title: Examining the Pathways Between Self-Awareness and Well-Being in Mild to Moderate Alzheimer Disease.
abstract: OBJECTIVE
  To investigate the relationship between awareness of memory loss and psychological well-being in a nonclinically depressed sample of participants with mild to moderate Alzheimer disease (AD).
  
  
  METHODS
  Study participants (N = 104) enrolled through Columbia University Medical Center and the University of Pennsylvania completed clinical and cognitive assessments. Participants were rated with regard to their degree of awareness of memory deficits and completed questionnaires relating to their psychological well-being, including mood and quality of life (QOL). Mediating models were used to establish the relationship between awareness, depression, and QOL and to examine potential mediators of awareness and depression, including psychological distress, objective memory deficits, and negative self-ratings.
  
  
  RESULTS
  There was a direct association between awareness of memory deficits and depressed mood but not awareness and QOL. However, there was an indirect association between awareness and QOL through depression. Neither psychological distress, memory deficits, nor negative self-ratings mediated the relationship between awareness and depression.
  
  
  CONCLUSIONS
  Awareness is associated with depressed mood in nonclinically depressed participants with mild to moderate AD. However, depressed mood does not appear to reflect the direct psychological reaction to awareness of memory loss. Moreover, awareness has only an indirect association with QOL via depressed mood. These results suggest that preserved awareness does not have a direct negative impact on overall psychological well-being in AD.
authors.affiliation: Cognitive Neuroscience Division, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY.
authors.forename: Sarah
authors.initials: S
authors.lastname: Cines
authors.affiliation: Cognitive Neuroscience Division, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY.
authors.forename: Meagan
authors.initials: M
authors.lastname: Farrell
authors.affiliation: Cognitive Neuroscience Division, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY.
authors.forename: Jason
authors.initials: J
authors.lastname: Steffener
authors.affiliation: The G.H. Sergievsky Center, Columbia University Medical Center, New York, NY.
authors.forename: Liz
authors.initials: L
authors.lastname: Sullo
authors.affiliation: Cognitive Neuroscience Division, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY; Department of Neurology, Columbia University Medical Center, New York, NY; Department of Psychiatry, Columbia University Medical Center, New York, NY.
authors.forename: Edward
authors.initials: E
authors.lastname: Huey
authors.affiliation: Departments of Medicine and Medical Ethics, Alzheimer's Disease Center, Institute on Aging, and Center for Health Incentives, The University of Pennsylvania, Philadelphia, PA.
authors.forename: Jason
authors.initials: J
authors.lastname: Karlawish
authors.affiliation: Cognitive Neuroscience Division, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY; The G.H. Sergievsky Center, Columbia University Medical Center, New York, NY; Department of Neurology, Columbia University Medical Center, New York, NY. Electronic address: sc2460@cumc.columbia.edu.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Cosentino
mesh_terms: D000339:Affect / Q000502:physiology*; D000368:Aged; D000544:Alzheimer Disease / Q000150:complications / Q000523:psychology*; D001364:Awareness / Q000502:physiology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000150:complications / Q000523:psychology*; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000150:complications / Q000523:psychology; D011795:Surveys and Questionnaires
keywords: Awareness; depression; quality of life