The present study analyzed the awareness of deficits in 117 mild Alzheimer's disease participants. Since few studies have examined the cognitive and behavioral domains of reduced awareness in detail, we performed a domain-specific assessment using the Awareness of deficit Questionnaire – Dementia scale with the novel aim of describing the relationship with everyday executive dysfunction. Through the use of the subtests of the Behavioral Assessment of the Dysexecutive Syndrome, we hypothesized that executive cognitive functions may play an important role in the reduced awareness of deficits. We also considered other variables of interest to provide a novel comprehensive explanation of this phenomenon. Our first approach to the study was a factor analysis considering the role of these variables in the awareness of deficits; subsequently, regression analysis models were used to define which variables were associated with a reduction of awareness in cognitive and behavioral domains. In particular, the factors retained from the factor analysis, in terms of inhibition, self-monitoring, set-shifting, and mood orientation changes, appear to be important skills for awareness of instrumental activities of daily living (R2 = .32). We also found hypo manic mood orientation and a tendency through apathy to be prominent indications of reduced behavioral awareness (R2 = .13). (JINS, 2013, 18, –)

Traditional neuropsychological measures of executive dysfunction (ED) are widely believed to lack adequate sensitivity and selectivity. This may indicate that existing measures are poorly designed and constructed, although an alternative explanation is that executive cognition is multifactorial, such that its assessment necessarily requires administration of multiple measures. This possibility led to the development of a test battery, the Behavioural Assessment of the Dysexecutive Syndrome (BADS). To investigate the sensitivity of the BADS to ED, it and various other measures of ED were administered to 64 persons who had sustained traumatic brain injury. The treating clinical neuropsychologist and occupational therapist for each participant also completed a behavioural rating scale, the Dysexecutive Questionnaire (DEX). Four factors were found to underlie scores on the neuropsychological measures, but few tests were sufficiently powerful to make a significant unique contribution to predicting scores on the DEX. This confirms that multiple tests, drawn from both the BADS and other sources, may be necessary to detect ED in a clinical population. (JINS, 2005, 11, 606–613.)