Login to MyKarger

New to MyKarger? Click here to sign up.



Login with Facebook

Forgot your password?

Authors, Editors, Reviewers

For Manuscript Submission, Check or Review Login please go to Submission Websites List.

Submission Websites List

Institutional Login
(Shibboleth or Open Athens)

For the academic login, please select your country in the dropdown list. You will be redirected to verify your credentials.

Original Research Article

Memory Awareness Profiles Differentiate Mild Cognitive Impairment from Early-Stage Dementia: Evidence from Assessments of Performance Monitoring and Evaluative Judgement

Clare L.a · Whitaker C.J.b · Roberts J.L.a · Nelis S.M.a · Martyr A.a · Marková I.S.c · Roth I.d · Woods R.T.a · Morris R.G.e

Author affiliations

aSchool of Psychology, and bNorth Wales Organisation for Randomised Trials in Health, Bangor University, Bangor, cDepartment of Psychiatry, University of Hull, Hull, dPsychology in Science, The Open University, Milton Keynes, and eKings College London Institute of Psychiatry, London, UK

Related Articles for ""

Dement Geriatr Cogn Disord 2013;35:266-279

Do you have an account?

Login Information





Contact Information











I have read the Karger Terms and Conditions and agree.



Login Information





Contact Information











I have read the Karger Terms and Conditions and agree.



To view the fulltext, please log in

To view the pdf, please log in

Buy

  • FullText & PDF
  • Unlimited re-access via MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!

If you would like to redeem your KAB credit, please log in.


Save over 20% compared to the individual article price.
Learn more

Rent/Cloud

  • Rent for 48h to view
  • Buy Cloud Access for unlimited viewing via different devices
  • Synchronizing in the ReadCube Cloud
  • Printing and saving restrictions apply

Rental: USD 8.50
Cloud: USD 20.00


Select

Subscribe

  • Access to all articles of the subscribed year(s) guaranteed for 5 years
  • Unlimited re-access via Subscriber Login or MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

Subcription rates


Select

* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

First-Page Preview
Abstract of Original Research Article

Accepted: December 11, 2012
Published online: March 27, 2013
Issue release date: May 2013

Number of Print Pages: 14
Number of Figures: 0
Number of Tables: 5

ISSN: 1420-8008 (Print)
eISSN: 1421-9824 (Online)

For additional information: https://www.karger.com/DEM

Abstract

Background: Measures of memory awareness based on evaluative judgement and performance monitoring are often regarded as equivalent, but the Levels of Awareness Framework suggests they reflect different awareness phenomena. Examination of memory awareness among groups with differing degrees of impairment provides a test of this proposition. Method: Ninety-nine people with dementia (PwD), 30 people with mild cognitive impairment (PwMCI), and their relatives completed isomorphic performance monitoring and evaluative judgement measures of memory awareness and were followed up at 12 and (PwD only) 20 months. In addition to the resulting awareness indices, comparative accuracy scores were calculated using the relatives' data to establish whether any inaccuracy was specific to self-ratings. Results: When making evaluative judgements about their memory in general, both PwD and PwMCI tended to overestimate their own functioning relative to informant ratings made by relatives. When monitoring performance on memory tests, PwD again overestimated performance relative to test scores, but PwMCI were much more accurate. Comparative accuracy scores indicated that, unlike PwD, PwMCI do not show a specific inaccuracy in self-related appraisals. Conclusions: The results support the proposition that awareness indices at the levels of evaluative judgement and performance monitoring should be regarded as reflecting distinct awareness phenomena.

