title: Unawareness of memory impairment and behavioral abnormalities in patients with Alzheimer's disease: relation to professional health care burden.
abstract: OBJECTIVE
  The present study investigates the impact of unawareness of deficit (anosognosia) in patients with Alzheimer's disease upon professional health care burden.
  
  
  METHODS
  Cross-sectional study with a consecutive clinical sample from an Alzheimer day-care hospital in France.
  
  
  METHODS
  65 patients with probable AD, aged from 75 to 94 years old, consecutively admitted at the Alzheimer Day Hospital to complete a program of cognitive stimulation and psychosocial rehabilitation.
  
  
  METHODS
  Each patient was submitted to a standardized evaluation including clinical investigation, cerebral imagery, and neuropsychological assessment. Anosognosia of memory deficit and anosognosia of behavioral disturbances were measured as the "discrepancy scores" between patients' self-reports and family member ratings of patient memory performance and behavioral disturbances. Professional health care burden was assessed with the Professional Health Care Dementia Burden Index (PCDBI; maximal score: 12), designed for this study. Multiple linear regressions were used to examine the correlations between the PCDBI and the severity of anosognosia.
  
  
  RESULTS
  The findings showed a significant positive correlation between the PCDBI and both anosognosia of memory impairment and behavioral abnormalities (both p at least less than 0.05). However, there was no significant correlation between the severity of the burden and the severity of cognitive decline or functional impairment (both p at least>0.05).
  
  
  CONCLUSIONS
  Anosognosia in Alzheimer disease patients has a negative impact upon the professional caregivers' burden over and above the cognitive deficit and the functional impairments.
authors.affiliation: Alzheimer Day Centre, Paul Doumer, GHU Nord, Assistance Publique-Hôpitaux de Paris, Liancourt, France. alaloucy@chups.jussieu.fr
authors.forename: M J
authors.initials: MJ
authors.lastname: Al-Aloucy
authors.forename: R
authors.initials: R
authors.lastname: Cotteret
authors.forename: P
authors.initials: P
authors.lastname: Thomas
authors.forename: M
authors.initials: M
authors.lastname: Volteau
authors.forename: I
authors.initials: I
authors.lastname: Benmaou
authors.forename: G
authors.initials: G
authors.lastname: Dalla Barba
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000544:Alzheimer Disease / Q000150:complications / Q000523:psychology*; D001364:Awareness; D003072:Cognition Disorders / Q000523:psychology*; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care; D005190:Family; D005260:Female; D015577:Geriatric Assessment; D006761:Hospitals; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000209:etiology / Q000523:psychology*; D001523:Mental Disorders / Q000209:etiology / Q000523:psychology*; D009483:Neuropsychological Tests; D012649:Self Concept; D057566:Self Report