Self‐awareness impairment in Alzheimer’s Disease: Its Impact on Decision‐Making for Aging in Place
Bibliographic record
Abstract
Abstract Alzheimer’s disease significantly impacts decision‐making abilities, potentially increasing risk‐taking behaviors and complicating the process of aging‐in‐place, particularly in cases of anosognosia (self‐awareness impairment). To understand how this affects patient and caregiver perspectives, we conducted a qualitative study to identify arguments used by older patients with Alzheimer’s disease and their family caregivers about aging‐in‐place. We included 18 dyads, each comprising an older adult living at home with mild dementia and their family caregiver. The older adults' arguments in favor of aging‐in‐place were primarily centered on maintaining a sense of safety and comfort through familiar surroundings and relationships, as well as preserving independence and lifestyle habits, which contribute to stability in their daily lives. Despite recognizing memory loss, many minimized or overlooked the associated risks in their thoughts about aging in place. Caregivers, while supportive of the desire for aging in place, emphasized the need for adaptability in daily functioning and proactive planning for foreseeable challenges. They advocated for external support strategies, including professional assistance, technology use, routine adaptations, and legal protective measures. Our study highlights the profound impact of anosognosia on the loss of adaptability, potentially undermining preventive strategies for aging in place. A deeper understanding of these factors is crucial for professionals in developing care and service plans tailored to individual needs. Such knowledge is vital in facilitating discussions and negotiations around care strategies, ensuring they address the needs and concerns of both patients and caregivers in the context of Alzheimer’s disease.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.002 | 0.003 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.000 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".