Patterns of discrepancies in different objects of awareness in mild and moderate Alzheimer's disease
Patterns of discrepancies in different objects of awareness in mild and moderate Alzheimer's disease
复制标题
DOI：
10.1080/13607863.2018.1544219
复制
发表时间：
2020-05-03
影响因子：
3.4
通讯作者：
Dourado, Marcia C. N.
中科院分区：
文献类型：
--
作者：
Lacerda, Isabel B.;Santos, Raquel L.;Dourado, Marcia C. N.
目的：认知被认为是痴呆中一种异质性和非线性的现象。我们旨在探讨轻度和中度阿尔茨海默病（AD）患者不同意识领域（认知功能和健康状况、日常生活活动、情绪状态、社会功能和人际关系的意识）的变化模式以及与每个领域相关的方面。方法：对AD （PwAD）患者和护理者二组（n = 128; CDR1 = 74, CDR2 = 54）进行横断面评估。PwAD完成了关于生活质量、认知和疾病意识的评估。护理人员提供了有关PwAD的信息，并接受了生活质量和护理负担评估。结果：轻度AD组有轻度意识损害（n = 40, 54.05%），中度AD组有较高程度的中度意识损害（n = 22, 40.74%）。两组患者在认知功能和健康状况意识（p < 0.004）、功能活动障碍（p < 0.001）和认知总分（p < 0.01）方面差异均有统计学意义。相反，情绪状态意识（p = 0.22）和社会功能和关系意识（p = 0.44）组间无显著差异。在两组中，PwAD和护理人员对功能活动障碍的认知差异较大。结论：仅在认知功能和健康状况意识、日常生活和社会情绪功能意识的差异模式上存在显著差异。在轻度和中度痴呆组中，不同的因素与不同的领域相关，强化了痴呆认知的异质性。ADL缺陷在意识现象中有重要作用，与疾病的严重程度无关。
Objectives: Awareness is considered a heterogeneous and non-linear phenomenon in dementia. We aim to investigate patterns of change of different domains of awareness (awareness of cognitive functioning and health condition, activities of daily living, emotional state, social functioning, and relationships) in people with mild and moderate Alzheimer's disease (AD) and aspects related to each domain. Method: Cross-sectional assessment of dyads of people with AD (PwAD) and caregivers (n = 128; CDR1 = 74, CDR2 = 54). PwAD completed assessments about quality of life, cognition and their awareness of disease. Caregivers provided information about PwAD and received quality of life and burden of care assessments. Results: Mild AD group showed a mildly impaired awareness (n = 40; 54.05%), while moderate AD group, showed higher presence of moderately impaired awareness (n = 22; 40.74%). There was a significant difference between groups in awareness of cognitive functioning and health condition (p < 0.004), functional activity impairments (p < 0.001) and total score of awareness (p < 0.01). Conversely, awareness of emotional state (p = 0.22) and of social functioning and relationship (p = 0.44) presented no significant difference between groups. Unawareness of functional activity impairments showed higher discrepancy scores between PwAD and caregivers in both groups. Conclusions: Significant differences were found only in patterns of discrepancies in awareness of cognitive functioning and health condition, of ADL and socio-emotional functioning. Different factors are related to different domains in mild and moderate group, reinforcing the heterogeneity of awareness in dementia. ADL deficits have an important role in awareness phenomenon, independent of the severity of disease.