Year: 2008
Type: article
Study design: Observational Study
Abstract: Timely diagnosis of Alzheimer's disease (AD) usually depends on the identification of symptoms by the patient or a family member. However, the relationship between the cognitive complaints made by patients or family members and the clinical diagnosis of either AD or mild cognitive impairment (MCI) remains unclear. Archival data from 386 patients were extracted from the Boston University Alzheimer's Disease Center Registry. Participants were diagnosed by a consensus conference as cognitively normal (n=119), MCI (n=163), or AD (n=104). Variables extracted included self- and informant ratings about the presence or absence of impairments in the participant's memory, judgment, language, visuospatial function, and attention. Crosstabulations were conducted to determine the agreement between participant and informant ratings. For the entire group of participants, substantial discrepancies existed on questions addressing the presence or absence of impairments in memory, judgment, language, visuospatial function, and attention. Participants and their informants disagreed most often on judgment, attention, and visuospatial function; least often on memory; and with an intermediate level of agreement regarding language function. When broken down by diagnostic group, participants with AD and their informants were in agreement 76% of the time regarding the presence of absence of memory symptoms, but only 26% of AD participants agreed with informants who endorsed impaired judgement.Concordance on ratings of language, visuospatial function, and attention were around chance levels. Participants with MCI agreed with their informants 68% of the time with regard to symptoms of memory impairment. There was good agreement in the other domains, primarily due to the fact that few abnormal ratings were made by either the participants or their informants. Interestingly, a greater proportion of participants with MCI (31%) endorsed significant memory symptoms than did their informants (15%). Elderly individuals and their family members often disagree on the presence of absence of cognitive symptoms. Participants with MCI and AD appear to be in better agreement with informants about memory functioning than functioning in other cognitive domains. Awareness of reduced judgment may be particularly lacking in AD.
Source: Alzheimer s & Dementia
Authors: B. Seltzer, M.S. Barrup, C.A. Bliss, B. Gonzalez, E. Steinberg, B.E. Gavett, A.L. Jefferson, A. Nair, R.C. Green, R.A. Stern
Institutions: Harvard University, VA Boston Healthcare System, Boston University
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2033393354