© 2013 S. Karger AG, Basel


References

  1. Derouesné C, Thibault S, Lagha-Pierucci S, Baudouin-Madec V, Ancri D, Lacomblez L: Decreased awareness of cognitive deficits in patients with mild dementia of the Alzheimer type. Int J Geriatr Psychiatry 1999;14:1019-1030.
  2. Smith CA, Henderson VW, McCleary CA, Murdock GA, Buckwalter JG: Anosognosia and Alzheimer's disease: the role of depressive symptoms in mediating impaired insight. J Clin Exp Neuropsychol 2000;22:437-444.
  3. Smyth KA, Neundorfer MM, Koss E, Geldmacher DS, Ogocki PK, Whitehouse PJ: Quality of life and deficit identification in dementia. Dementia 2002;1:345-358.
    External Resources
  4. Rymer S, Salloway S, Norton L, Malloy P, Correia S, Monast D: Impaired awareness, behavior disturbance, and caregiver burden in Alzheimer disease. Alzheimer Dis Assoc Disord 2002;16:248-253.
  5. Dalla Barba G, Parlato V, Iavarone A, Boller F: Anosognosia, intrusions and ‘frontal' functions in Alzheimer's disease and depression. Neuropsychologia 1995;33:247-259.
  6. Wagner MT, Spangenberg KB, Bachman DL, O'Connell P: Unawareness of cognitive deficit in Alzheimer disease and related dementias. Alzheimer Dis Assoc Disord 1997;11:125-131.
  7. Hannesdottir K, Morris RG: Primary and secondary anosognosia for memory impairment in patients with Alzheimer's disease. Cortex 2007;43:1020-1030.
  8. Marková IS: Insight in Psychiatry. Cambridge, Cambridge University Press, 2005.
  9. Clare L, Marková IS, Roth I, Morris RG: Awareness in Alzheimer's disease and associated dementias: theoretical framework and clinical implications. Aging Ment Health 2011;15:936-944.
  10. Clare L, Whitaker CJ, Nelis SM: Appraisal of memory functioning and memory performance in healthy ageing and early-stage Alzheimer's disease. Aging Neuropsychol Cognit 2010;17:462-491.
  11. De Bettignies BH, Mahurin RK, Pirozzolo FJ: Insight for impairment in independent living skills in Alzheimer's disease and multi-infarct dementia. J Clin Exp Neuropsychol 1990;12:355-363.
  12. Jorm AF, Christensen H, Henderson AS, Korten AE, Mackinnon AJ, Scott R: Complaints of cognitive decline in the elderly: a comparison of reports by subjects and informants in a community survey. Psychol Med 1994;24:365-374.
  13. Graham DP, Kunik ME, Doody R, Snow AL: Self-reported awareness of performance in dementia. Cogn Brain Res 2005;25:144-152.
  14. Oyebode JR, Telling AL, Hardy RM, Austin J: Awareness of memory functioning in early Alzheimer's disease: lessons from a comparison with healthy older and young adults. Aging Ment Health 2007;11:761-767.
  15. Petersen RC, Smith GE, Waring SC, Ivnik RJ, Kokmen E, Tangelos EG: Aging, memory, and mild cognitive impairment. Int Psychogeriatr 1997;9(suppl 1):65-69.
  16. Chung JC, Man DW: Self-appraised, informant-reported, and objective memory and cognitive function in mild cognitive impairment. Dement Geriatr Cogn Disord 2009;27:187-193.
  17. Onor ML, Trevisiol M, Negro C, Aguglia E: Different perception of cognitive impairment, behavioral disturbances, and functional disabilities between persons with mild cognitive impairment and mild Alzheimer's disease and their caregivers. Am J Alzheimers Dis Other Demen 2006;21:333-338.
  18. Vogel A, Stokholm J, Gade A, Andersen BB, Hejl A-M, Waldemar G: Awareness of deficits in mild cognitive impairment and Alzheimer's disease: do MCI patients have impaired insight? Dement Geriatr Cogn Disord 2004;17:181-187.
