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International Journal of Alzheimer’s Disease
Volume 2011 (2011), Article ID 483897, 9 pages
http://dx.doi.org/10.4061/2011/483897
Research Article

Memory Awareness Influences Everyday Decision Making Capacity about Medication Management in Alzheimer's Disease

1Cognitive Neuroscience Section of the Gertrude H. Sergievsky Center, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, and the Department of Neurology, Columbia University Medical Center, 630 West 168th Street, P&S Mailbox 16, New York, NY 10032, USA
2Department of Psychology, Columbia University, New York, NY 10027, USA
3Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA 19104, USA
4Departments of Medicine and Medical Ethics, Alzheimer's Disease Center, Institute on Aging, Center for Health Incentives, University of Pennsylvania, Philadelphia, PA 19104, USA

Received 15 December 2010; Revised 15 March 2011; Accepted 28 March 2011

Academic Editor: Scott Kim

Copyright © 2011 Stephanie Cosentino et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Memory awareness in early Alzheimer’s disease (AD) influences capacity to provide informed consent for a memory treatment. This study investigated the extent to which aspects of memory awareness influence everyday decision-making capacity about medication management in AD. 42 participants with mild AD and 50 healthy elders underwent clinical ratings of memory awareness, metamemory testing, and an interview of everyday decision-making capacity regarding medication management. 45% of AD subjects were classified as aware (AAD) and 55% as unaware (UAD) based on clinical ratings and supported by metamemory testing (P=.015). Capacity was impaired in each of the AD groups as compared to the healthy elders F(2, 67)=17.63, UAD, P<.01; AAD, P=.01). Within the AD group, capacity correlated selectively with awareness as measured with clinical ratings (r=−.41, P=.007) but not objective metamemory testing (r=−.10, P=.60 ). Appreciation scores were lower in UAD as compared with AAD F(1, 35)=8.36, P=.007. Unawareness of memory loss should heighten clinicians’ concern about everyday decision-making capacity in AD.