Depression in Alzheimer patients: discrepancies between patient and caregiver reports

Estimates of the prevalence of depression in dementia patients vary widely. One problem in accurate identification of such depression is determining whether to rely on demented patients' reports or second-party caregivers' reports of symptoms. To further explore this problem, 31 outpatients with probable Alzheimer disease and their 31 caregivers were interviewed separately with depressive symptom questionnaires. Caregivers reported more depressive symptoms in dementia patients than patients reported for themselves. Correlations between caregivers' and patients' reports of individual symptoms ranged between -0.23 to 0.76, with lowest correlations found for intrapsychic distress, cognitive impairment, and hallucinations. Patients' responses were not necessarily affected by stereotypic responding or severity of impairment, but patients appeared to under-report symptomatology. Caregivers' responses were associated with the extent of contact with the patients, familial relationship, and sources of information used to determine patients' mood but were not correlated with caregivers' depression or ratings of how they would feel if they were "in the patient's shoes."