Description of original award (Fiscal Year 2007, $441,017)
Alzheimer's disease and related dementias currently affect about 5 million older Americans, a majority of which are women. While we know that at least one in twenty older Americans is a victim of elder abuse, mistreatment is even more prevalent in persons with dementia. Persons with dementia are at especially high risk of being mistreated due to a variety of factors, such as behavior problems, memory loss, dependency, and caregiver stress. Sadly, part of their vulnerability is due to loss of credibility. They are often the only witnesses to these abusive events, and yet, because of impaired memory, the veracity of their reports is doubted, negating the possibility of an intervention to stop the abuse, or effort to bring the perpetrators to justice.
Research has shown that people with dementia retain some ability to recall events that carry an emotional impact. The applicant's clinical and research experiences with this population demonstrate that abusive events may be salient to people with dementia, and that certain behaviors and characteristics enhance their credibility as historians. For example, someone in the early stages of the disease who is not experiencing psychotic symptoms and who is able to relate convincing details about the event, may be able to serve as a credible witness. Yet, to date, no systematic research has been conducted to identify the characteristics of a demented person associated with reliable accounts of emotional experiences. The applicants propose a cross sectional study of a population of people with dementia and a control group, in which the Geriatric Life Events Scale will serve as the basis for a structured interview to determine their credibility as witnesses to recent autobiographical events. The accuracy of these events will be independently verified by a previously identified, non-demented informant, most typically a family caregiver. In addition, both members of the dyad will be interviewed to assess other characteristics of the person with dementia, such as disease stage and neuropsychiatric symptoms.