Informant reported cognitive decline in older adults

Objectives: Gaining an informant’s perspective on cognitive decline has become an increasingly popular, and recommended practice, in the assessment of dementia. However, concern regarding the accuracy of such reports has been documented. The current study aimed to explore factors that might influence such reports, with a particular focus on informant burden.

Design: Using a cross-sectional, single-group design, routinely collected data from 82 patient-informant dyads within a memory assessment service, was analysed. Univariate and multivariate analyses explored associations between informant-reported cognitive decline, demographic characteristics and clinical variables (including burden).

Results: None of the demographic characteristics explored were associated with informant-reported cognitive decline. Informant reports were associated with patient cognitive functioning, as assessed by a standardised psychometric measure, and the final outcome of the assessment. Patient affective state and informant-reported burden interacted in influencing informant-reported cognitive decline. Informant-reported burden did not mediate the relationship between informant-reported cognitive decline and patient performance on a standardised psychometric measure.

Conclusions: Findings suggest that informant subjective burden predicts informant-reported cognitive decline, and that patient affective state interacts with subjective burden in doing so. Clinical and empirical implications are discussed.