[en] INTRODUCTION
Awareness influences the evolution of neurodegenerative dementias. We gathered participants’ and caregivers assessments of dependence in daily activities and we studied how each score would be related to next year participant autonomy, independently of other explicative variables.
METHOD
We retrospectively analyzed data from mildly demented participants with a clinical diagnosis of Alzheimer's disease (AD, n = 186) and frontotemporal dementia (FTD, n = 29) and their relatives. A research tool was used to assess participant dependence in 98 daily activities and associated caregiver burden. A discrepancy score between the patient's and relative's judgment was calculated to evaluate awareness of dependence in activities at baseline. This dependence scores, as well as sex, age, education, and 1 year difference in Mini-Mental State Examination were taken as possible explicative variables for dependence in activities adapted by therapists during a 1-year cognitive rehabilitation program.
RESULTS
Patients with FTD showed less awareness for daily dependence (discrepancy 20.9% vs. 11.8% in AD). Both groups benefited from cognitive rehabilitation (25% decrease in dependence) and subjective burden of relatives was decreased in both groups. In the AD group, there was a significant positive relationship between both caregiver (P < 0.001) and participant's (P < 0.02) evaluation of dependence in daily activities at inclusion and dependence of participants in adapted activities after 1 year.
DISCUSSION
Awareness of impairment in daily activities is a clinical symptom that is more important at inclusion in FTD than in AD. However, in participants with AD who, as a group, significantly benefit from a cognitive rehabilitation program, not only caregiver's but also participant's assessment of dependence at baseline is correlated to subsequent, next year greater dependence in daily activities adapted by the therapists. Although discrepant, both caregiver and participant evaluations appear to be important variables to understand the evolution and the benefit of care in participants at early stages of dementia.
Disciplines :
Neurosciences & behavior
Author, co-author :
Salmon, Eric ; Université de Liège - ULiège > Département des sciences cliniques
LEKEU, Françoise ; Centre Hospitalier Universitaire de Liège - CHU > > Service de neurologie
QUITTRE, Anne ; Centre Hospitalier Universitaire de Liège - CHU > > Service de neurologie
GODICHARD, Vinciane ; Centre Hospitalier Universitaire de Liège - CHU > > Service de psychologie clinique et d'action sociale
OLIVIER, Catherine ; Centre Hospitalier Universitaire de Liège - CHU > > Service de neurologie
WOJTASIK, Vinciane ; Centre Hospitalier Universitaire de Liège - CHU > > Service de neurologie
Bastin, Christine ; Université de Liège - ULiège > GIGA > GIGA CRC In vivo Imaging - Aging & Memory ; Université de Liège - ULiège > Département de Psychologie
Language :
English
Title :
Awareness and cognitive rehabilitation in Alzheimer and frontotemporal dementia
Publication date :
2024
Journal title :
Alzheimer's and Dementia: Translational Research and Clinical Interventions
eISSN :
2352-8737
Publisher :
Wiley, Hoboken, United States - New Jersey
Volume :
10
Pages :
e12469
Peer reviewed :
Peer Reviewed verified by ORBi
Funding text :
This is a pilot program of the Belgian Federal Institute for Health Insurance. CB is a senior research associate at the F.R.S.-FNRS.
scite shows how a scientific paper has been cited by providing the context of the citation, a classification describing whether it supports, mentions, or contrasts the cited claim, and a label indicating in which section the citation was made.
Bibliography
Tondelli M, Galli C, Vinceti G, et al. Anosognosia in early- and late-onset dementia and its association with neuropsychiatric symptoms. Front Psychiatry 2021;12:1-8. https://doi.org/10.3389/fpsyt.2021.658934
Bastin C, Giacomelli F, Mievis F, Lemaire C, Guillaume B, Salmon E. Anosognosia in mild cognitive impairment: lack of awareness of memory difficulties characterizes prodromal Alzheimer's disease. Front Psychiatry 2021;12:631518. https://doi.org/10.3389/fpsyt.2021.631518
Munro CE, Donovan NJ, Amariglio RE, et al. The impact of awareness of and concern about memory performance on the prediction of progression from mild cognitive impairment to Alzheimer disease dementia. Am J Geriatr Psychiatry 2018;26(8):896-904.
Salmon E, Perani D, Collette F, et al. A comparison of unawareness in frontotemporal dementia and Alzheimer's disease. J Neurol Neurosurg Psychiatry 2008;79(2):176-179.
