Department of Rehabilitation Sciences, Gunma University School of Health Sciences, Gunma, Japan.
Am J Alzheimers Dis Other Demen. 2012 Aug;27(5):339-45. doi: 10.1177/1533317512452039.
We aimed to study how patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD) suffer from awareness of their deficits. Self-awareness was assessed using the Anosognosia Questionnaire for Dementia in 12 pairs of MCI outpatients and caregivers, 23 with mild AD, and 18 with moderate AD. The discrepancy between patient's and caregiver's evaluation (anosognosia) became greater as AD progressed. The predictors of patients' distress, shown by multiple linear regression analyses, were awareness of decline in intellectual or social functioning; self-awareness of deficits in remembering appointments in MCI; in remembering appointments, writing, mental calculation, and understanding the newspaper in mild AD; and in mental calculation and doing clerical work in moderate AD. Caregivers assumed the predictors of patients' distress differently: awareness of deterioration of memory in MCI and mild AD, and basic activities of daily living in moderate AD. Understanding patients' disability from patients' perspective is required for successful care.
我们旨在研究轻度认知障碍（MCI）和阿尔茨海默病（AD）患者如何遭受认知缺陷的困扰。使用痴呆症认知障碍自知力问卷评估了 12 对 MCI 门诊患者和护理人员、23 例轻度 AD 和 18 例中度 AD 的自我意识。随着 AD 的进展，患者和护理人员评估之间的差异（自知力缺失）变得更大。通过多元线性回归分析显示，患者痛苦的预测因素是智力或社会功能下降的意识；在 MCI 中记住约会、在轻度 AD 中记住约会、写作、心算和理解报纸、在心算和做文书工作中存在缺陷的自我意识；在中度 AD 中进行文书工作。护理人员对患者痛苦的预测因素有不同的假设：在 MCI 和轻度 AD 中，记忆恶化，以及中度 AD 中基本的日常生活活动。从患者的角度理解患者的残疾是成功护理的必要条件。
