Awareness of memory deficits in subjective cognitive decline, mild cognitive impairment, Alzheimer's disease and Parkinson's disease
Awareness of memory deficits in subjective cognitive decline, mild cognitive impairment, Alzheimer's disease and Parkinson's disease
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DOI：
10.1017/s1041610214002245
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发表时间：
2015-03-01
影响因子：
7
通讯作者：
Auff, Eduard
中科院分区：
文献类型：
--
作者：
Lehrner, Johann;Kogler, Sandra;Auff, Eduard
背景：记忆缺陷意识受损已被认为是阿尔茨海默病 (AD) 的常见现象，目前研究越来越关注未来有痴呆风险的群体的意识。本研究旨在确定健康老年人和患有主观认知衰退 (SCD)、遗忘型和非遗忘型轻度认知障碍 (aMCI、naMCI)、阿尔茨海默病 (AD) 和帕金森病 (PD) 的患者的意识水平是否存在差异，探索意识的相关性并确定每个诊断组内记忆高估和低估的频率。方法：对记忆诊所的 756 名连续门诊患者和 211 名健康对照进行了研究彻底的神经心理学测试。意识障碍的衡量标准是主观记忆评估（针对当前日常生活中记忆相关问题的 16 项调查问卷）和客观记忆表现（15 项延迟回忆任务）之间的差异。使用对照的百分位等级对高估和低估者的亚组进行分类。结果：在组水平上，意识沿着 naMCI -> aMCI -> AD 连续体显着下降，naMCI 患者表现出高估记忆功能障碍的倾向。只要记忆功能基本不受影响，帕金森病患者就会表现出准确的自我评价。然而，组间认知得分存在相当大的重叠。此外，根据诊断组的不同，观察到不同的认知相关性。一般来说，无意识似乎与各个领域的认知能力下降（尤其是记忆力）、年龄较大、抑郁程度较低以及自我报告的功能障碍有关。结论：意识障碍是 aMCI 的一个重要症状。然而，鉴于认知得分存在相当大的差异，需要进行纵向研究来评估其预测能力。
Background: Impaired awareness of memory deficits has been recognized as a common phenomenon in Alzheimer's disease (AD) and research is now increasingly focusing on awareness in groups at risk for future dementia. This study aimed to determine whether levels of awareness differ among healthy elderly people and patients with subjective cognitive decline (SCD), amnestic and non-amnestic subtypes of mild cognitive impairment (aMCI, naMCI), Alzheimer's disease (AD) and Parkinson's disease (PD), to explore correlates of awareness and to establish frequencies of memory over-and underestimation within each diagnostic group.Methods: 756 consecutive outpatients of a memory clinic and 211 healthy controls underwent thorough neuropsychological testing. Impairment of awareness was measured as the difference between subjective memory appraisals (16-item questionnaire on current memory-related problems in everyday life) and objective memory performance (15-item delayed recall task). Subgroups of over- and underestimators were classified using percentile ranks of controls.Results: At group level, awareness significantly decreased along the naMCI -> aMCI -> AD continuum, with naMCI patients showing a tendency towards overestimation of memory dysfunction. PD patients showed accurate self-appraisals as long as memory function was largely unaffected. However, there was a considerable between-group overlap in awareness scores. Furthermore, different correlates of awareness were observed depending on the diagnostic group. In general, unawareness seems to be associated with decreased cognitive performance in various domains (especially memory), higher age and lower levels of depression and self-reported functional impairment.Conclusion: Impaired awareness is an important symptom in aMCI. Yet, given the considerable variability in awareness scores, longitudinal studies are required to evaluate their predictive power.