Awareness of Disease in Dementia: Factor Structure of the Assessment Scale of Psychosocial Impact of the Diagnosis of Dementia

Abstract

Despite the growing understanding of the conceptual complexity of awareness, there currently exists no instrument for assessing different domains of awareness in dementia. In the current study, the psychometric properties of a multidimensional awareness scale, the Assessment Scale of Psychosocial Impact of the Diagnosis of Dementia (ASPIDD), are explored in a sample of 201 people with dementia and their family caregivers. Cronbach's alpha was high (α = 0.87), indicating excellent internal consistency. The mean of corrected item-total correlation coefficients was moderate. ASPIDD presented a four-factor solution with a well-defined structure: awareness of activities of daily living, cognitive functioning and health condition, emotional state, and social functioning and relationships. Functional disability was positively correlated with total ASPIDD, unawareness of activities of daily living, cognitive functioning, and with emotional state. Caregiver burden was correlated with total ASPIDD scores and unawareness of cognitive functioning. The results suggest that ASPIDD is indeed a multidimensional scale, providing a reliable measure of awareness of disease in dementia. Further studies should explore the risk factors associated with different dimensions of awareness in dementia.

Quality of life in mild dementia: patterns of change in self and caregiver ratings over time

“…Awareness of disease can be expressed at different levels, including ability to monitor immediate performance, to make evaluative judgments about functioning in a given domain, and to reflect on the nature and impact of a diagnosis or health condition. 25 ASPIDD is a multidimensional scale designed to evaluate awareness of disease in PwD through the scoring of discrepant responses across domains that include awareness of cognitive deficits, family and social relationships, and instrumental and basic ADLs. Studies suggest a relative independence between awareness levels for different objects.…”

“…Awareness is rated as preserved (0 to 4), mildly impaired (5 to 11), moderately impaired (12 to 17), and absent (18 or more). 25,26 Cognitive function. The Mini-Mental State Examination (MMSE) includes tests of orientation, registration, short-term memory, language use, comprehension, and basic motor skills.…”

MacArthur Competence Assessment Tool for Treatment in Alzheimer disease: cross-cultural adaptation

“…The ratings of awareness are preserved (0-4), mildly impaired (5-11), moderately impaired (12)(13)(14)(15)(16)(17) and absent (over 18), with one point being scored for each discrepant response 22 .…”

“…3) Awareness of disease We applied the Assessment Scale of Psychosocial Impact of the Diagnosis of Dementia 22 , a 30-question scale based on the scoring of discrepant responses between the reports of people with dementia and their caregivers. The ratings of awareness are preserved (0-4), mildly impaired (5-11), moderately impaired (12)(13)(14)(15)(16)(17) and absent (over 18), with one point being scored for each discrepant response 22 .…”

Computerized Structured Cognitive Training in Patients Affected by Early-Stage Alzheimer's Disease is Feasible and Effective: A Randomized Controlled Study

“…Amongst them, Alzheimer's disease (AD) is the most common form of dementia, and it accounts for an estimated 60-80% of all cases. AD affects the patient, their family and their wider social network through its deep impacts at cognitive, behavioural and social levels (Cheston & Bender, 1999;Dourado et al, 2014). Clinical manifestation of AD typically includes significant neuropsychological deficits such as memory problems, frequently associated to other cognitive deficits such as aphasia, apraxia and/or agnosia, that significantly interfere with everyday life (McKhann et al, 1984;.…”