  19. Ries ML, Jabbar BM, Schmitz TW, Trivedi MA, Gleason CE, Carlsson CM, Rowley HA, Asthana S, Johnson SC: Anosognosia in mild cognitive impairment: relationship to activation of cortical midline structures involved in self-appraisal. J Int Neuropsychol Soc 2007;13:450-461.
  20. Roberts JL, Clare L, Woods RT: Subjective memory complaints and awareness of memory functioning in mild cognitive impairment: a systematic review. Dement Geriatr Cogn Disord 2009;28:95-109.
  21. Tabert MH, Albert SM, Borukhova-Milov L, Camacho Y, Pelton G, Liu X, Stern Y, Devanand DP: Functional deficits in patients with mild cognitive impairment: prediction of AD. Neurology 2002;58:758-764.
  22. Clare L, Nelis SM, Martyr A, Whitaker CJ, Marková IS, Roth I, Woods RT, Morris RG: Longitudinal trajectories of awareness in early-stage dementia. Alzheimer Dis Assoc Disord 2012;26:140-147.
  23. Roberts JL, Clare L, Whitaker CJ, Marková IS, Roth I, Woods RT, Nelis SM, Martyr A, Morris RG: The longitudinal trajectory of awareness in mild cognitive impairment. Submitted.
  24. Roberts JL: Awareness in Mild Cognitive Impairment. Bangor, Bangor University, 2011.
  25. Larrabee GJ, West RL, Crook TH: The association of memory complaint with computer-simulated everyday memory performance. J Clin Exp Neuropsychol 1991;13:466-478.
  26. Trosset MW, Kaszniak AW: Measures of deficit unawareness for predicted performance experiments. J Int Neuropsychol Soc 1996;2:315-322.
  27. McGlynn SM, Kaszniak AW: Unawareness of deficits in dementia and schizophrenia; in Prigatano GP, Schacter DL (eds): Awareness of Deficit after Brain Injury: Clinical and Theoretical Issues. New York, Oxford University Press, 1991, pp 84-110.
  28. Folstein MF, Folstein SE, McHugh PR: ‘Mini-mental state': a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189-198.
  29. Petersen RC, Smith GE, Waring SC, Ivnik RJ, Tangalos EG, Kokmen E: Mild cognitive impairment: clinical characterization and outcome. Arch Neurol 1999;56:303-308.
  30. Petersen RC, Stevens JC, Ganguli M, Tangalos EG, Cummings JL, De Kosky ST: Practice parameter: early detection of dementia: mild cognitive impairment (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2001;56:1133-1142.
  31. Nelson HE, Willison JR: The Revised National Adult Reading Test: Test Manual. Windsor, NFER-Nelson, 1991.
  32. Wechsler D: Wechsler Memory Scale, ed 3. San Antonio, The Psychological Corporation, 1997.
  33. McKenna P, Warrington EK: Graded Naming Test: Manual. Cambridge, Cambridge Cognition Ltd, 1983.
  34. Delis DC, Kaplan E, Kramer JH: Delis-Kaplan Executive Function System (D-KEFS). San Antonio, The Psychological Corporation, 2001.
  35. Snaith RP, Zigmond AS: The Hospital Anxiety and Depression Scale. Windsor, NFER-Nelson, 1994.
  36. Clare L, Wilson BA, Carter G, Roth I, Hodges JR: Assessing awareness in early-stage Alzheimer's disease: development and piloting of the Memory Awareness Rating Scale. Neuropsychol Rehabil 2002;12:341-362.
  37. Wilson BA, Baddeley AD, Cockburn J: Rivermead Behavioural Memory Test, ed 2. Bury St Edmunds, Thames Valley Test Company, 2003.
  38. Wilson BA, Clare L, Cockburn J, Baddeley A, Tate R, Watson P: The Rivermead Behavioural Memory Test - Extended Version. Bury St Edmunds, Thames Valley Test Company, 1999.
  39. West BT: Analyzing longitudinal data with the linear mixed models procedure in SPSS. Eval Health Prof 2009;32:207-228.
  40. Laird NM, Ware JH: Random-effects models for longitudinal data. Biometrics 1982;38:963-974.
