Participant-Informant Relationship Affects Quality of Life Ratings in Incipient and Clinical Alzheimer’s Disease (P2.226)

Objective: Determine the role of the participant-informant relationship on informant assessments of quality of life (QOL), functional abilities, and behavioral symptoms in individuals with normal cognition (NC), mild cognitive impairment (MCI), and Alzheimer’s disease dementia (AD). Background: Clinical trials in incipient and clinical AD typically include informant-reported outcomes, since cognitive impairment may limit participant reliability. Informant reports in AD dementia may be modified by the nature of the participant-informant relationship. However, the effect of such relationships at earlier disease stages remains uncertain. Methods: We analyzed cross-sectional data from an ongoing study at the Easton Center for Alzheimer’s Disease Research at UCLA. Participants with NC (n=100), MCI (amnestic n=125, nonamnestic n=61), and AD (n=113) were subdivided into groups based on the participant-informant relationship (spouse versus non-spouse). We examined group differences in the Quality of Life-Alzheimer’s Disease (QOL-AD) scale, Functional Activities Questionnaire (FAQ), and Neuropsychiatric Inventory (NPI). Multiple regression analyses were used to identify associations between informant relationship, demographics, participant Mini-Mental Status Exam (MMSE) scores and informant ratings of: 1) QOL for participants and themselves, 2) FAQ, and 3) NPI. Results: After adjusting for demographics, MMSE, and self-rated informant QOL, spouse informants reported higher participant QOL than non-spouses in the MCI (p=0.003) and AD (p=0.04) groups. Within the MCI group, spouse informants rated QOL higher than non-spouses for participants with amnestic MCI (p<0.001). There were no differences in informant QOL ratings for participants with nonamnestic MCI or NC. There were also no differences between spouse and non-spouse informant ratings on the FAQ or NPI in any of the groups. Conclusions: Informant relationship to the participant may modulate responses on subjective measures like the QOL-AD throughout the AD spectrum. Analyses of clinical trials that use informant measures may need to address these effects, which persist after adjustments for demographic factors and MMSE. Disclosure: Dr. Lin has nothing to disclose. Dr. Brook has nothing to disclose. Dr. Grill has received research support from Elan, Janssen, Bristol-Myers Squibb, Medivation, and Pfizer. Dr. Teng9s spouse holds stock and/or in GE Healthcare and Cerner Corporation.