title: Multidimensional assessment of awareness in early-stage dementia: a cluster analytic approach.
abstract: OBJECTIVE
  Research on awareness in dementia has yielded variable and inconsistent associations between awareness and other factors. This study examined awareness using a multidimensional approach and applied cluster analytic techniques to identify associations between the level of awareness and other variables.
  
  
  METHODS
  Participants were 101 individuals with early-stage dementia (PwD) and their carers. Explicit awareness was assessed at 3 levels: performance monitoring in relation to memory, evaluative judgement in relation to memory, everyday activities and socio-emotional functioning, and metacognitive reflection in relation to the experience and impact of the condition. Implicit awareness was assessed with an emotional Stroop task.
  
  
  RESULTS
  Different measures of explicit awareness scores were related only to a limited extent. Cluster analysis yielded 3 groups with differing degrees of explicit awareness. These groups showed no differences in implicit awareness. Lower explicit awareness was associated with greater age, lower MMSE scores, poorer recall and naming scores, lower anxiety and greater carer stress.
  
  
  CONCLUSIONS
  Multidimensional assessment offers a more robust approach to classifying PwD according to level of awareness and hence to examining correlates and predictors of awareness.
authors.affiliation: Bangor University, UK. l.clare @ bangor.ac.uk
authors.forename: Linda
authors.initials: L
authors.lastname: Clare
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Whitaker
authors.forename: Sharon M
authors.initials: SM
authors.lastname: Nelis
authors.forename: Anthony
authors.initials: A
authors.lastname: Martyr
authors.forename: Ivana S
authors.initials: IS
authors.lastname: Markova
authors.forename: Ilona
authors.initials: I
authors.lastname: Roth
authors.forename: Robert T
authors.initials: RT
authors.lastname: Woods
authors.forename: Robin G
authors.initials: RG
authors.lastname: Morris
mesh_terms: D000203:Activities of Daily Living; D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D001364:Awareness / Q000502:physiology; D017028:Caregivers / Q000523:psychology; D016000:Cluster Analysis; D003071:Cognition / Q000502:physiology; D017281:Cost of Illness; D003704:Dementia / Q000175:diagnosis* / Q000523:psychology*; D004522:Educational Status; D056344:Executive Function; D005260:Female; D006801:Humans; D007600:Judgment; D007802:Language; D008137:Longitudinal Studies; D008297:Male; D008568:Memory / Q000502:physiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D011597:Psychomotor Performance / Q000502:physiology; D011788:Quality of Life; D011795:Surveys and Questionnaires