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Predictors of Discrepancies in Parkinson's Disease Patient and Caregiver Ratings of Apathy, Disinhibition, and Executive Dysfunction before and after Diagnosis

Published online by Cambridge University Press:  15 January 2013

Dawn M. Schiehser ,
Lin Liu ,
Stephanie L. Lessig ,
David D. Song ,
Kristalyn M. Obtera ,
Mathes M. Burke III ,
Shannon R. Earl  and
J. Vincent Filoteo
Dawn M. Schiehser*
Affiliation:
Research Service, VA San Diego Healthcare System, San Diego, California Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, California
Lin Liu
Affiliation:
Department of Neurosciences, School of Medicine, University of California, San Diego, La Jolla, California
Stephanie L. Lessig
Affiliation:
Research Service, VA San Diego Healthcare System, San Diego, California Department of Family and Preventive Medicine, School of Medicine, University of California, San Diego, La Jolla, California
David D. Song
Affiliation:
Research Service, VA San Diego Healthcare System, San Diego, California Department of Family and Preventive Medicine, School of Medicine, University of California, San Diego, La Jolla, California
Kristalyn M. Obtera
Affiliation:
Research Service, VA San Diego Healthcare System, San Diego, California
Mathes M. Burke III
Affiliation:
Research Service, VA San Diego Healthcare System, San Diego, California
Shannon R. Earl
Affiliation:
Research Service, VA San Diego Healthcare System, San Diego, California
J. Vincent Filoteo
Affiliation:
Research Service, VA San Diego Healthcare System, San Diego, California Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, California
*
Correspondence and reprint requests to: Dawn M. Schiehser, VA San Diego Healthcare System (116B), 3350 La Jolla Village Drive, San Diego, CA 92161. E-mail: [email protected]
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Abstract

Parkinson's disease (PD) patient and caregiver reports of patient functioning are often used interchangeably in clinical and research settings; however, the consistency of these reports is largely unknown. This study aimed to investigate the consistency and predictors of discrepancy between self- and caregiver reports of patient apathy, disinhibition, and executive dysfunction. Fifty-one pairs of nondemented PD patients and their caregivers completed the Frontal Systems Behavior Scale (FrSBe). Patients were administered a neuropsychological battery, and mood and burden were assessed in a subset of caregivers. Patients and caregivers significantly differed in their ratings of all retrospective prediagnosis behaviors and current levels of disinhibition. Current levodopa equivalent dosages predicted patient-caregiver rating differences in prediagnosis and current apathy and current executive dysfunction, while patient motor function, cognition, and mood failed to predict any disparities in ratings. Caregiver burden and depression were associated with apathy rating discrepancies, while burden was associated with discrepancies in ratings of disinhibition. These results suggest that consistency of patient and caregiver behavioral ratings may vary depending on the behavior assessed; and underscore the importance of considering the reporter when using subjective measures, as discrepancies in behavioral reports may be influenced by specific patient and/or caregiver symptoms or factors. (JINS, 2013, 19, 1–10)

Keywords

BehaviorCarersCognitionExecutive functionParkinson's diseaseSelf report
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 19 , Issue 3 , March 2013 , pp. 295 - 304
Copyright
Copyright © The International Neuropsychological Society 2012

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