Awareness of Diagnosis in Persons with Early-Stage Alzheimer's Disease: An Observational Study in Spain
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2022
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Springer
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Villarejo-Galende A, García-Arcelay E, Piñol-Ripoll G, Del Olmo-Rodríguez A, Viñuela F, Boada M, Franco-Macías E, de la Peña AI, Riverol M, Puig-Pijoan A, Abizanda-Soler P, Arroyo R, Baquero-Toledo M, Feria-Vilar I, Balasa M, Berbel Á, Rodríguez-Rodríguez E, Vieira-Campos A, García-Ribas G, Rodrigo-Herrero S, Lleó A, Maurino J. Awareness of Diagnosis in Persons with Early-Stage Alzheimer's Disease: An Observational Study in Spain. Neurol Ther. 2022 Sep;11(3):1183-1192. doi: 10.1007/s40120-022-00367-3. Epub 2022 Jun 1. PMID: 35648383; PMCID: PMC9338197.
Abstract
Introduction: Limited information is available on people’s experiences of living with Alzheimer’s disease (AD) at earlier stages. This study assessed awareness of diagnosis among people with early-stage AD and its impact on different person-centered outcome measures. Methods: We conducted an observational, cross-sectional study in 21 memory clinics in Spain. Persons aged 50–90 years, diagnosed with prodromal or mild AD (NIA/AA criteria), a Mini Mental State Examination (MMSE) score ≥ 22, and a Clinical Dementia Rating-Global score (CDR-GS) of 0.5 or 1.0 were recruited. The Representations and Adjustment to Dementia Index (RADIX) was used to assess participants’ beliefs about their condition and its consequences. Results: A total of 149 persons with early-stage AD were studied. Mean (SD) age was 72.3 (7.0) years and 50.3% were female. Mean duration of AD was 1.4 (1.8) years. Mean MMSE score was 24.6 (2.1) and 87.2% had a CDR-GS score of 0.5. Most participants (n = 84, 57.5%) used a descriptive term related to specific AD symptoms (e.g., memory difficulties) when asked what they called their condition. Participants aware of their diagnosis using the term AD (n = 66, 45.2%) were younger, had more depressive symptoms, and poorer life satisfaction and quality of life compared to those without awareness of their specific diagnosis. Practical and emotional consequences RADIX scores showed a significant negative correlation with Quality of Life in Alzheimer’s Disease score (rho = − 0.389 and − 0.413, respectively; p < 0.0001). Years of education was the only predictor of awareness of AD diagnosis [OR = 1.04 (95% CI 1.00–1.08); p = 0.029]. Conclusions: Awareness of diagnosis was a common phenomenon in persons with early-stage AD negatively impacting their quality of life. Understanding illness representations in earlier stages may facilitate implementing optimized care that supports improved quality of life and well-being.