Awareness of diagnosis predicts changes in quality of life in individuals with mild cognitive impairment and mild stage dementia

Details

• Alternative Title:
  Int J Geriatr Psychiatry
• Personal Author:
  Stites, Shana D. ; Rubright, Jonathan D. ; Harkins, Kristin ; Karlawish, Jason
• Description:
  Background and Objective:
  
  This observational study examined how awareness of diagnosis predicted changes in cognition and quality of life (QOL) 1 year later in older adults with normal cognition and dementia diagnoses.
  
  Research Design and Methods:
  
  Older adults (n = 259) with normal cognition, mild cognitive impairment (MCI), or mild stage Alzheimer’s disease (AD) completed measures of diagnostic awareness, cognition, and multiple domains of QOL. We compared 1-year change in cognition and QOL by diagnostic group and diagnostic awareness.
  
  Results:
  
  Patients who were unaware of their diagnosis at baseline showed average decreases in both satisfaction with daily life (QOL-AD; paired mean difference (PMD) = −0.9, p < 0.05) and physical functioning (SF-12 PCS; PMD = −2.5, p < 0.05). In contrast, patients aware of their diagnosis at baseline showed no statistically discernable changes in most QOL domains (all p > 0.05). Of patients aware of their diagnosis at baseline (n = 111), those who were still aware (n = 84) showed a decrease in mental functioning at follow up (n = 27; SF-12 MCS). Change in MoCA scores in patients unaware of their diagnosis was similar to that in patients aware of their diagnosis, −1.4 points (95% CI −2.6 to −0.6) and −1.7 points (95% CI −2.4 to −1.1) respectively.
  
  Discussion and Implications:
  
  Awareness of one’s diagnosis of MCI or AD, not the severity of cognitive impairment, may predict changes in patients’ mental functioning, expectations of their memory, satisfaction with daily life, and physical functioning. The findings may help clinicians anticipate the types of threats to wellbeing that a patient might encounter and identify key domains for monitoring.
  
  
• Keywords:
  Aged Alzheimer Disease Cognition Cognitive Decline Cognitive Dysfunction Cognitive Impairment Cognitive Performance Dementia Diagnosis Awareness Humans Neuropsychological Tests Quality Of Life Self-reported Symptoms

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• Source:
  Int J Geriatr Psychiatry. 38(6):e5939
• Pubmed ID:
  37300313
• Pubmed Central ID:
  PMC10638664
• Document Type:
  Journal Article
• Funding:
  U48DP005053/ACL/ACL HHSUnited States/ ; P30 AG010124/AG/NIA NIH HHSUnited States/ ; U48 DP005053/DP/NCCDPHP CDC HHSUnited States/ ; P30-AG-010124/AG/NIA NIH HHSUnited States/ ; P30 AG036468/AG/NIA NIH HHSUnited States/ ; K23 AG065442/AG/NIA NIH HHSUnited States/ ; K23AG065442/AG/NIA NIH HHSUnited States/
• Volume:
  38
• Issue:
  6
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:a4bfde89d3d64a9dfb0060df2f548800affa2357ae5c852f32ead41fa1522b53
• Download URL:
  https://stacks.cdc.gov/view/cdc/135493/cdc_135493_DS1.pdf
• File Type:
  [PDF - 556.57 KB ]