Insight, Cognition and Quality of Life in Alzheimer’S Disease
- Catherine S Hurt1,*,
- Sube Banerjee1,
- Catherine Tunnard1,
- Daisy Whitehead1,
- Magda Tsolaki2,
- Patrizia Mecocci3,
- Iwona Kloszewska4,
- Hilkka Soininen5,
- Bruno Vellas6,
- Simon Lovestone1
- 1 King's College London, United Kingdom;
- 2 Aristotle University of Thessaloniki, United Kingdom;
- 3 University of Perugia, United Kingdom;
- 4 Medical University of Lodz, United Kingdom;
- 5 Kuopio University Hospital, Greece;
- 6 Centre Mémoire de Ressources et de Recherché de Toulouse, Italy
- Correspondence to: Catherine S Hurt, King's College London, Institute of Psychiatry, Department of Psychology PO77, De Crespigny Park, London, SE5 8AF, United Kingdom; catherine.hurt{at}iop.kcl.ac.uk
- Received 29 May 2009
- Accepted 29 August 2009
- Published Online First 13 October 2009
Abstract
Background: The detrimental impact of dementia upon patient health related quality of life (HRQL) is well established as is the importance of improving HRQL. However, relatively little is known about the natural history of HRQL in dementia and those factors influencing it. This limited knowledge potentially restricts the evaluation of the efficacy of interventions designed to improve HRQL. One such area concerns the relationship between HRQL and patient insight. It remains unclear what impact, if any, impaired insight has upon a patient’s HRQL. The present study aimed to investigate the relationship between insight and HRQL in a sample of patients with Alzheimer’s disease (AD) and their carers.
Methods: 256 patients with AD were recruited as part of AddNeuroMed, a multi-centre European AD biomarkers study. Of these 174 completed a quality of life measure in addition to a comprehensive battery of clinical and neuropsychological assessments.
Results: Insight was found to be differentially related to patient perceptions of HRQL in mild and moderate dementia. Within moderate dementia impaired insight was associated with better perceived HRQL. Conversely cognition, but not insight, was associated with impaired HRQL in mild dementia. Insight was not found to be associated with carer perceptions of patient HRQL.
Conclusion: Impairment of insight is associated with better HRQL in moderate dementia. This finding has implications for interventions which focus on increasing patient awareness and orientation as impairment of insight appears to have a positive impact upon HRQL.
