Discrepancies in Memory Disorder Patient/Caregiver Ratings of Patient Depression and Anxiety and Their Relation to Patient Functional Status and Caregiver Burden
Gordon Matthewson1, Francesca Dino1, Peter Pressman1
1Neurology, University of Colorado Anschutz Medical Campus
Objective:
To examine differences between self-rated and caregiver-rated patient depression and anxiety and the relationship of these differences to clinical outcomes.
Background:
Discrepancies in ratings of patient symptoms between memory disorder patients and their caregivers are common, yet the relationship between discrepancies in ratings of mood symptoms and functional outcomes is particularly complex and not well understood, in part due to the protective effects that unawareness of symptoms can impart on mood.
Design/Methods:
Clinical survey data collected between 2017-2023 from patients at the Memory Disorders Clinic of the University of Colorado was used for analysis. Caregivers rated patient symptoms with the Neuropsychiatric Inventory Questionnaire (NPI-Q) and the Functional Activities Questionnaire (FAQ), as well as their own caregiving burden with the Zarit Burden Interview (ZBI-12). Patients simultaneously completed a Primary Health Questionnaire (PHQ-9) and a Generalized Anxiety Disorder Questionnaire (GAD-7). Scores of the PHQ-9 and GAD-7 were converted to a 0-3 point severity scale, and patient/caregiver discrepancies were calculated by subtracting the 0-3 point depression or anxiety subscale of the caregiver’s NPI-Q rating from the patient’s self-filled PHQ-9 or GAD-7 score.
Results:
Linear regression analysis revealed that larger patient/caregiver discrepancies in ratings of patient depression did not correlate with FAQ scores (n=198, p=.799), but were positively correlated with ZBI-12 scores (n=190, p=0.015, 95% CI .004-.044, R2 = .031). Larger discrepancies in ratings of anxiety were negatively correlated with FAQ scores (n=198, p=0.026, 95% CI -0.052- -.003, R2 = .025), but had no correlation with ZBI-12 scores (n=190, p=0.891).
Conclusions:
These findings suggest that discrepancies in patient/caregiver ratings of depression and anxiety can respectively be reliable indicators of caregiver burden and functional status deficits in memory disorder patients, and that driving forces behind these challenges may be elucidated by further work describing patient/caregiver discrepancies in ratings of patient mood.