Carer informants for dementia sufferers: Carer awareness of cognitive impairment in an elderly community-resident sample

By comparing data obtained from the carers of 170 community-resident dementia sufferers with the results of objective cognitive testing, we assessed carer awareness of a range of cognitive deficits in their dependants. Spouses living with demented patients were the best at estimating the overall severity of cognitive impairment, whereas both first-degree (particularly if living with the dementia sufferer) and second-degree relatives were better at identifying and reporting the severity of memory impairment and topographical disorientation. Only one carer was aware of problems with object recognition, although a definite problem was detected in at least 40% of the study group. The testing instruments used (MMSE and CAMCOG) probably under-detected dysnomia and appeared to be inconclusive when compared with carer reports of difficulties that could be attributable to dyspraxia, highlighting the problem of sole reliance on either these instruments or informant accounts to obtain accurate clinical information.