Objectives:

Assessments of unawareness in Alzheimer’s disease mainly focus on the objects (the “what”) of unawareness. A recent person-centered approach proposes to also assess the processes (the “how”). The present study combines 2 approaches to understand this heterogeneity in assessments of unawareness.

Method:

We recruited 46 participants from 8 nursing homes. They underwent a semi-structured interview and were assessed using a prediction–performance paradigm. Spearman correlations were calculated, and generalized additive models were established.

Results:

The 2 approaches are associated through cognitive deficits, confrontation with difficulties and identity changes. Objects (the what), mechanisms, and modes of expression (the how) explain at least 29.6% of the variance of unawareness.

Conclusions:

Unawareness is more than simply being unaware of something; it is a synergy between the objects and processes of arousal and expression. Moreover, unawareness extends beyond the disease to include the self. Considering the entire person seems to be necessary.

中文翻译：

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“什么”和“如何”：通过两种观点的结合来理解阿尔茨海默病的无意识的新视角。

 目标：

对阿尔茨海默病无意识的评估主要集中在无意识的对象（“什么”）上。最近以人为本的方法还建议评估流程（“如何”）。本研究结合了两种方法来理解无意识评估中的这种异质性。

 方法：

我们从 8 家疗养院招募了 46 名参与者。他们接受了半结构化访谈，并使用预测绩效范式进行评估。计算Spearman相关性，并建立广义相加模型。

 结果：

这两种方法通过认知缺陷、面对困难和身份改变相关联。对象（什么）、机制和表达方式（如何）至少解释了 29.6% 的无意识差异。

 结论：

无意识不仅仅是不知道某事；它是唤醒和表达的对象和过程之间的协同作用。此外，无意识不仅限于疾病，还包括自我。考虑到整个人似乎是必要的。