Kelleher M, Tolea MI, Galvin JE. Anosognosia increases caregiver burden in mild cognitive impairment. Int J Geriatr Psychiatry 2016;31(7):799-808. https://doi.org/10.1002/gps.4394
Koltai DC, Welsh-Bohmer KA, Schmechel DE. Influence of anosognosia on treatment outcome among dementia patients. Neuropsychol. Rehabil 2001;11(3-4):455-475. https://doi.org/10.1080/09602010042000097
Starkstein SE. Anosognosia in Alzheimer's disease: diagnosis, frequency, mechanism and clinical correlates. Cortex 2014;61:64-73. https://doi.org/10.1016/j.cortex.2014.07.019
Clare L. Awareness in early-stage Alzheimer's disease: a review of methods and evidence. Br J Clin Psychol 2004;43(Pt 2):177-196.
Alexander CM, Martyr A, Savage SA, Morris RG, Clare L. Measuring awareness in people with dementia: Results of a systematic scoping review. J Geriatr Psychiatry Neurol 2021;34(5):335-348. https://doi.org/10.1177/0891988720924717
Clare L, Nelis SM, Martyr A, et al. The influence of psychological, social and contextual factors on the expression and measurement of awareness in early-stage dementia: testing a biopsychosocial model. Int J Geriatr Psychiatry 2012;27(2):167-177. https://doi.org/10.1002/gps.2705
Thorsen K, Dourado MCN, Johannessen A. Awareness of dementia and coping to preserve quality of life: a five-year longitudinal narrative study. Int J Qual Stud Health Well-being 2020;15(1):1798711. https://doi.org/10.1080/17482631.2020.1798711
Kurth S, Wojtasik V, Lekeu F, et al. Efficacy of cognitive rehabilitation versus usual treatment at home in patients with early stages of Alzheimer disease. J Geriatr Psychiatry Neurol 2021;34(3):209-215. https://doi.org/10.1177/0891988720924721
McKhann GM, Knopman DS, Chertkow H, et al. The diagnosis of dementia due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement 2011;7(3):263-269. https://doi.org/10.1016/j.jalz.2011.03.005
Rascovsky K, Hodges JR, Knopman D, et al. Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia. Brain 2011;134(Pt 9):2456-2477. https://doi.org/10.1093/brain/awr179
Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12(3):189-198.
Germain S, Wojtasik V, Lekeu F, et al. Efficacy of cognitive rehabilitation in Alzheimer disease: a 1-year follow-up study. J Geriatr Psychiatry Neurol 2019;32(1):16-23. https://doi.org/10.1177/0891988718813724
Anselme P, Poncelet M, Bouwens S, et al. Profinteg: A tool for real-life assessment of activities of daily living in patients with cognitive impairment. Psychologica Belgica 2013;53(1):3-22.
Zarit SH, Reever KE, Bach-Peterson J. Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist 1980;20(6):649-655.
Cummings JL, Mega M, Gray K, Rosenberg-Thompson S, Carusi DA, Gornbein J. The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology 1994;44(12):2308-2314.
Garre-Olmo J, Vilalta-Franch J, Calvó-Perxas L, Turró-Garriga O, Conde-Sala JL, López-Pousa S. A path analysis of patient dependence and caregiver burden in Alzheimer's disease. Int. Psychogeriatr 2016;28(7):1133-1141. https://doi.org/10.1017/S1041610216000223
Georges J, Jansen S, Jackson J, Meyrieux A, Sadowska A, Selmes M. Alzheimer's disease in real life—the dementia carer's survey. Int J Geriatr Psychiatry 2008;23(5):546-551. https://doi.org/10.1002/gps.1984
Razani J, Kakos B, Orieta-Barbalace C, et al. Predicting caregiver burden from daily functional abilities of patients with mild dementia. J Am Geriatr Soc 2007;55(9):1415-1420. https://doi.org/10.1111/j.1532-5415.2007.01307.x
Amieva H, Robert PH, Grandoulier AS, et al. Group and individual cognitive therapies in Alzheimer's disease: the ETNA3 randomized trial. Int Psychogeriatr 2016;28(5):707-717. https://doi.org/10.1017/S1041610215001830
Clare L, Kudlicka A, Oyebode JR, et al. Individual goal-oriented cognitive rehabilitation to improve everyday functioning for people with early-stage dementia: a multicentre randomised controlled trial (the GREAT trial). Int J Geriatr Psychiatry 2019;34(5):709-721. https://doi.org/10.1002/gps.5076
