Search

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. Key points: Older adults aware of their diagnosis of Alzheimer's disease (AD) or mild cognitive impairment were more likely to expect their memory to worsen at baseline and continued to expect their memory to worsen at 1‐year follow‐up than those who were unaware of their diagnosis.From baseline to 1‐year, persons aware of their diagnosis experienced a decline in mental functioning. In contrast, those unaware of their diagnosis experienced decreases in satisfaction with daily life and physical functioning.We discuss our findings in terms of their applicability to help clinicians monitor patient wellbeing and whether they might extend to awareness of other AD diagnostic data beyond clinical diagnosis such as AD gene and biomarker test results. [ABSTRACT FROM AUTHOR]