Memory Awareness Influences Everyday Decision Making Capacity about Medication Management in Alzheimer′s Disease

Memory awareness in early Alzheimer’s disease (AD) influences capacity to provide informed consent for a memory treatment. This study investigated the extent to which aspects of memory awareness influence everyday decision-making capacity about medication management in AD. 42 participants with mild AD and 50 healthy elders underwent clinical ratings of memory awareness, metamemory testing, and an interview of everyday decision-making capacity regarding medication management. 45% of AD subjects were classified as aware (AAD) and 55% as unaware (UAD) based on clinical ratings and supported by metamemory testing (P=.015). Capacity was impaired in each of the AD groups as compared to the healthy elders F(2, 67)=17.63, UAD, P<.01; AAD, P=.01). Within the AD group, capacity correlated selectively with awareness as measured with clinical ratings (r=−.41, P=.007) but not objective metamemory testing (r=−.10, P=.60). Appreciation scores were lower in UAD as compared with AAD F(1, 35)=8.36, P=.007. Unawareness of memory loss should heighten clinicians’ concern about everyday decision-making capacity in AD