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Introduction: There was limited evidence on the ability of people with Alzheimer disease (AD) to perceive their own emotions. We aimed to compare socioemotional self-perception in persons with mild and moderate AD to their caregivers' perspective., Method: Cross-sectional assessment of people with mild (n=102) and moderate (n=59) AD and caregivers. Each participant and their caregivers completed the socioemotional questionnaire (SEQ); a 30-item rating scale assessing five dimensions of socioemotional cognition (empathy, emotion recognition, social conformity, antisocial behavior, sociability). We evaluated global cognition, awareness of disease, dementia severity, functionality, neuropsychiatric symptoms, and caregiver burden., Results: Participants in the mild and moderate groups showed a similar pattern of socioemotional self-perception. They differed in the anger domain of the emotion recognition subscale, in the antisocial behavior dimension, and in the sociability subscale. In contrast, the caregivers' perspective of people with mild and moderate AD showed a significant difference in the emotion recognition domain for fear, disgust, and sadness. There were also significant differences in the empathy subscale for disgust and in the sociability subscale. Cognition was correlated with self-reported reduced perception in social conformity, antisocial behavior, and sociability. Awareness was correlated with emotion recognition, antisocial behavior, and sociability. Neuropsychiatric symptoms were correlated with empathy, emotion recognition, and social conformity., Conclusions: Significant differences were found between caregivers' perspectives of socioemotional functioning in people with mild and moderate AD. Meanwhile, there were minimal differences in self-perception between the mild and moderate groups., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

The study aimed to explore the impact of Alzheimer's disease (AD) on spouse-carer's lives and the ways it affects their marital relationship and sexual activity. Data were obtained from qualitative interviews conducted with 11 spouse-carers of people with AD. Using interpretative phenomenological analysis (IPA), three themes emerged: psychological and emotional impact, social impact, and sexual impact. Some spouse-carers reported stress, poor emotional well-being, frustration, doubts about how to deal with the situation, sadness, loneliness, perception of losing connection with the partner, and feelings of companionship disappearing. Meanwhile, other spouse-carers reported closer relations and greater affection for their care-recipients after the diagnosis. Changes in sexual activity were attributed to aging and/or the effects of the illness. Gender influenced the perception of changes in the marital relationship but not in sexual activity. Participants reported conflicting perspectives towards the importance of sexual activity in the marital relationship and the replacement of sexual intercourse with other modes of expressing affection. We believe that understanding the specificities of marital relationships of couples in whom one spouse was diagnosed with AD would be helpful for developing coping strategies for persons living with dementia and their spouses., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Objective: Awareness is a developing area in dementia research and the evaluation of its domains has been increasingly included as part of care for people with Alzheimer's disease (PwAD). Our aim is to examine whether executive dysfunction is associated with awareness domains., Methods: A consecutive series of 75 people with mild-to-moderate Alzheimer's disease completed assessments about global cognitive function, executive functioning, and their awareness of disease. Their primary caregivers' dyad provided information about demographics, awareness of disease, dementia severity, neuropsychiatric symptoms, and functional status., Results: Different types of executive dysfunction were presented as a predictor for awareness of disease (cognitive flexibility, inhibitory control, and working memory), of emotional state (short-term memory and attention) and of social functioning and relationships (visuospatial organization, integrative functions, and abstract thinking). Awareness of cognitive functioning and health condition and of functional activity impairments exhibit only global cognitive function as a predictor., Conclusions: Findings confirm some degree of independence between awareness domains. The importance of identifying differences in domains of awareness relies in the understanding of awareness as a clinical phenomenon in order to guide the management and support of PwAD and their caregivers., (© 2021 John Wiley & Sons Ltd.)

The quality of life (QoL) of people with Alzheimer disease (PwAD) may be influenced by the type of relationship between carer and the PwAD. Dyads of 98 PwAD/carers (N = 49 spouse-carers; N = 49 nonspouses carers) were measured about QoL, cognition, dementia severity, awareness of disease, functionality, depression, anxiety, and burden of care. Univariate and multivariate regression analyses were conducted to identify the factors that influenced the spouse and nonspouse self-report PwAD QoL (PQOL) and to compare carers' ratings of PwAD QoL (C-PQOL). The total score of QoL for spouse and nonspouse PwAD showed no significant difference ( P = .29). The linear regression demonstrated that higher awareness of disease was significantly related to spouse PQOL ( P = .001). Nonspouse PQOL was negatively related to lower depression ( P = .007). The total score of QoL for spouse and nonspouse C-PQOL showed no significant difference ( P = .14). The linear regression demonstrated that depression of spouse-PwAD ( P < .001) and burden of care ( P = .001) were negatively related to spouse-dyads' C-PQOL. The nonspouse-dyads C-PQOL was negatively related to depression of nonspouse-PwAD ( P < .001), awareness of disease ( P = .001), and the mood of the carer ( P = .01). Spouse and nonspouse PwAD evaluate PQOL better than carers (C-PQOL). No significant difference was found in the total PQOL and C-PQOL of spouse and nonspouse, but dyads evaluated differently about what is important to assess QoL.

