Knowledge of personal information and caregiver awareness in Alzheimer's disease.

We assessed the ability of 73 patients with Alzheimer's disease (AD) to recall important personal information like their names, their caregivers 'names, their addresses, and their telephone numbers. We also assessed their caregivers' awareness of their abilities. There was an association between the abilities of the patients and their Mini-Mental Status Examination (MMSE) scores, with the patients with the lowest MMSE scores making the most errors. Five to 10 percent of the mildest patients were unable to state their addresses and telephone numbers correctly. The caregivers of the patients with intermediate MMSE scores made the most errors in their predictions, with up to 50 percent being incorrect and up to 37 percent overestimating their patients' abilities. We concluded that AD patients lose their ability to provide personal information as their illness progresses. Caregivers of patients with MMSE ranging from 10 to 25 are the most likely to be unaware of their patients' impairment. These findings highlight safety concerns in AD.

Measurement and relevance of personality characteristics in persons with dementia: a longitudinal perspective.

Studies of personality and outcomes in persons with dementia (PWD) have focused primarily on disease stages or change from premorbid personality following diagnosis. Data from a longitudinal study of 96 caregiver/PWD dyads was used to evaluate psychometric properties of two personality measures: one rated by proxies, the other by PWD. Proxy ratings indicate change in strength of personality traits across disease stages; self-ratings were stable, excepting decreased extroversion. Items detracting from reliability of some subscales reflected disease-related changes in PWD rather than true shifts in personality. Findings support importance of collecting both proxy and self-ratings of personality, examining individual items contributing to low reliability, and evaluating change in personality within the context of expected changes inherent in dementia.

Using the telephone to call for help and caregiver awareness in Alzheimer disease.

We assessed the ability of 73 patients with Alzheimer disease (AD) and mild cognitive impairment (MCI) from our outpatient clinic to demonstrate how they would use the telephone to call for help in case of an emergency. We also assessed their caregivers' awareness of their abilities. Overall, 44% of the patients did not demonstrate how to call for help correctly if they had no written telephone number to call, and 18% did not when they had a written number. There was an association between the abilities of the patients and their Mini-Mental State Examination (MMSE) scores, with the patients with the lowest scores having the most difficulty (P < 0.0001). Surprisingly, 21% of those with MMSE scores 26-30 did not use the telephone correctly when they had no written number. Of the caregivers, 31% were incorrect in predicting their patients' abilities for the first task, and 11% were incorrect in predicting the second task. We conclude that AD patients lose their ability to use the telephone to call for help as their illness progresses. Furthermore, many caregivers are unaware of their patients' impairment. These findings highlight safety concerns in AD and suggest that caregivers could benefit from education about potential patient losses.