Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
J Alzheimers Dis. 2021;81(1):169-178. doi: 10.3233/JAD-201603.
There is a lack of research investigating whether there are differences in the domains of awareness according to the age at onset of dementia.
This study is designed to investigate differences in awareness of cognitive functioning and health condition, functional activity impairments, emotional state, and social functioning and relationships among people with young onset (YOD) and late onset dementia (LOD); and examine associations between awareness and its domains with cognition, functionality, neuropsychiatric symptoms, social and emotional functioning, and quality of life (QoL) in both groups.
A group of 136 people with dementia and their respective caregivers (YOD = 50 and LOD = 86) were consecutively selected. We assessed awareness of disease, dementia severity, cognition, functionality, neuropsychiatric symptoms, social and emotional functioning, and QoL.
People with YOD had more neuropsychiatric symptoms than people with LOD. People with YOD were more aware of disease (total score), of their cognitive functioning and health condition and of their functional activity impairments, even if this group was more severely cognitive impaired and had a worse level of functionality than LOD group. Multivariate linear regressions showed that functionality has a wide relationship to awareness for people with YOD. While neuropsychiatric symptoms and QoL has a greater relation to awareness for people with LOD.
Different clinical variables are associated to different domains in YOD and LOD groups, reinforcing the heterogeneity of awareness in dementia.
目前缺乏研究调查痴呆发病年龄不同是否会导致意识领域存在差异。
本研究旨在调查早发性痴呆（YOD）和晚发性痴呆（LOD）患者在认知功能和健康状况、功能活动障碍、情绪状态和社会功能及人际关系方面的意识差异；并探讨两组患者的意识及其各领域与认知、功能、神经精神症状、社会和情感功能以及生活质量（QoL）之间的关联。
连续选择了 136 名痴呆患者及其各自的照顾者（YOD=50，LOD=86）。我们评估了疾病意识、痴呆严重程度、认知、功能、神经精神症状、社会和情感功能以及生活质量。
与 LOD 组相比，YOD 组患者的神经精神症状更多。YOD 组患者对疾病（总分）、认知功能和健康状况以及功能活动障碍的意识更为明显，尽管该组认知障碍更为严重，功能水平比 LOD 组更差。多变量线性回归显示，对于 YOD 患者，功能与意识之间存在广泛的关系。而对于 LOD 患者，神经精神症状和 QoL 与意识的关系更为密切。
不同的临床变量与 YOD 和 LOD 组的不同领域相关，这强化了痴呆患者意识的异质性。
