Consciência da doença na demência do tipo Alzheimer: Uma revisão sistemática de estudos longitudinais

Abstract

Objectives: To evaluate the definitions, assessment methods and etiological hypotheses used in longitudinal studies on awareness of disease in dementia of the Alzheimer type. Method: Search in Medline, ISI, Lilacs and SciELO database, looking for longitudinal studies about awareness of disease in dementia of the Alzheimer type between 1999 and 2009. The keywords used were "Alzheimer", "dementia", "anosognosia", "awareness of deficit", "awareness of disease", "insight" e "longitudinal study". The articles reviewed were classified according to the etiological hypotheses. Results: Nine articles were selected and they were divided into two areas: biological etiological hypotheses and psychosocial etiological hypotheses. The terms "lack of awareness of deficits","awareness of deficit", "insight" and "denial of memory" deficit were used as synonyms of "anosognosia", although conceptually different. The questionnaires discrepancy between patients and caregivers was the most used evaluation method. Conclusions: Longitudinal studies show heterogeneous etiological hypotheses, a lack of a standard conceptual and methodological assessment. These difficulties make impossible to obtain homogeneous results. There is a need of further studies in the area.