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Awareness and behavioral problems in dementia patients: a prospective study
Pauline Aalten1, Evelien van Valen, Marjolein E de Vugt
1Department of Psychiatry and Neuropsychology, Brain and Behavior Institute, University of Maastricht, Maastricht, the Netherlands. paalten@np.unimaas.nl
International Psychogeriatrics
|January 4, 2006
Summary
Awareness in dementia patients decreases over time and is linked to behavioral symptoms like depression and anxiety. Early intervention with psychosocial support may help manage these affective symptoms.
Area of Science:
- Neurology
- Gerontology
- Psychiatry
Background:
- Inconclusive evidence exists on the link between awareness and clinical factors in dementia patients.
- Previous research has not definitively established how awareness changes during dementia progression.
- The association between awareness and specific behavioral symptoms in dementia requires further investigation.
Purpose of the Study:
- To investigate changes in awareness over the course of dementia.
- To determine the association between awareness and specific behavioral symptoms.
- To test the hypothesis that intact awareness correlates with affective disorders.
Main Methods:
- A prospective 18-month follow-up study included 199 dementia patients.
- Behavioral problems were assessed using the Neuropsychiatric Inventory and Cornell Scale for Depression in Dementia.
- Awareness was evaluated using the Guidelines for the Rating of Awareness Deficits.
Main Results:
- Awareness positively correlated with age, gender, education, and socioeconomic status at baseline.
- Awareness negatively correlated with psychosis, apathy, and overall behavioral disorders at baseline.
- Higher awareness at baseline predicted depression and anxiety after 1 year, and awareness levels decreased during the study.
Conclusions:
- Elevated awareness is linked to subsyndromal depression and anxiety.
- Reduced awareness is associated with psychosis and apathy.
- Awareness declines as dementia progresses; clinicians should monitor changes to offer timely psychosocial support.