This study aimed to compare care recipient and caregiver perceptions of quality of life in patients (QoL-p) with Alzheimer's disease (AD) and to identify associated factors, and the concordances-discrepancies. A cross-sectional analytic study of 236 patients and their carers was carried out using the Quality of Life in Alzheimer's Disease (QoL-AD) scale, socio-demographic data and clinical examination. Patients scored the QoL-AD more favourably than did caregivers. Cognitive deterioration did not affect the perception of QoL-AD. The neuropsychiatric symptoms was associated with a negative perception of the QOL-AD in both patients and caregivers. Greater functional autonomy was associated with a better perception of the QOL-AD in patients and even more so in caregivers. In carers, burden and mental health were inversely associated with the QoL-AD. QoL-AD scores of both patients and caregivers were higher for men, married subjects, those who lived with their spouse and those living in their own home. When the carer was a spouse both patients and caregivers scored the QoL-AD higher than when the carer was a son or daughter (35.5 vs 33.4 and 33.7; 32.9 vs 30.5 and 27.7, p < 0.001). Conclusions: Patients have a better perception of QoL-p. Caregivers give a more negative evaluation of neuropsychiatric symptoms, but have a more positive view of functional autonomy. Carers who are spouses have a better perception of QoL-p than do carers who are sons or daughters. Copyright © 2008 John Wiley & Sons, Ltd.