We examined 170 outpatients, 103 with Alzheimer's disease, 43 with vascular dementia and 24 with various other causes, in order to investigate whether or not depressive symptoms were more likely to occur in dementia patients who had some degree of awareness of their cognitive deterioration. Awareness was rated on a four‐point scale that assessed discrepancies between the patient's and the caregiver's history. The level of awareness was significantly related to the severity of dementia but not to depression or to the score on Hamilton's depression scale. However, the score from the item “psychic anxiety” showed a weak but significant correlation with the level of awareness of one's deficits. It is concluded that intact awareness of deterioration was not clearly related to the development of depression or depressive symptoms in dementia. Copyright © 1993 John Wiley & Sons, Ltd.