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J Neurol Sci. 2017 Jun 15;377:155-160. doi: 10.1016/j.jns.2017.04.009. Epub 2017 Apr 7.

Awareness of cognitive impairment in individuals with essential tremor.

Author information

1
Cognitive Neuroscience Division, Department of Neurology, Gertrude H. Sergievsky Center, NY, USA; Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, NY, USA.
2
Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, USA; Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT, USA; Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, Yale University, New Haven, CT, USA.
3
Cognitive Neuroscience Division, Department of Neurology, Gertrude H. Sergievsky Center, NY, USA; Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, NY, USA. Electronic address: sc2460@cumc.columbia.edu.

Abstract

OBJECTIVE:

The extent to which individuals with ET who have clinically significant cognitive impairment are aware of their cognitive changes is unclear. Reduced awareness has important implications for everyday function and decision-making.

METHODS:

150 individuals with ET (109 Normal Cognition (ET-NC group), and 30 with MCI and 11 dementia (ET-CI group)) completed self-ratings and objective assessments of memory, language, and executive functioning. Discrepancy scores were calculated to assess awareness of cognitive functioning. One sample t-tests evaluated whether mean discrepancy scores in each group were comparable to zero (i.e., accurate). Analyses of covariance (ANCOVA) compared discrepancy scores across two groups controlling for age and education.

RESULTS:

In the ET-NC group, discrepancy scores for language (M=-0.08, SD=1.10) and executive functioning (M=-0.01, SD=0.99) were comparable to zero. Memory discrepancy scores (M=0.32, SD=1.22) were greater than zero. In the ET-CI group, memory, (M=0.78, SD=1.01), language, (M=0.46, SD=0.95), and executive (M=0.39, SD=1.14) discrepancy scores were all greater than zero. Discrepancy scores were larger in ET-CI group than in ET-NC group for memory: F(1,148)=4.02, p=0.047, language: F(1,148)=6.16, p=0.014, and executive: F(1,148)=4.51, p=0.035.

CONCLUSIONS:

Individuals with ET and normal cognition accurately assessed their language and executive abilities, demonstrating mild overconfidence in memory function. Individuals with ET and cognitive impairment overestimated their performance in all domains of functioning. Since ET is linked to increased risk for cognitive impairment, and such impairment may not be accurately perceived, cognitive functioning should be proactively and regularly screened in ET.

KEYWORDS:

Awareness; Cognitive impairment; Essential tremor

PMID:
28477687
PMCID:
PMC5899423
DOI:
10.1016/j.jns.2017.04.009
[Indexed for MEDLINE]
Free PMC Article

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