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The role of unawareness on functional status in mild Alzheimer's dementia.

机译:意识不清对轻度阿尔茨海默氏痴呆患者功能状态的作用。

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摘要

Alzheimer's dementia (AD) is characterized by a progressive decline in memory in addition to decline in at least one other cognitive domain. Integral to the diagnosis is a simultaneous decline in functional abilities such as driving skills, and often an unawareness of this decline. Individuals who are unaware of deficits are often unable to accept the help that they need in completing functional tasks and may put themselves in dangerous situations. For example, individuals with an unawareness of their own deficits may prolong driving cessation. Cognitive status explains some, but not all, of the variability in functional abilities. This study examined the relationship between cognition, unawareness, and functional ability in individuals with mild AD as well as in healthy older adults. Understanding this relationship in healthy older adults will help to establish a baseline prior to disease onset. This baseline is not well understood thereby potentially compromising the safety of even healthy older adults. For example, current driving laws with older adults rely on the assumption that individuals will be able to regulate their driving behaviors as they become aware of age-related changes. This study used a virtual reality driving simulator (VRDS) to assess driving performance in healthy controls with exploratory analyses conducted on individuals with mild AD. Awareness was measured by participant-reliable informant discrepancy scores on the Instrumental Activities of Daily Living (IADL) Questionnaire, as well as discrepancy scores between the participant's perception of performance on the VRDS versus actual performance. Results with healthy controls established no relationship between functional ability and awareness when holding performance on cognitive testing constant. Instead, a relationship was found between functional ability, as measured by the IADL questionnaire, and awareness of functional ability in healthy older adults (r= -.747, p .01). As functional ability decreased, awareness of functioning also decreased suggesting that those individuals with greater functional impairments are less aware of such impairments and therefore pose a safety risk. The MMSE was also linked to functional ability in healthy controls, as measured by the IADL, suggesting a relationship continuum between global cognitive status and functioning in healthy older adults from the community. Additionally, trends in the data for individuals with mild AD suggest a correlation between global cognitive status, as measured by the MMSE, and measures of awareness on both functional measures. Findings suggest that unawareness can lead to increased safety risks in healthy older adults. Measurement tools such as the IADL and MMSE may serve to identify those individuals at risk for both healthy older adults as well as individuals with mild AD.
机译:阿尔茨海默氏痴呆症(AD)的特征是记忆力的逐步下降,以及至少一个其他认知领域的下降。诊断中不可或缺的是功能能力(例如驾驶技能)的同时下降,并且常常不知道这种下降。不了解缺陷的个人通常无法接受完成功能任务所需的帮助,并且可能使自己陷入危险境地。例如,对自己的赤字一无所知的人可能会延长驾驶时间。认知状态可以解释部分但不是全部功能功能的变异性。这项研究检查了轻度AD患者以及健康老年人的认知,意识和功能能力之间的关系。了解健康老年人的这种关系将有助于在疾病发作之前建立基线。对这个基线的了解还不够,因此有可能损害甚至健康的成年人的安全。例如,当前针对老年人的驾驶法律所依据的假设是,当人们意识到与年龄有关的变化时,他们将能够调节其驾驶行为。这项研究使用虚拟现实驾驶模拟器(VRDS)通过对轻度AD患者进行的探索性分析来评估健康对照中的驾驶性能。意识是通过参与者对日常生活的工具性活动(IADL)问卷中可靠的线人差异评分以及参与者对VRDS的绩效感知与实际绩效之间的差异得分来衡量的。当保持认知测试的表现不变时,健康对照的结果在功能能力和意识之间没有关系。取而代之的是,发现了通过IADL问卷测量的功能能力与健康老年人的功能能力意识之间的关系(r = -.747,p <.01)。随着功能能力的下降,对功能的认识也下降,这表明那些功能受损程度更大的人对此类损害的意识较弱,因此存在安全风险。 MMSE还与IADL测得的健康对照的功能能力相关联,表明全球认知状况与社区健康老年人的功能之间存在连续性关系。此外,针对轻度AD患者的数据趋势表明,通过MMSE衡量的整体认知状态与对这两种功能性措施的认知程度之间存在相关性。研究结果表明,不注意可能导致健康的老年人增加安全风险。 IADL和MMSE等测量工具可用于识别那些健康的老年人和轻度AD的人。

著录项

  • 作者

    Roseman, Emily C.;

  • 作者单位

    Drexel University.;

  • 授予单位 Drexel University.;
  • 学科 Psychology Clinical.
  • 学位 Ph.D.
  • 年度 2010
  • 页码 152 p.
  • 总页数 152
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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