Clare L, Linden DE, Woods RT, et al. Goal-oriented cognitive rehabilitation for people with early-stage Alzheimer disease: a single-blind randomized controlled trial of clinical efficacy. Am J Geriatr Psychiatry 2010;18(10):928-939. https://doi.org/10.1097/JGP.0b013e3181d5792a
Thivierge S, Jean L, Simard M. A randomized cross-over controlled study on cognitive rehabilitation of instrumental activities of daily living in Alzheimer disease. Am J Geriatr Psychiatry 2014;22(11):1188-1199. https://doi.org/10.1016/j.jagp.2013.03.008
Jessen F, Amariglio RE, Buckley RF, et al. The characterisation of subjective cognitive decline. Lancet Neurol 2020;19(3):271-278. https://doi.org/10.1016/S1474-4422(19)30368-0
Clare L, Markova I, Verhey F, Kenny G. Awareness in dementia: A review of assessment methods and measures. Aging Ment Health 2005;9(5):394-413. https://doi.org/10.1080/13607860500142903
Aalten P, van Valen E, Clare L, Kenny G, Verhey F. Awareness in dementia: a review of clinical correlates. Aging Ment Health 2005;9(5):414-422. https://doi.org/10.1080/13607860500143075
Jorm AF, Butterworth P, Anstey KJ, et al. Memory complaints in a community sample aged 60–64 years: associations with cognitive functioning, psychiatric symptoms, medical conditions, APOE genotype, hippocampus and amygdala volumes, and white-matter hyperintensities. Psychol Med 2004;34(8):1495-1506. https://doi.org/10.1017/s0033291704003162
Salmon E, Perani D, Herholz K, et al. Neural correlates of anosognosia for cognitive impairment in Alzheimer's disease. Hum Brain Mapp 2006;27(7):588-597.
Kashiwa Y, Kitabayashi Y, Narumoto J, Nakamura K, Ueda H, Fukui K. Anosognosia in Alzheimer's disease: association with patient characteristics, psychiatric symptoms and cognitive deficits. Psychiatry Clin Neurosci 2005;59(6):697-704.
Migliorelli R, Teson A, Sabe L, et al. Anosognosia in Alzheimer's disease: a study of associated factors. J Neuropsychiatry Clin Neurosci 1995;7(3):338-344.
Clare L, Wilson BA, Carter G, Roth I, Hodges JR. Awareness in early-stage Alzheimer's disease: relationship to outcome of cognitive rehabilitation. J Clin Exp Neuropsychol 2004;26(2):215-226. https://doi.org/10.1076/jcen.26.2.215.28088
Martyr A, Gamble LD, Nelis SM, et al. Predictors of awareness of functional ability in people with dementia: the contribution of personality, cognition, and neuropsychiatric symptoms—Findings from the IDEAL program. Dement Geriatr Cogn Disord 2022;51(3):221-232. https://doi.org/10.1159/000524607
Roberts JL, Clare L, Woods RT. Subjective memory complaints and awareness of memory functioning in mild cognitive impairment: a systematic review. Dement Geriatr Cogn Disord 2009;28(2):95-109. https://doi.org/10.1159/000234911
Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969;9(3):179-186.
Vogel A, Hasselbalch SG, Gade A, Ziebell M, Waldemar G. Cognitive and functional neuroimaging correlate for anosognosia in mild cognitive impairment and Alzheimer's disease. Int J Geriatr Psychiatry 2005;20(3):238-246.
This website uses cookies to improve user experience. Read more
Save & Close
Accept all
Decline all
Show detailsHide details
Cookie declaration
About cookies
Strictly necessary
Performance
Strictly necessary cookies allow core website functionality such as user login and account management. The website cannot be used properly without strictly necessary cookies.
This cookie is used by Cookie-Script.com service to remember visitor cookie consent preferences. It is necessary for Cookie-Script.com cookie banner to work properly.
Performance cookies are used to see how visitors use the website, eg. analytics cookies. Those cookies cannot be used to directly identify a certain visitor.
Used to store the attribution information, the referrer initially used to visit the website
Cookies are small text files that are placed on your computer by websites that you visit. Websites use cookies to help users navigate efficiently and perform certain functions. Cookies that are required for the website to operate properly are allowed to be set without your permission. All other cookies need to be approved before they can be set in the browser.
You can change your consent to cookie usage at any time on our Privacy Policy page.