Consciência da doença na demência do tipo Alzheimer: uma revisão sistemática de estudos longitudinais

Abstract

resuMo objetivos: Avaliar as definições, métodos de avaliação e hipóteses etiológicas utilizadas em estudos longitudinais sobre consciência da doença na demência do tipo Alzheimer. Méto-do: Pesquisa, nas bases de dados Medline, ISI, Lilacs e SciELO, de estudos longitudinais sobre consciência da doença na demência do tipo Alzheimer entre 1999 e 2009. As palavras-chave utilizadas foram: "Alzheimer", "dementia", "anosognosia", "awareness of deficit", "awareness of disease", "insight" e "longitudinal study". Os artigos examinados foram classificados conforme as hipóteses etiológicas encontradas. resultados: Os nove artigos selecionados foram divididos em duas áreas: hipóteses etiológicas biológicas e hipóteses etiológicas psicossociais. Os termos "falta de consciência dos déficits", "consciência do déficit", "insight" e "negação do déficit de memória" são utilizados nos estudos como sinônimos do termo "anosognosia", mesmo sendo, conceitualmente, diferentes. O método de avaliação mais utilizado foi o uso de questionários de discrepância entre os relatos dos pacientes e cuidadores. Conclusões: Os estudos longitudinais apresentam hipóteses etiológicas heterogêneas, além da inexistên-cia de um padrão conceitual e metodológico de avaliação. Essas dificuldades impossibilitam a obtenção de resultados homogêneos, o que gera a necessidade de aprofundamento dos estudos na área. 1999 and 2009. The keywords used were "Alzheimer", "dementia", "anosognosia", "awareness of deficit", "awareness of disease", "insight" e "longitudinal study". The articles reviewed were classified according to the etiological hypotheses. Results: Nine articles were selected and they were divided into two areas: biological etiological hypotheses and psychosocial etiological hypotheses. The terms "lack of awareness of deficits", "awareness of deficit", "insight" and "denial of memory" deficit were used as synonyms of "anosognosia", although con-

Cross-cultural adaptation of the Social and Emotional Questionnaire on Dementia for the Brazilian population

“…11 The items that loaded most highly in each factor were used to form five subscales: emotion recognition (5,8,12,18,23); empathy (3,9,15,20,30); social conformity (11,14,25); antisocial behavior (1,6,13,24); and sociability (4,16,17,19,21,27,29). The total score for the patient version of the SEQ had good correlation with the patients' total score on the Patient Competency Rating Scale (PCRS) (P = 0.01) and the total score for the proxy version had strong correlation with the proxy-version total score of PCRS (P < 0.01).…”

“…11 Nelis et al 7 conducted the first validation study on the SEQ among people with dementia. Varimax rotation yielded three interpretable solutions: the 11-item emotional recognition and empathy (ERE) domain (3,5,8,9,11,12,15,18,20,23,30), the 7-item social relationship (SR) domain (16,17,19,25,26,28,29) and the 6-item prosocial behavior (PB) domain (2,4,6,10,13,22). There were small but significant differences between self-ratings and caregivers' ratings for all the domains: ERE: …”

“…3 Unawareness of deficits has been commonly reported as a clinical feature of neurodegenerative disorders, but there are conflicting results regarding the frequency and its relationship with disease severity. 4,5 Impaired awareness of deficits may be present in the early stages, ranging from very mild to very severe. 6 Awareness of social and emotional functioning relates to essential aspects of social interactions, such as the capacity to understand other people and oneself, and the capacity to comprehend interpersonal relationships.…”

“…The ratings are scored on a five-point Likert scale, from "strongly disagree" (1) to "strongly agree" (5). The "people with dementia" and "caregivers" versions are essentially identical.…”

Cultural aspects in dementia: differences in the awareness of Brazilian caregivers

“…[1][2][3] It encompasses three dimensions: the ability to recognize a specific deficit; emotional response to difficulties; and the ability to understand the impact of impairment on activities of daily living. 4 One of the approaches that have been taken to assess the level of patients' awareness consists of calculating the discrepancy between the patient's own account of the perceived difficulties and that of the patient's spouse or caregiver.…”