  41. Kalbe E, Salmon E, Perani D, Holthoff V, Sorbi S, Elsner A, Weisenbach S, Brand M, Lenz O, Kessler J, Luedecke S, Ortelli P, Herholz K: Anosognosia in very mild Alzheimer's disease but not in mild cognitive impairment. Dement Geriatr Cogn Disord 2005;19:349-356.
  42. Hanyu H, Sakurai H, Iwamoto T: Are subjective memory complaints mandatory for the diagnosis of mild cognitive impairment? Intern Med 2007;46:791-792.
  43. Michon A, Deweer B, Pillon B, Agid Y, Dubois B: Relation of anosognosia to frontal lobe dysfunction in Alzheimer's disease. J Neurol Neurosurg Psychiatry 1994;57:805-809.
  44. Lingler JH, Nightingale MC, Erlen JA, Kane AL, Reynolds CF, Schulz R, De Kosky ST: Making sense of mild cognitive impairment: a qualitative exploration of the patient's experience. Gerontologist 2006;46:791-800.
  45. Roberts JL, Clare L: Meta-representational awareness in mild cognitive impairment: an interpretative phenomenological analysis. Aging Ment Health 2012 DOI: 10.1080/13607863.2012.732033.
    External Resources
  46. Farias ST, Mungas D, Jagust W: Degree of discrepancy between self and other-reported everyday functioning by cognitive status: dementia, mild cognitive impairment, and healthy elders. Int J Geriatr Psychiatry 2005;20:827-834.
  47. Morris RG, Mograbi DC: Anosognosia, autobiographical memory and self knowledge in Alzheimer's disease. Cortex 2012 DOI: 10.1016/j.cortex.2012.09.006.
    External Resources
  48. Agnew SK, Morris RG: The heterogeneity of anosognosia for memory impairment in Alzheimer's disease: a review of the literature and a proposed model. Aging Ment Health 1998;2:7-19.
  49. Okonkwo OC, Griffith HR, Belue K, Lanza S, Zamrini EY, Harrell LE, Brockington JC, Clark D, Raman R, Marson DC: Cognitive models of medical decision-making capacity in patients with mild cognitive impairment. J Int Neuropsychol Soc 2008;14:297-308.
  50. Luck T, Luppa M, Briel S, Matschinger H, Konig HH, Bleich S, Villringer A, Angermeyer MC, Riedel-Heller SG: Mild cognitive impairment: incidence and risk factors: results of the Leipzig Longitudinal Study of the Aged. J Am Geriatr Soc 2010;58:1903-1910.
  51. Ravaglia G, Forti P, Maioli F, Martelli M, Servadei L, Brunetti N, Pantieri G, Mariani E: Conversion of mild cognitive impairment to dementia: predictive role of mild cognitive impairment subtypes and vascular risk factors. Dement Geriatr Cogn Disord 2006;21:51-58.
  52. Gabryelewicz T, Styczynska M, Luczywek E, Barczak A, Pfeffer A, Androsiuk W, Chodakowska-Zebrowska M, Wasiak B, Peplonska B, Barcikowska M: The rate of conversion of mild cognitive impairment to dementia: predictive role of depression. Int J Geriatr Psychiatry 2007;22:563-567.
  53. Lin F, Wharton W, Dowling NM, Ries ML, Johnson SC, Carlsson CM, Asthana S, Gleason CE: Awareness of memory abilities in community-dwelling older adults with suspected dementia and mild cognitive impairment. Dement Geriatr Cogn Disord 2010;30:83-92.
  54. Clare L, Nelis SM, Martyr A, Roberts J, Whitaker CJ, Markova IS, Roth I, Woods RT, Morris RG: The influence of psychological, social and contextual factors on the expression and measurement of awareness in early-stage dementia: testing a biopsychosocial model. Int J Geriatr Psychiatry 2012;27:167-177.

Article / Publication Details

First-Page Preview
Abstract of Original Research Article

Accepted: December 11, 2012
Published online: March 27, 2013
Issue release date: May 2013

Number of Print Pages: 14
Number of Figures: 0
Number of Tables: 5

ISSN: 1420-8008 (Print)
eISSN: 1421-9824 (Online)

For additional information: https://www.karger.com/DEM


Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.