale) were examined as correlates of self- and proxy-reported QOL ratings and the differences between the QOL reports.
  
  
  RESULTS
  Self- and proxy-reported PWD QOL ratings were only modestly correlated. Medical comorbidity was associated with self-report whereas NPI was associated with proxy-report. Dementia severity was associated with discrepancies in self- and proxy-report, with worse patient cognition associated with poorer proxy-reported QOL ratings.
  
  
  CONCLUSIONS
  PWD self- and proxy-reported QOL ratings are associated with different variables. Discrepancies between PWD and caregiver perceptions of PWD QOL should be recognized, particularly in cases of more severe dementia.
authors.affiliation: Center for Epidemiologic Studies, Utah State University, Logan, UT, USA.
authors.forename: Trevor
authors.initials: T
authors.lastname: Buckley
authors.forename: Elizabeth B
authors.initials: EB
authors.lastname: Fauth
authors.forename: Ann
authors.initials: A
authors.lastname: Morrison
authors.forename: Joann
authors.initials: J
authors.lastname: Tschanz
authors.forename: Peter V
authors.initials: PV
authors.lastname: Rabins
authors.forename: Kathleen W
authors.initials: KW
authors.lastname: Piercy
authors.forename: Maria
authors.initials: M
authors.lastname: Norton
authors.forename: Constantine G
authors.initials: CG
authors.lastname: Lyketsos
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D015897:Comorbidity; D003704:Dementia / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011581:Psychological Tests; D011788:Quality of Life / Q000523:psychology*; D057566:Self Report; D012720:Severity of Illness Index; D014589:Utah