Awareness dimensions and associated factors in Alzheimer's disease.

Autor: Jacus JP; CH des vallées de l'Ariège, EHPAD et consultations mémoire, Foix, France; University Lille, CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, 59000 Lille, France. Electronic address: jeanpierrej@chi-val-ariege.fr., Voltzenlogel V; CERPPS, Centre d'Etudes et de Recherche en Psychopathologie et Psychologie de la Santé, EA7411, Université Jean Jaurès, Toulouse, France., Mayelle A; University Lille, CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, 59000 Lille, France., Antoine P; University Lille, CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, 59000 Lille, France; LabEx DISTALZ - Development of Innovative Strategies for a Transdisciplinary approach to ALZheimer's disease, 59000 Lille, France., Cuervo-Lombard CV; CERPPS, Centre d'Etudes et de Recherche en Psychopathologie et Psychologie de la Santé, EA7411, Université Jean Jaurès, Toulouse, France.
Jazyk: angličtina
Zdroj: Revue neurologique [Rev Neurol (Paris)] 2022 Apr; Vol. 178 (4), pp. 363-369. Date of Electronic Publication: 2021 Sep 24.
DOI: 10.1016/j.neurol.2021.05.011
Abstrakt: Objectives: We recently reported the major role depression and apathy in awareness among Alzheimer patients, using the stage of the disease as an exposure factor and exploring different assessment methods. Using the same patient data, we aimed here to explore the different dimensions of awareness assessed by different sub-scales in awareness scales.
Method: Sixty-one Alzheimer patients were examined using four awareness scales relating to three assessment methods: (a) patient-caregiver discrepancy; (b) clinical rating; and (c) prediction of performance discrepancy. Global cognition, executive functioning, autonomy, depression and apathy were also assessed. Multivariate logistic models were performed using disease stage as an exposure factor for awareness scales and sub-scales. Correlations across the different factors and patient and caregiver awareness ratings were computed.
Results: The patient-caregiver discrepancy and clinical rating methods (a, b) both identified the factors associated with awareness in the overall scales and the sub-scales as being depression and/or apathy. Depression correlated with patient self-ratings while apathy correlated with caregiver ratings. The prediction of performance discrepancy method (c) identified different factors in the overall scale, executive factors in three sub-scales involving executive domains and the memory factor in a sub-scale involving the mnesic domain.
Discussion: The awareness scales using a referential based on a human rating (a, b) suggest that awareness is unidimensional, with depression impacting self-reports and apathy influencing caregiver/clinical reports. Scales based on a test rating (c) appear to be more closely associated with the dimensions assessed. This highlights the role of the reference system for awareness assessment in Alzheimer's disease.
(Copyright © 2021 Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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