title: Effects of anosognosia and neuropsychiatric symptoms on the quality of life of patients with Alzheimer's disease: a 24-month follow-up study.
abstract: OBJECTIVE
  Neuropsychiatric symptoms and anosognosia are known to influence the perceived quality of life of patients (QoL-p) with Alzheimer's disease (AD). This study analysed their impact on patient and caregiver ratings of QoL-p and how these ratings changed in relation to the severity of dementia.
  
  
  METHODS
  A baseline sample of 221 patients and caregivers was followed up over 24 months. Instruments: Neuropsychiatric Inventory (NPI), Anosognosia Questionnaire-Dementia (AQ-D), Quality of life-Alzheimer's Disease (QoL-AD) and the Global Deterioration Scale (GDS). Longitudinal data were analysed using generalized linear models.
  
  
  RESULTS
  In the multivariate analysis, greater anosognosia was always associated with higher ratings of QoL-p among patients, especially at 24 months (p < 0.001), and with more negative ratings among caregivers, especially at baseline (p < 0.001). A higher total NPI score was associated with a more negative rating of QoL-p among caregivers (p < 0.001), and it also had a smaller negative effect on patients' self-ratings (p = 0.001). The neuropsychiatric symptoms (NPI) associated with a more negative view of QoL-p were depression, for patients' self-ratings, and apathy and agitation for caregiver ratings. The discrepancy between patient and caregiver ratings increased in line with the severity of dementia.
  
  
  CONCLUSIONS
  Neuropsychiatric symptoms had a similarly negative effect on the QoL-p ratings of both patients and caregivers, whereas the effect of anosognosia differed according to the rater (positive for patients, negative for caregivers).
authors.affiliation: Faculty of Psychology, University of Barcelona, Spain.
authors.forename: Josep L
authors.initials: JL
authors.lastname: Conde-Sala
authors.affiliation: Research Unit, Santa Caterina Hospital, Institut d'Assistència Sanitària, Salt, Spain.
authors.forename: Oriol
authors.initials: O
authors.lastname: Turró-Garriga
authors.affiliation: Faculty of Psychology, University of Barcelona, Spain.
authors.forename: Sara
authors.initials: S
authors.lastname: Piñán-Hernández
authors.affiliation: Faculty of Psychology, University of Barcelona, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Portellano-Ortiz
authors.affiliation: Dementia Unit, Department of Neurology, Bellvitge University Hospital, Hospitalet de Llobregat, Spain.
authors.forename: Vanesa
authors.initials: V
authors.lastname: Viñas-Diez
authors.affiliation: Dementia Unit, Department of Neurology, Bellvitge University Hospital, Hospitalet de Llobregat, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Gascón-Bayarri
authors.affiliation: Dementia Unit, Department of Neurology, Bellvitge University Hospital, Hospitalet de Llobregat, Spain.
authors.forename: Ramón
authors.initials: R
authors.lastname: Reñé-Ramírez
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000377:Agnosia / Q000523:psychology*; D000544:Alzheimer Disease / Q000523:psychology*; D057565:Apathy; D017028:Caregivers / Q000523:psychology; D003866:Depressive Disorder / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011595:Psychomotor Agitation / Q000523:psychology*; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
keywords: Alzheimer's disease; anosognosia; caregivers; neuropsychiatric symptoms; patients; quality of life