Observed Affect in Nursing Home Residents with Alzheimer's Disease

O NE'S MOST immediate impression of a person with Alzheimer's disease (AD) or a similar disorder is likely to be conveyed by the massive inroads on overall competence made by the brain damage resulting from these conditions. Personality, everyday needs, interests, emotional attachments, and all else related to the positive goals of ordinary human existence become leveled and dwarfed by the psychopathology. However, closer contact with AD patients reveals significant individual differences in residual functions and preferences. Research interest in quality of life (QOL) for AD patients, and especially the concern expressed in the reforms embedded in the Omnibus Reconciliation Act of 1987, recognize to some degree the need to restore the breadth of our conceptions of AD patients as individuals. This research investigated manifestations of affect in nursing home residents suffering from Alzheimer's disease. Affect is an important aspect of personality and deserves study in its own right. Affect is also a potentially important avenue toward understanding the likes and dislikes of a class of patients who are limited in their ability to introspect and report on their internal states. If affect states can be discerned in patients with dementing illness, this information may guide us in designing programs, treatments, and environmental features to enhance their quality of life. This report describes the qualities of an instrument designed to measure observed affect expression in Alzheimer patients. The reliability with which trained observers made such ratings was tested.