Clinical factorial distribution of Anosognosia Questionnaire for Dementia (AQ-D) in a sample of patients with Alzheimer's disease

Patients with anosognosia have been presented more dangerous behaviours and difficulties with treatment adherence, leading to increased burden on caregivers(Conde-Sala et al., 2015). Anosognosia Questionnaire for Dementia (AQ-D; Migliorelli et al., 1995) has been used to collect patients and caregivers'perceptions about anosognosia

Factors associated with caregiver burden: comparative study between Brazilian and Spanish caregivers of patients with Alzheimer's disease (AD)

Background: Transcultural studies regarding the comparison of levels of burden in caregivers of patients with Alzheimer's disease (AD) from Europe and Latin America are rare. We designed this study to investigate the differentiating factors associated with burden in Brazilian and Spanish caregivers of patients with AD. Methods: This is a cross-sectional study composed by samples of outpatients with AD and their caregivers from Brazil (n = 128) and Spain (n = 146). Caregivers answered the Zarit Burden Interview (ZBI) and a Sociodemographic Questionnaire. Patients were assessed with the Mini-Mental State Examination (MMSE), Functional Activities Questionnaire (FAQ), Disability Assessment for Dementia (DAD), Neuropsychiatric Inventory (NPI), and Clinical Dementia Rating (CDR) Scale. Results: In the multivariate regression analysis, high burden levels were reported in Brazil, when caregivers were female (p = 0.025) and when patients did not attend Day Care Center (p = 0.025). In Spain, high burden levels were associated with living with the patient (p = 0.014), younger caregivers (p = 0.003), and participation of patients at Day Care Center (p = 0.046). Also, different neuropsychiatric symptoms explained high burden levels: in Brazil, depression (p < 0.001) and anxiety (p = 0.024) and, in Spain, apathy/indifference (p < 0.001), agitation/aggression (p = 0.019) and irritability/lability (p = 0.027). Conclusions: Caregivers' gender, patients who attendedDay Care Center and neuropsychiatric symptoms were differentiating factors in the burden of Brazilian and Spanish caregivers

Course of depressive symptoms and associated factors in people aged65+ in Europe: A two-year follow-up

Background: The epidemiology of depressive disorders presents notable differences among European countries. The objectives of the study are to determine the prevalence, incidence, persistence and remission rates of depressive symptoms and to identify risk factors and differences between four European regions. Method: Prospective cohort design using data from waves 5 and 6 (2013-15) of the Survey of Health, Ageing and Retirement in Europe. Sample size included 31,491 non-institutionalized adults aged 65+. Depressive symptoms were assessed using the EURO-D. Results: The prevalence of depressive symptoms (EURO-D ≥4) was 29.8% and 31.5%in waves 5 and 6, respectively. The risk factors associated depressive symptoms were poorer self-rated health, loneliness, impairment in ADL, female gender and financial difficulties. Incidence was 6.62 (99.9% CI: 6.61-6.63)/100 person-years and the persistence and remission rates were 9.22 and 5.78, respectively. Regarding the differences between European regions, the incidence (4.93 to 7.43) and persistence (5.14 to 11.86) rates followed the same ascending order: Northern, Eastern, Continental and Southern. The remission presented higher rates in the Eastern and Southern (6.60-6.61) countries than in the Northern and Continental (4.45-5.31) ones. Limitations: The EURO-D scale is unable to distinguish between clinically relevant depressive symptoms and major depression. Conclusion: The risk factors related to the incidence of depressive symptoms differed across European regions. In countries of eastern and southern Europe the most important predictors were female gender and impairment in ADL. Poorer self-rated health and older age were more relevant in the Northern countries, and chronic diseases were a key factor in the Continental region

Abridged Scale for the Screening Anosognosia in Patients With Dementia

The objective of this cross-sectional study was to validate an abridged version of the Anosognosia Questionnaire - Dementia (AQ-D). The authors reduce the AQ-D from 30 items to 9, with a large sample of Alzheimer's disease (AD) patients (n=352). The Cronbach's alpha was 0.793 and an area under the COR curve was 0.946. Kappa index between new Abridged AQ-D (AAQ) and original AQ-D was =0.800. The AAQ presents good validity and reliability indicators and kept concordance with the original scale. It's quick and easy to application and it can simplify the clinical evaluation of anosognosia in AD patients