The Concealing effect of Major depression And other Chronic diseases on Metacognition of patients with Mild Alzheimer’s disease, A cross-sectional Case control study

Abstract

Background: Metacognition is a very important variable to improve quality of life in patients with Alzheimer’s disease, also patients with Major depression are proved to have significant metacognitive awareness deficits and in light of the fact that depression is a common comorbidity in early Alzheimer’s disease we need to explore the effect of depression on metacognition of those patients. Methods: a sample of 64 patients with mild Alzheimer’s disease were recruited and divided to group of patients with comorbid depression and a control group having only mild Alzheimer’s with no depression, they were subjected to detailed history taking, psychometric tests for cognitive functions as MMSE, MoCA, ACE III, for depression the Cornell depression in dementia scale (CSDD) and for metacognition the metacognitive awareness inventory (MAI). Results: A significant inverse Correlation between prevalence and the severity of depression and the metacognitive awareness total and sub scores, also a significant correlation between the severity of cognitive impairment and the metacognitive awareness scores. chronic diseases were significantly associated with MAI scores, while diabetes showed direct correlation with total MAI scores, ischemic heart disease showed inverse correlation with total MAI scores, Also hypertension, ischemic heart disease and regular intake of antiplatelet were associated with higher prevalence of depression in patients with mild Alzheimer disease. Conclusions: Metacognition is a very vital variable in cases of AD that needs to be assessed comprehensively given into account also assessing any depressive symptoms that might affect it using valid reliable scales as the MAI and the CSDD as our study showed that it’s possible that depression might conceal the severity of metacognitive deficits in patients with mild Alzheimer’s disease.