Center for Alzheimer's disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro.
Department of Political Sociology, Universidade Federal de Santa Catarina, Florianópolis, Brazil.
Alzheimer Dis Assoc Disord. 2019 Apr-Jun;33(2):129-135. doi: 10.1097/WAD.0000000000000299.
Awareness of disease is the ability to acknowledge changes caused by deficits related to the disease process. We aimed to investigate whether there are differences in awareness of disease between young-onset dementia (YOD) and late-onset dementia (LOD) and examined how awareness interacts with cognitive and clinical variables.
Using a cross-sectional design, 49 people with YOD and 83 with LOD and their caregivers were included. We assessed awareness of disease, cognition, functionality, stage of dementia, mood, neuropsychiatric symptoms, and caregivers' quality of life (QoL) and burden.
We found that people with YOD were more aware of the disease than people with LOD (P<0.005). Multivariate linear regression revealed that higher impairment in functional level was associated with unawareness in both groups (YOD=P<0.001; LOD=P<0.001). In the YOD group, preserved awareness was related to worse self-reported QoL (P<0.05), whereas, in LOD, deficits in awareness were related to caregivers' worst perceptions about people with dementia QoL (P<0.001).
The findings highlight the distinct nature of awareness between YOD and LOD. The YOD group had higher levels of disease awareness compared with the LOD group, even though the first group had a greater impairment in functionality.
对疾病的认知是指能够认识到与疾病过程相关的缺陷所导致的变化。我们旨在研究早发性痴呆（YOD）和晚发性痴呆（LOD）之间对疾病的认知是否存在差异，并探讨认知与认知和临床变量的相互作用。
采用横断面设计，纳入 49 例 YOD 患者和 83 例 LOD 患者及其照顾者。我们评估了疾病认知、认知功能、功能状态、痴呆阶段、情绪、神经精神症状以及照顾者的生活质量（QoL）和负担。
我们发现 YOD 患者比 LOD 患者对疾病的认知程度更高（P<0.005）。多变量线性回归显示，两组患者的功能水平受损程度越高，对疾病的认知程度越低（YOD=P<0.001；LOD=P<0.001）。在 YOD 组中，保持认知与自我报告的 QoL 较差有关（P<0.05），而在 LOD 组中，认知缺陷与照顾者对痴呆患者 QoL 的最差感知有关（P<0.001）。
这些发现突出了 YOD 和 LOD 之间认知的不同性质。与 LOD 组相比，YOD 组对疾病的认知水平更高，尽管前者的功能障碍程度更大。
