Multidimensional assessment of awareness in early-stage dementia: a cluster-analytic approach

Clare, Linda; Whitaker, Christopher J.; Nelis, Sharon M.; Martyr, Anthony; Markova, Ivana S.; Roth, Ilona; Woods, Robert T. and Morris, Robin G. (2011). Multidimensional assessment of awareness in early-stage dementia: a cluster-analytic approach. Dementia and Geriatric Cognitive Disorders, 31(5) pp. 317–327.



Background/Aims: 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. Conclusion: Multidi-mensional assessment offers a more robust approach toclassifying PwD according to level of awareness and hence to examining correlates and predictors of awareness.

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