"Has your Memory Been Letting you Down?" Use of Figurative Language Modulates Expression of Awareness of Impairments in Alzheimer's Disease.

IntroductionWe compared responses of people with Alzheimer's disease (PwAD) on the Assessment Scale of Psychosocial Impact of the Diagnosis of Dementia and an adapted figurative language version. We hypothesize that figurative language improves acknowledgment of difficulties, varying by awareness object.Methods27 mild to moderate PwAD completed measures of cognition, depression and self-reported impairments. Caregivers informed about functionality, apathy and neuropsychiatric symptoms.ResultsAcknowledgment of difficulties in activities of daily living was higher in the figurative version, while acknowledgment in the emotional domain was higher in the regular version, in both cases with medium effect sizes. No significant differences emerged for total scores, acknowledgement of cognitive deficits, or changes in social relationships, all with small effect sizes.DiscussionLanguage modulation altered acknowledgment by awareness object. Findings support clear, not complex language in assessments. Future studies should define strategies to improve awareness and its predictors across clinical groups.