{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T09:20:40Z","timestamp":1788254440788,"version":"build-2803163510"},"reference-count":53,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Alzheimer\u2019s Disease"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Evidence on how distinct stages of mild cognitive impairment (MCI) and Alzheimer's disease (AD) affect decisional capacity and disease awareness remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We aim to examine the impairment of decision-making capacity, hypothesizing that people with MCI would demonstrate greater capacity and awareness than those with AD. We also aim to explore associations with cognitive and clinical variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cross-sectional study including 137 participants: MCI (n\u2009=\u200937), mild AD (n\u2009=\u200950), and moderate AD (n\u2009=\u200950). Standardized assessments were used to evaluate domains of decision-making capacity and awareness of the illness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>People with MCI performed significantly better in understanding, appreciation, and reasoning domains, while expression of choice was preserved across all groups. Disease awareness was higher in MCI, whereas AD participants showed marked deficits, particularly in cognitive and functional domains. Differences in socioemotional awareness were less consistent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings indicate a decline, from MCI to moderate AD, in decisional capacity and awareness, with expression of choice remaining relatively intact. These results have important ethical and clinical implications for shared decision-making and dementia care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13872877261468737","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:43:47Z","timestamp":1784555027000},"page":"250-260","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["From mild cognitive impairment to moderate Alzheimer's disease: Associations between decision-making capacity and awareness"],"prefix":"10.1177","volume":"113","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5238-9204","authenticated-orcid":false,"given":"Natalie Aparecida","family":"Pereira De Souza","sequence":"first","affiliation":[{"name":"Universidade Federal do Rio de Janeiro (UFRJ)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatiana Teresa","family":"Belfort Almeida Dos Santos","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio de Janeiro (UFRJ)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcela Moreira","family":"Lima Nogueira","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio de Janeiro (UFRJ)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6267-8202","authenticated-orcid":false,"given":"Marcia Cristina Nascimento","family":"Dourado","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio de Janeiro (UFRJ)"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2024.105291"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/HRP.0000000000000163"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198812223192504"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/oso\/9780195103724.001.0001"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1080\/13803395.2012.740000"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1080\/13803395.2020.1711873"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1041610220004056"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/WAD.0000000000000484"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13677-025-00738-9"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/1533317507308312"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1348\/014466504323088033"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-140183"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.3233\/ADR-230090"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2015.10.002"},{"key":"e_1_3_3_16_2","first-page":"180","article-title":"Conscience des troubles dans la maladie d\u00b4Alzheimer et le mild cognitive impairment [awareness disorders in Alzheime\u0155s disease and in mild cognitive impairment]","volume":"40","author":"Stites SD","year":"2014","unstructured":"Stites SD, Dupont MP, Herades Y, et al. 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