The Longitudinal Association Between a Discrepancy Measure of Anosognosia in Patients with Dementia, Caregiver Burden and Depression.
According to cross-sectional studies, there is an association between anosognosia in people with dementia and caregiver's burden and depression. Anosognosia in patients may be a cause of caregiver burden and depression. However, variability in caregiver anosognosia ratings may exist as caregivers with burden and depression may have a more pessimistic view of the patients' health.



To assess the variability of caregiver anosognosia ratings of patients with dementia using a widely used anosognosia scale and its longitudinal relationship with caregiver burden and depression.



A convenience cohort of 221 consecutive dementia outpatient and caregiver dyads was followed up at 12 and 24 months. The main instruments used were the Anosognosia Questionnaire-Dementia (AQ-D), Caregiver Burden Interview, and Geriatric Depression Scale. Linear mixed models were used including time as a factor in every model. Multivariate analyses controlled for caregiver's socio-demographic and possible confounding factors.



Attrition at 12 and 24 months was 24.9% and 42.5% respectively. Patients at baseline were on average 77.8 years of age, 63.3% were women, and 63.3% had < 5 years of education. In the bivariate analyses, caregiver burden, depression, and gender were associated with caregiver ratings of total, cognitive, and personality AQ-D of the patient at different time points. Multivariate analyses revealed burden as the caregiver variable most consistently associated with total, cognitive, and personality caregiver AQ-D ratings of the patient.



Some caregiver characteristics, especially burden, are associated with caregiver ratings of AQ-D with regard to the patient.
University of Kansas Medical Center, Department of Preventive Medicine and Public Health, Kansas, USA.
Jaime
J
Perales
Research Unit, Santa Caterina Hospital, Institut d'Assistència Sanitària, Salt, Spain.
Oriol
O
Turró-Garriga
Dementia Unit, Department of Neurology, Bellvitge University Hospital, Hospitalet de Llobregat, Spain.
Jordi
J
Gascón-Bayarri
Dementia Unit, Department of Neurology, Bellvitge University Hospital, Hospitalet de Llobregat, Spain.
Ramón
R
Reñé-Ramírez
Faculty of Psychology, University of Barcelona, Spain.
Josep Lluís
JL
Conde-Sala
D000368:Aged; D000369:Aged, 80 and over; D000377:Agnosia / Q000175:diagnosis* / Q000209:etiology*; D017028:Caregivers / Q000523:psychology*; D003704:Dementia / Q000150:complications*; D003863:Depression / Q000150:complications*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires; D013997:Time Factors
Anosognosia; bias; burden of illness; caregivers; dementia; depression; longitudinal studies