Conscience de soi et démence sévère

Anosognosia is a common phenomenon in patients with dementia. Between 22% and 93% of patients with mild to moderate Alzheimer's disease relate such syndrome. However, little is known about Self-awareness and anosognosia in patients with severe dementia. The main objective of this work was to study the self-awareness and anosognosia in patients with severe dementia using a new tool, elaborated for this study (the QCSDS). Subjects were 59 nursing home residents, aged from 65 to 102 years with a mean age of 86,18 (SD = 10,01) years. Cognitive function was measured with the Mini mental state examination (MMSE), Severe impairment battery (SIB), Frontal assessment battery (FAB) and sub-tests derived from the Wechsler adult intelligence scale-revised (WAIS-R). Results showed that 53% of the sample suffered from moderate to severe anosognosia for both cognitive deficit and behavioral abnormalities. An inter- examinator study of 29 patients yielded a correlation coefficient r = 0.367 (p = 0.003). In an inter-test study of 19 patients the correlation coefficient was also very high (r = 0.537, p < 0.0001). Thus, the QCSDS seems to be a reliable tool to evaluate Self-Awareness and anosognosia in patients with severe dementia.