Background: Awareness of functional status may underlie specific profiles and differences related to stage severity in individuals with Alzheimer's disease (AD)., Objective: This study aimed to assess self-reported experiences of awareness of functional activity in people with mild and moderate AD., Methods: This is a mixed methods approach. The qualitative part was conducted through semi-structured interviews concerning the experiences and awareness of deficits in 38 older adults with mild or moderate AD. The quantitative approach included a comparison between groups with regard to concerns of awareness and clinic and demographic data., Results: Impairment on awareness of disease and awareness of functional deficits was observed even in the mild stages of AD. There was also a noticeable progression of impairments of both kinds of awareness from mild to moderate stage of disease. The majority of participants with mild and moderate AD were partially aware of their functional deficits. Both groups of participants reported some negative impact; however, they were not able to entirely describe their functional status. Also, deficits to recognize the need for help with hygiene and general tasks were observed. Significant differences were found in awareness of need for help with general tasks and awareness of need for help with hygiene tasks., Conclusion: People with mild and moderate AD may describe their aware of the disease better than specific functional deficits, and most of them can provide some reports concerning to the impact of the disease., Competing Interests: The authors have no conflict of interest to report., (© 2020 – IOS Press and the authors. All rights reserved.)

Objectives: Awareness is considered a heterogeneous and non-linear phenomenon in dementia. We aim to investigate patterns of change of different domains of awareness (awareness of cognitive functioning and health condition, activities of daily living, emotional state, social functioning, and relationships) in people with mild and moderate Alzheimer's disease (AD) and aspects related to each domain. Method: Cross-sectional assessment of dyads of people with AD (PwAD) and caregivers ( n  = 128; CDR1 = 74, CDR2 = 54). PwAD completed assessments about quality of life, cognition and their awareness of disease. Caregivers provided information about PwAD and received quality of life and burden of care assessments. Results: Mild AD group showed a mildly impaired awareness ( n  = 40; 54.05%), while moderate AD group, showed higher presence of moderately impaired awareness ( n  = 22; 40.74%). There was a significant difference between groups in awareness of cognitive functioning and health condition ( p  < 0.004), functional activity impairments ( p  < 0.001) and total score of awareness ( p  < 0.01). Conversely, awareness of emotional state ( p  = 0.22) and of social functioning and relationship ( p  = 0.44) presented no significant difference between groups. Unawareness of functional activity impairments showed higher discrepancy scores between PwAD and caregivers in both groups. Conclusions: Significant differences were found only in patterns of discrepancies in awareness of cognitive functioning and health condition, of ADL and socio-emotional functioning. Different factors are related to different domains in mild and moderate group, reinforcing the heterogeneity of awareness in dementia. ADL deficits have an important role in awareness phenomenon, independent of the severity of disease.

Young-onset Alzheimer disease (YOAD) causes psychological and emotional difficulties for carers. However, even in the face of considerable caregiving demands and burden, some carers are resistant to stress, which may be a sign of resilience. This study investigated whether the clinical symptoms of the person with YOAD might be associated with resilience in their carers. A consecutive series of 43 persons with YOAD and their 43 family caregivers were assessed. The carers showed moderate to high level of resilience, low level of anxiety and depressive symptoms, and moderate level of burden. No relationship was found between resilience and sociodemographic characteristics of both carers and care recipient and with clinical characteristics of persons with YOAD. A linear regression analysis showed that resilience was inversely associated with carers' depressive symptoms. The findings suggest that resilience may mainly be related to carers' mental health.

Awareness of deficits is a multidimensional phenomenon described as the ability to acknowledge difficulties and impairments. We investigated whether unawareness affects distinct domains to different degrees and identified the factors related to the awareness impairment in Alzheimer Disease (AD). Using a cross-sectional design, we assessed 89 people with AD (PwAD) and their caregivers. Awareness was evaluated by scoring discrepant responses between PwAD and their caregivers across domains including cognitive functioning and health condition, functional activity impairments, emotional state, social functioning, and interpersonal relationships. The awareness of functional activity impairments domain showed a greater discrepancy compared with the other domains. Multiple regression analysis revealed that lack of awareness of cognitive functioning and health condition was related to PwAD unawareness of functional activity impairments, age, and caregiver burden. The emotional state domain was related to PwAD unawareness of functional activity impairments and depressive symptoms. There was also a relationship between the social functioning and relationships domain and caregiver burden. The functional activity impairments domain was related to deficits in the following domains: cognitive functioning and health condition, emotional state, social and emotional functioning, and PwAD self-reported quality of life. Although we observed that 1 domain can influence another, our results suggest that the factors related to each of the different objects of awareness are varied.