Anosognosia increases caregiver burden in mild cognitive impairment

被引:37
作者
Kelleher, Mary [1 ]
Tolea, Magdalena I. [1 ,2 ]
Galvin, James E. [1 ,2 ]
机构
[1] NYU Langone Med Ctr, Ctr Cognit Neurol, New York, NY 10016 USA
[2] Florida Atlantic Univ, Charles E Schmidt Coll Med, Boca Raton, FL 33431 USA
基金
美国国家卫生研究院;
关键词
mild cognitive impairment; neurocognitive disorders; anosognosia; caregiver burden; depression; patient insight; ALZHEIMERS ASSOCIATION WORKGROUPS; BRIEF INFORMANT INTERVIEW; NEUROPSYCHIATRIC SYMPTOMS; DIAGNOSTIC GUIDELINES; PSYCHIATRIC-SYMPTOMS; NATIONAL INSTITUTE; DISEASE; DEMENTIA; DEFICITS; AWARENESS;
D O I
10.1002/gps.4394
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
ObjectiveOur aim is to determine the clinical correlates of impaired insight in patients with mild cognitive impairment (MCI) by examining its impact on cognition, functional status, neuropsychiatric symptoms, and caregiver burden. MethodsThe study involved 75 patients with MCI and their caregivers. Patients and caregivers underwent a comprehensive evaluation including the Clinical Dementia Rating, memory tests, and the Functional Assessment Questionnaire. Behavioral symptoms were assessed by the Neuropsychiatric Inventory, caregiver burden by the Zarit Burden Inventory, and insight by comparing self-report on the AD8 dementia screening tool to informant collateral. Patients were asked about their perceptions of their memory, and answers were compared with informants' responses. Patient mood was assessed with the Hospital Anxiety Depression Scale. ResultsThere was a significant difference in AD8 scores among patients who retained versus lacked insight. Zarit Burden Inventory scores showed a significant rise as patient insight declined; the burden appeared greater on spouse versus non-spouse caregivers. Patients with poor insight had significantly worse ratings in Clinical Dementia Rating domains of personal care and judgment, while patients who retained insight had significantly higher depression and anxiety. Insight impairment was associated with worse caregiver mood. ConclusionsDecreased patient awareness for cognitive problems was significantly associated with higher caregiver burden, independent of neuropsychiatric symptoms, functional abilities, and cognition. Personal care, judgment, and problem-solving skills could contribute to caregiver burden. Increased awareness seemed a source of patient depression and anxiety. The research highlights the need to focus on the needs of MCI caregivers and to incorporate psychosocial assessments of caregiver-patient dyads into office visits.
引用
收藏
页码:799 / 808
页数:10
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