title: Memory awareness profiles differentiate mild cognitive impairment from early-stage dementia: evidence from assessments of performance monitoring and evaluative judgement.
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.
  
  
  METHODS
  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.
authors.affiliation: School of Psychology, Bangor University, Bangor LL57 2AS, 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: Judith L
authors.initials: JL
authors.lastname: Roberts
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: Marková
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: D000328:Adult; D000339:Affect / Q000502:physiology; D000368:Aged; D000369:Aged, 80 and over; D001364:Awareness / Q000502:physiology*; D060825:Cognitive Dysfunction / Q000523:psychology*; D003704:Dementia / Q000523:psychology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D007600:Judgment / Q000502:physiology*; D008137:Longitudinal Studies; D008297:Male; D008568:Memory / Q000502:physiology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D011597:Psychomotor Performance / Q000502:physiology*