title: Memory Awareness Influences Everyday Decision Making Capacity about Medication Management in Alzheimer's Disease.
abstract: Memory awareness in early Alzheimer's disease (AD) influences capacity to provide informed consent for a memory treatment. This study investigated the extent to which aspects of memory awareness influence everyday decision-making capacity about medication management in AD. 42 participants with mild AD and 50 healthy elders underwent clinical ratings of memory awareness, metamemory testing, and an interview of everyday decision-making capacity regarding medication management. 45% of AD subjects were classified as aware (AAD) and 55% as unaware (UAD) based on clinical ratings and supported by metamemory testing (P = .015). Capacity was impaired in each of the AD groups as compared to the healthy elders F(2, 67) = 17.63, UAD, P < .01; AAD, P = .01). Within the AD group, capacity correlated selectively with awareness as measured with clinical ratings (r = -.41, P = .007) but not objective metamemory testing (r = -.10, P = .60 ). Appreciation scores were lower in UAD as compared with AAD F(1,35) = 8.36, P = .007. Unawareness of memory loss should heighten clinicians' concern about everyday decision-making capacity in AD.
authors.affiliation: Cognitive Neuroscience Section of the Gertrude H. Sergievsky Center, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, and the Department of Neurology, Columbia University Medical Center, 630 West 168th Street, P&S Mailbox 16, New York, NY 10032, USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Cosentino
authors.forename: Janet
authors.initials: J
authors.lastname: Metcalfe
authors.forename: Mark S
authors.initials: MS
authors.lastname: Cary
authors.forename: Jessica
authors.initials: J
authors.lastname: De Leon
authors.forename: Jason
authors.initials: J
authors.lastname: Karlawish