The relation between anosognosia and dementia severity in Alzheimer's disease (AD) has been unclear. We constructed a measure that quantified the difference between the perceptions of deficits of patients with AD (n = 23) and ratings from a knowledgeable informant as a measure of anosognosia. There was no correlation between dementia severity and anosognosia. However, dementia severity was positively correlated with the degree of anosognosia after controlling for depressive symptomatology (p =.03). Post-hoc analyses, also controlling for depressive symptoms, indicated that higher levels of anosognosia were associated with lower performance on specific cognitive tasks. These results suggest depressive symptoms may confound the relationship between anosognosia and dementia severity.
Accurate neuropsychological assessment of Alzheimer's disease may require consideration of potentially subtle differences between older adults tested at university centers and those tested in the community.
The current study examines the effects of lateralized brain injury on Raven's Coloured Progressive Matrices (CPM) performance. Archival data on 106 unilateral brain-damage patients, 59 with right hemisphere damage and 47 with left, was utilized to examine four aspects of differential performance. Right brain-damaged subjects performed significantly lower than left brain-damaged subjects overall on the CPM. They also showed evidence of a higher incidence of and greater severity of hemi-neglect. After partialling out the effects of hemi-neglect, the subject groups were no longer significantly different on overall CPM performance. Evidence supporting the presence of heterogeneous subtests was not found. The results support the emerging pattern in research findings indicating that hemi-neglect plays a central role in differential performance. The CPM appears limited in its application and interpretation for patients with hemi-neglect.
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