Awareness of deficits in the context of Alzheimer's disease: representations and experiences of healthcare professionals

The quality of care provided to people living with Alzheimer's Disease (AD) depends, in part, on the ability of professionals to identify the extent of awareness in patients. The present research focused on professional caregivers' representations concerning patients' awareness of disorders in residents of long-term care institutions diagnosed with AD. The predictive power of anosognosia on healthcare professionals' burden was also investigated. Anosognosia for construction and initiation impairments (r= 0.40, p = 0.0164; r = 0.32, p = 0.052) was correlated with caregivers' burden. Professionals tended to form representations of patients as being unaware of their condition, including in the absence of anosognosia. Indeed, anosognosia scores did not predict professionals' estimates, except for the overall anosognosia score (chi(2) = 3.38, p = 0.066). However, caregivers overestimated patients' cognitive performances, as measured via the Misawareness protocol (caregiver predictions/actual performances: DC = 12.32, p <0.0001).