DENIAL OF MEMORY DEFICIT IN ALZHEIMERS-DISEASE

Objective: Patients with probable Alzheimer's disease often deny or un derestimate the severity of their memory impairment. The authors exami ned the relationships between denial and severity of cognitive impairm ent and between denial and the presence of depressed mood and sad affe ct in 128 patients with probable Alzheimer's disease. Method: Denial o f memory deficit was evaluated by structured interview. Cognition was evaluated with a quantitative examination that assessed performance on 16 subtests. Depression was rated by using a scale that included pati ents' self-ratings as well as caregivers' and examiners' assessments o f the patient's mood and affect. Pearson correlation coefficients were used to quantify the relationship between denial and demographic, cog nitive, and depression variables. Stepwise multiple regression analysi s was used to further examine the relationship between denial and indi vidual cognitive subtest scores. Results: Denial did not correlate wit h age at onset of Alzheimer's disease, duration of illness, or educati onal background. It did correlate with gender: women exhibited greater denial than men. A significant correlation was found between denial a nd overall severity of cognitive deficit and particularly with impairm ent in object naming. A negative correlation was found between denial and depression. Conclusions: The association between denial and cognit ive impairment may suggest that denial of probable Alzheimer's disease results from disruption of cognitive abilities needed for awareness o f illness. The negative association between denial and depression may suggest that depression in Alzheimer's disease is in part reactive in nature.