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Abstract
This article provides a review of the literature on clinical correlates of awareness in dementia. Most inconsistencies were found with regard to an association between depression and higher levels of awareness. Dysthymia, but not major depression, is probably related to higher levels of awareness. Anxiety also appears to be related to higher levels of awareness. Apathy and psychosis are frequently present in patients with less awareness, and may share common neuropathological substrates with awareness. Furthermore, unawareness seems to be related to difficulties in daily life functioning, increased caregiver burden, and deterioration in global dementia severity. Factors that may be of influence on the inconclusive data are discussed, as are future directions of research.
Acknowledgements
This work was carried out as part of the AWARE (awareness in early-stage dementia: understanding, assessment, and implications for early intervention) project and was supported by the European Commission, contract number QLK6-CT-2002-30491. The project was conceived and developed by members of the INTERDEM network, which is co-ordinated by Esme Moniz-Cook. Thanks are due to Barbara Romero, Mike Wang, Bob Woods, Orazio Zanetti, and all those who participated in the AWARE project meetings.