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Caregiver rating bias in mild cognitive impairment and mild Alzheimer's disease: impact of caregiver burden and depression on dyadic rating discrepancy across domains

Published online by Cambridge University Press:  07 May 2013

Livia Pfeifer ,
Reinhard Drobetz ,
Sonja Fankhauser ,
Moyra E. Mortby ,
Andreas Maercker  and
Simon Forstmeier
Livia Pfeifer*
Affiliation:
Institute of Psychology, Division Psychopathology and Clinical Intervention, University of Zurich, Binzmühlestr. 14/17, 8050 Zurich, Switzerland
Reinhard Drobetz
Affiliation:
Institute of Psychology, Division Psychopathology and Clinical Intervention, University of Zurich, Binzmühlestr. 14/17, 8050 Zurich, Switzerland
Sonja Fankhauser
Affiliation:
Institute of Psychology, Division Psychopathology and Clinical Intervention, University of Zurich, Binzmühlestr. 14/17, 8050 Zurich, Switzerland
Moyra E. Mortby
Affiliation:
Centre for Research on Ageing, Health and Wellbeing, Australian National University, Eggleston Road, Canberra, ACT 0200, Australia
Andreas Maercker
Affiliation:
Institute of Psychology, Division Psychopathology and Clinical Intervention, University of Zurich, Binzmühlestr. 14/17, 8050 Zurich, Switzerland
Simon Forstmeier
Affiliation:
Institute of Psychology, Division Psychopathology and Clinical Intervention, University of Zurich, Binzmühlestr. 14/17, 8050 Zurich, Switzerland
*
Correspondence should be addressed to: Livia Pfeifer, MSc, Institute of Psychology, Division Psychopathology and Clinical Intervention, University of Zurich, Binzmühlestr. 14/17, 8050 Zurich, Switzerland. Phone: +41 44 635 73 26; Fax: +41 44 635 73 19. Email: l.pfeifer@pychologie.uzh.ch.
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Abstract

Background: Caregivers of individuals with dementia are biased in their rating of mental health measures of the care receiver. This study examines caregiver burden and depression as predictors of this bias for mild cognitive impairment and mild Alzheimer's disease in different domains.

Methods: The sample consisted of 202 persons: 60 with mild cognitive impairment, 41 with mild Alzheimer's disease, and 101 caregivers. Discrepancy scores were calculated by subtracting the mean caregiver score from the respective mean patient score on the following assessment instruments: the Geriatric Depression Scale, Apathy Evaluation Scale, Bayer-Activities of Daily Living Scale, and Quality of Life-AD scale. Caregiver burden and depression were assessed by the Zarit Burden Interview and the Center for Epidemiologic Studies Depression Scale.

Results: Intraclass correlation coefficients were low for apathy (0.38), daily functioning (0.38), and quality of life (0.30) and moderate for depression (0.49). These domains showed negative rating discrepancies, which indicates caregiver rating bias for all four domains. Regression analyses revealed that caregiver burden significantly contributed to explaining these discrepancies in the domains apathy, daily functioning, and quality of life.

Conclusion: Caregiver rating bias can be attributed to caregiver burden. When caregiver burden is present, data based on caregiver ratings should therefore be interpreted with caution.

Keywords

Alzheimer's diseasemild cognitive impairmentcaregiveranosognosiarating discrepancydyadic data
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 8: Elder abuse an international perspective , August 2013 , pp. 1345 - 1355
Copyright
Copyright © International Psychogeriatric Association 2013 

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