How Well do Your Family Members Know you? The Relationship Between Informant-Report and Cognitive Performance of Older Adults

Mairy Yousif, Florida Institute of Technology, Melboure, United States
Anthony LoGalbo, Florida Institute of Technology, Melbourne, United States


To compare collateral reports of cognitive and functional status using the Dementia Severity Rating Scale (DSRS) to memory clinic patients’ performances on neuropsychological tests, explore whether DSRS informant-ratings predict neuropsychological test scores, and determine whether caregivers are more or less accurate depending on their relationship and frequency of contact with the patient.

Participants and Methods:

Participants were referred to a memory clinic by their medical provider for a brief neuropsychological evaluation (BNE) to help clarify diagnosis and inform treatment and recommendations. The BNE included a test of adaptive functioning (Texas Functional Living Scale (TFLS)), global cognition (Montreal Cognitive Assessment (MoCA)), and measures of executive functioning (Trail Making Test Part B (TMT-B), Stroop Color-Word Test, and Modified Wisconsin Card Sorting Test (M-WCST)), among others. Patients’ caregivers completed the Dementia Severity Rating Scale (DSRS) during the intake appointment. Notably, higher DSRS scores indicate greater cognitive and functional impairment. Diagnostic impressions were made by a multidisciplinary team. A total of 254 participants were included: 151 patients diagnosed with dementia (60.3% female, M = 80.61, SD = 6.54), 64 patients diagnosed with Mild Cognitive Impairment (MCI; 57.8% female, M = 78.59, SD = 6.95), and 39 diagnosed with Normal Cognition (NC; 53.8% female, M = 76.64, SD = 7.13).


Overall DSRS scores were statistically different among diagnostic groups. Specifically, scores from the AD group were significantly higher than both MCI and NC groups, and those from the MCI group were significantly higher than the NC group. Overall DSRS scores were significantly negatively correlated with overall TFLS scores, suggesting that as DSRS scores increase, TFLS scores decrease. A linear regression indicated that DSRS scores significantly predicted TFLS scores, accounting for 9.9% of the variance. Furthermore, a significant negative correlation was observed between overall DSRS scores and the MoCA, suggesting that as DSRS scores increase, MoCA scores decrease. Correlations among measures of executive functioning with overall DSRS scores suggested that as DSRS scores increase, executive functioning decreases, as evidenced by greater time to complete TMT-B, more perseverative errors on M-WCST, fewer correctly completed categories on M-WCST, and fewer correct items on Stroop Color-Word subtest. Meanwhile, the degree of agreement between overall TFLS and DSRS scores revealed no relationship with frequency of caregiver contact with the patient (e.g., <1 day per week, 1 day per week, 2 days per week, 3-4 days per week, 5+ days per week), or with respect to caregivers’ relationships with the patient (e.g., spouse, child, friend).


Results indicate that collateral informants provide information consistent with measures of cognitive and functional status regardless of their relationship to the patient or how much time they spend together. This suggests that the accuracy of collateral reports from caregivers and family members may not be dependent on the nature of their relationship or frequency of contact.

Category: Dementia (Alzheimer's Disease)

Keyword 1: neuropsychological assessment
Keyword 2: adaptive functioning
Keyword 3: self-report