N J O'Shaughnessy1, J E Chan1, R Bhome1, P Gallagher1, H Zhang1,2,3, L Clare4, E L Sampson1, P Stone1, J Huntley1. 1. Division of Psychiatry, University College London, London, UK. 2. National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China. 3. Dementia Care and Research Center, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China. 4. Centre for Research for Ageing and Cognitive Health, University of Exeter, Exeter, UK.
Abstract
Objective: There is limited understanding about how people in the severe stages of Alzheimer's disease (AD) experience and demonstrate awareness. We synthesised all available evidence with the aim of understanding how awareness is preserved or impaired in severe AD and what evidence there is for different levels of awareness according to the levels of awareness framework.Method: A systematic search of the following databases: Embase, PsycINFO, MEDLINE and Web of Science was carried out. A narrative synthesis and analysis was conducted of all included studies. All studies were assessed for quality using the AXIS and CASP tools. Results: Our findings suggest that lower level sensory awareness is relatively maintained in severe AD. Findings for higher level awareness are variable and this may be related to the diversity of methods that have been used to explore awareness in these circumstances. Conclusion: Awareness is complex, heterogeneous and varies significantly between individuals. Environmental and contextual factors have a significant impact on whether awareness is observed in people with severe AD. Adaptation of the environment has the potential to facilitate the expression of awareness while education of caregivers may increase understanding of people with severe AD and potentially improve the quality of care that is received.
Objective: There is limited understanding about how people in the severe stages of Alzheimer's disease (AD) experience and demonstrate awareness. We synthesised all available evidence with the aim of understanding how awareness is preserved or impaired in severe AD and what evidence there is for different levels of awareness according to the levels of awareness framework.Method: A systematic search of the following databases: Embase, PsycINFO, MEDLINE and Web of Science was carried out. A narrative synthesis and analysis was conducted of all included studies. All studies were assessed for quality using the AXIS and CASP tools. Results: Our findings suggest that lower level sensory awareness is relatively maintained in severe AD. Findings for higher level awareness are variable and this may be related to the diversity of methods that have been used to explore awareness in these circumstances. Conclusion: Awareness is complex, heterogeneous and varies significantly between individuals. Environmental and contextual factors have a significant impact on whether awareness is observed in people with severe AD. Adaptation of the environment has the potential to facilitate the expression of awareness while education of caregivers may increase understanding of people with severe AD and potentially improve the quality of care that is received.
Authors: Amandine Mayelle; Capucine Hazebrouck; Mohamad El Haj; Daniel C Mograbi; Pascal Antoine Journal: Front Aging Neurosci Date: 2022-01-13 Impact factor: 5.750
Authors: Jonathan D Huntley; Stephen M Fleming; Daniel C Mograbi; Daniel Bor; Lorina Naci; Adrian M Owen; Robert Howard Journal: Alzheimers Dement (N Y) Date: 2021-11-29