UNAWARENESS OF DEFICIT IN ALZHEIMERS-DISEASE - DOMAIN-SPECIFIC DIFFERENCES AND DISEASE CORRELATES

Domain-specific differences in awareness of deficit were investigated in 43 patients diagnosed with Alzheimer's disease (AD). Impairment of awareness was measured by calculating the degree to which patients and their caregivers disagreed on ratings of patient memory, health status, self-care ability, depression, anxiety, and irritability. The results indicated that patient awareness differed according to domain assessed with greatest patient-caregiver disagreement occurring in ratings of memory and self-care, moderate disagreement in ratings of anxiety and irritability, and least disagreement in ratings of depression and health status. Overall, impairment of awareness was associated with more advanced disease and greater dementia severity, but not with age, age at onset, education, or duration of illness. These findings argue against conceptualizing awareness as a unitary construct and are congruent with neuropsychological models of awareness that emphasize potential dissociations according to functional domain.