This study investigated the discrepancy between patients' and caregivers' ratings of patients' QoL in a cross-sectional study. the focus was on the main predictors of patients' and caregivers' QoL ratings, with an emphasis on awareness of disease, cognitive function, depressive status, functional activities and caregiver burden.

Forty-one patients and their caregivers were recruited from a center for Alzheimer's disease. the quality of life was assessed using the Alzheimer's disease Scale for Patients and Caregivers, the Assessment Scale of Psychosocial Impact of the Diagnosis of Dementia, the Mini-Mental State Examination, the Clinical Dementia Rating, the Cornell Scale for Depression in Dementia, the Pfeffer Functional Activities Questionnaire and the Zarit Burden Interview.

Patients reported a positive QoL when awareness of disease was impaired (p < 0.01). Caregivers' ratings were correlated with patients' QoL perception (p < 0.01) and patients' depressive status (p < 0.001). A discrepancy between patients' and caregivers' ratings was reported in terms of energy, living situation, memory, friends, chores and fun. Regression analysis suggested that awareness of disease and depressive status explained patients' Quality of life in Alzheimer's disease (QoL-AD) (31%). the educational status of the caregiver, caregiver burden, self-reported QoL-AD and patients' depressive status were all predictors of proxy QoL-AD (79%).

The quality of life in Alzheimer's disease patients is not directly correlated with cognition. Awareness of disease and depressive status impact self-reported QoL-AD. A relevant measure of awareness must be included in all assessments that target the well-being of dementia patients.