ABSTRACT
This study evaluated Alzheimer disease (AD) patients' awareness of impairment in several domains, including cognitive, psychiatric, and behavioral functioning. Ratings made by 13 patients with moderate to moderately severe probable AD were compared with ratings made by their relatives using the Cognitive Behavior Rating Scales (Williams et al., 1985; Williams, 1987). Unawareness was defined as the discrepancy between informant and patient ratings. Informants consistently rated patients' impairment as more severe than the patients rated themselves. However, the discrepancy between the ratings was statistically significant only for Language Disorder, Higher Cognitive Deficits, Memory Disorder, Dementia, and Apraxia, and not for Agitation, Need for Routine, Depression, and Disorientation scales. Unawareness was not related to severity of memory impairment, as measured by the Rivermead Behavioural Memory Test (Wilson et al., 1985). The results of this small, preliminary study of relatively severely impaired AD patients suggest that awareness of psychiatric and behavioral problems may be relatively preserved compared to awareness of cognitive problems. These findings should be replicated with a larger sample with a broader range of severity.
Subject(s)
Agnosia/diagnosis , Alzheimer Disease/diagnosis , Awareness , Neuropsychological Tests , Activities of Daily Living/psychology , Aged , Aged, 80 and over , Agnosia/psychology , Alzheimer Disease/psychology , Disability Evaluation , Female , Humans , Male , Mental Recall , Middle AgedABSTRACT
Ethanol induces changes in eicosanoid synthesis in blood platelets and brain tissue. Cigarette smoking also causes alterations in eicosanoid formation. This preliminary report examined in vitro platelet sonicate eicosanoid production using 14C-arachidonic acid (14C-AA) and in separate experiments, 14C-PGH2, as substrates. Radiometric thin layer chromatography (TLC) was used to identify the products formed. Eicosanoid product formation in platelet sonicates collected from 28 abstinent male alcoholics were compared to those from 11 male control subjects. All but one of the alcoholics were chronic smokers and all control subjects were non-smokers. All smokers abstained from smoking for 12 h prior to the blood collection to control for any acute effects of cigarette smoke on eicosanoid production. Significant reductions in platelet sonicate production of PGD2 and PGE2 in vitro were observed in alcoholic smokers when 14C-PGH2, but not 14C-AA, was the substrate. These reductions were predicted equally well by two variables, smoking and alcoholism, using several statistical models. This is the first investigation that controlled for the acute effects of smoking and accounted for the potential effects of cigarette smoking on platelet eicosanoid production in alcoholics. Because cigarette smoking is prevalent among alcoholics, future studies on the role of eicosanoids in alcoholism should control for smoking.
