Improving the assessment of everyday cognitive functioning in patients with epilepsy by means of proxy reports

Objectives The self-report of cognitive deficits by of patients with epilepsy is often poorly correlated with objective test performances but highly related to mood and personality. The aim of this study was to evaluate whether information obtained by close relatives of the patient shows higher correlations with the patients' objective test scores and thereby can be a complementary measure for ensuring a reliable basis for diagnostic decision-making. Methods Thirty-four patients and 29 relatives were asked to fill in a questionnaire about everyday cognitive deficits of the patient. All patients completed a neuropsychological test battery comprising measures of memory, attention, and executive functioning and questionnaires on anxiety, depression, and the personality trait neuroticism. Results Correlations between relatives' reports and patients' test performances were highly significant across all examined domains. By contrast, self-reports of the patients significantly correlated with none of the neuropsychological measures of memory and with only a subset of the objective measures of attention and executive functioning. Regression analyses additionally revealed a strong dependency of the patients' self-assessment on depression, anxiety, and neuroticism (R2 = 0.42). Conclusions These results point out the risk of self-reports distorting reality and additionally recommend consulting a close relative of the patient to ensure reliable information about the patient's everyday cognitive functioning.