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Disagreement in the Reporting of Depressive Symptoms Between Patients With Dementia of the Alzheimer Type and their Collateral Sources

Received November 14, 1996; revised May 13, 1997; accepted October 24, 1997. From the Division of Geriatric Psychiatry, Department of Psychiatry, University of Nebraska College of Medicine, and Creighton University School of Medicine, Omaha, Nebraska. Address correspondence to Dr. Burke, University of Nebraska Medical Center, 600 South 42nd Street, Omaha NE 68198-5575. e-mail: wjburke{at}unmc.edu

The authors investigated sources of disagreement on the Geriatric Depression Scale (GDS) between patients and their collateral sources (CSs). There were 198 subjects with possible or probable Alzheimer's disease (DAT) and 64 cognitively intact subjects evaluated at an outpatient geriatric assessment center. The 30-item GDS was completed by the patient and the CS version of the GDS by the CS. A sizable discrepancy was found in the reporting of depressive symptoms by the subjects vs. the CSs. Multiple-regression analyses revealed that both level of insight and level of physical illness in the subjects with DAT significantly influenced the discrepancy. An increased sense of burden in the CSs was associated with a larger symptom gap in both DAT and control subjects. CSs consistently perceived more depressive symptoms than subjects, especially subjects with DAT who had no insight into their cognitive impairment.

Key Words: depression • dementia • self-report • collateral sources

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