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Keywords:

  • metacognition;
  • anosognosia;
  • insight;
  • dementia;
  • elderly

Abstract

Objective

To examine the utility of a brief, metacognition questionnaire by examining its association with objective cognitive testing and informant ratings. We hypothesized that the association between self-ratings of change and both outcomes would be greater among individuals without dementia than among those with dementia.

Methods

Participants were 535 persons without dementia and 152 with dementia from the Cache County Memory Study who had completed a metacognition questionnaire, two administrations of the Modified Mini-Mental State Exam (3 MS) and who had data on the Informant Questionnaire of Cognitive Decline in the Elderly (IQCODE). Cronbach's alpha was calculated as a measure of internal consistency of the metacognition questionnaire. Multiple regression was used to examine the relationship between metacognition and 3 MS change. Logistic regression was used to examine the relationship between metacognition and IQCODE ratings (no change vs. worse).

Results

Cronbach's alpha was 0.75. Among individuals without dementia, metacognition significantly predicted 3 MS change (p = .027) and IQCODE ratings (OR = 4.0, 95% CI = 1.2–13.8, p = .029), suggesting consistency among measures. For those with dementia, there was a weak, inverse relationship between 3 MS change and metacognition (r = −0.16, p = .056). IQCODE ratings were not significantly associated with metacognition (p = .729). Degree of dementia severity did not modify the relationship between metacognition and either outcome (p > .05).

Conclusions

We demonstrated adequate internal consistency and evidence for validity of a brief metacognition questionnaire. The questionnaire may provide a useful adjunct to memory and functional assessments for assessing anosognosia in elderly populations. Copyright © 2009 John Wiley & Sons, Ltd.