Anosognosia and depression in patients with Alzheimer's dementia

Verhülsdonk, Sandra; Quack, Robin; Höft, Barbara; Lange-Asschenfeldt, Christian; Supprian, Tillmann

doi:10.1016/j.archger.2013.03.012

Cited by 45 publications

(56 citation statements)

References 43 publications

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“…Of course, these patients varied for clinical and neuropsychological conditions. The total number of discrepant items is widely variable (range [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. This suggests the possibility of identifying various degrees of anosognosia (Table 5).…”

Section: The Diagnosis Of Anosognosiamentioning

confidence: 97%

“…9,12 Furthermore, a form of anosognosia known as affective anosognosia, which specifically involves changes in mood and interpersonal reactions, has been reported. 9 Research on functional neuroanatomy has identified the crucial role of cingulofrontal and parietotemporal networks in the awareness of deficits, 13 in particular in the right hemisphere. Hypometabolism and reduced blood flow have been found to be associated with a lack of awareness of memory deficits and anosognosia in AD, in particular in the right inferior frontal gyrus, 14 in the right prefrontal and orbitofrontal cortex, 15,16 in the anterior cingulate gyri and medial and orbital frontal areas, 17 and in medial temporal structures.…”

Section: Introductionmentioning

confidence: 98%

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The Italian Validation of the Anosognosia Questionnaire for Dementia in Alzheimer’s Disease

Gambina

Valbusa

Corsi

et al. 2015

Am J Alzheimers Dis Other Demen

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Although the Anosognosia Questionnaire-Dementia (AQ-D) is one of the main instruments for assessing awareness in Alzheimer's disease (AD), the normative data were until now limited to people from Argentina and Japan. This study aims to validate this instrument in an European context, in particular in an Italian sample. In a multicenter project (Verona, Padova, and Trapani), 130 patients with AD and their caregivers participated in the study. Psychometric characteristics of AQ-D are confirmed indicating that the scale permits the early identification of anosognosia and the correct care management of patients. Indeed, anosognosia results to be present also in patients with very mild AD (moderate: 44.44%; mild: 47.17%; and very mild: 23.73%). Moreover, the results indicate that deficits in awareness may vary in severity and that different types of anosognosia may be identified.

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Section: The Diagnosis Of Anosognosiamentioning

confidence: 97%

Section: Introductionmentioning

confidence: 98%

The Italian Validation of the Anosognosia Questionnaire for Dementia in Alzheimer’s Disease

Gambina

Valbusa

Corsi

et al. 2015

Am J Alzheimers Dis Other Demen

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“…First, studies show mixed results when exploring awareness for different objects in dementia, with some findings suggesting that patients with AD present greater unawareness for cognitive deficits relative to behavioural changes (Kotler-Cope & Camp, 1995) and others results indicating also an "affective anosognosia" (Verhülsdonk, Quack, Höft, Lange-Asschenfeldt, & Supprian, 2013), that is, a lack of awareness for mood disturbance. Second, the literature suggests that people with AD may present an emotional response to failure situations even in the absence of explicit awareness.…”

Section: Introductionmentioning

confidence: 99%

Mood-congruent recollection and anosognosia in Alzheimer's disease

Bertrand

Dourado

Laks

et al. 2016

Cortex

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The aim of the study was to investigate experimentally the impact of current mood state on anosognosia or awareness of symptoms in AD patients, in which mood state was manipulated by giving tasks that were either easy (success condition) or very difficult (failure condition). Twenty-two patients with mild to moderate AD participated. Four success-failure manipulation (SFM) computerized tasks were used as mood induction procedures, two based on reaction time tasks and the other on memory tasks. Level of awareness and the current mood state were assessed before and after each task, using a modified version of the Anosognosia Questionnaire for Dementia and a self-reported questionnaire respectively. For both types of task, the results indicate that the emotional state of the participants was similar before performing the tasks and that only the failure conditions induced a negative mood state. Additionally, regarding the level of awareness, there were no significant differences after the reaction time tasks but for the memory tasks, there was greater awareness of symptoms after performing the task in the failure condition. To the best of our knowledge, this study is the first exploring experimentally the impact of mood on anosognosia in AD. The results showed an improvement of awareness of symptoms after negative mood induction, but only when the task used in the SFM was memory-based.

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“…Among them, 13 evaluated only this domain 20,23,27,38,39,41,44,47,[50][51][52][53]55 . Ten studies evaluated awareness of cognitive and functional deficits domains 1,18,20,[33][34][35]40,45,46,54 , nine assessed cognitive and social-emotional functioning domains 12,13,17,24,28,30,36,37,49 , and three focused on cognitive and behavioral impairment domains 14,16,42 . Three researches compared awareness of cognitive, functional and behavioral impairment domains 22,25,32 and four studied the recognition of cognitive, functional, and social-emotional 15,19,29,43 .…”

Section: Resultsmentioning

confidence: 99%

Concepts and objects of awareness in Alzheimer’s disease: an updated systematic review

Lacerda¹,

Sousa²,

Santos³

et al. 2016

J. bras. psiquiatr.

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Objectives: To compare and discuss the objects of awareness in Alzheimer's disease (AD): awareness of cognitive deficits, of functional activities, of social-emotional functioning and behavioral impairment. Methods: A search in the PsycINFo, Pilots, PubMed/Medline and ISI electronic databases according to Prisma methodology was performed. We included studies about awareness in people with AD published between 2010 and 2015, with the combination of keywords: "Alzheimer AND awareness of deficits", "Alzheimer AND anosognosia", "Alzheimer AND insight", "dementia AND awareness of deficits", "dementia AND anosognosia", "dementia AND insight". The articles were categorized according to the specific object of awareness. Results: Seven hundred and ten records were identified and, after application of the exclusion criteria, 191 studies were retrieved for potential use. After excluding the duplicates, 46 studies were included. Most studies assessed the cognitive domain of awareness, followed by the functional, social-emotional, and behavioral impairment domains. Memory deficits were not sufficient to explain impaired awareness in AD. Longitudinal studies did not find discrepancies between patients and caregivers' reports, indicating that awareness is not related to cognition. Conflicting findings were observed, including the relation between awareness, mood, severity of disease, and personal characteristics. Conclusions: The studies show lack of conceptual consensus and significant methodological differences. The inclusion of samples without differentiation of dementia etiology is associated to symptomatic differences, which affect awareness domains. Awareness in AD is a complex and multidimensional construct. Different objects elicit different levels of awareness. RESUMOObjetivos: Comparar e discutir os objetos de consciência na doença de Alzheimer (DA): consciência dos déficits cognitivos, das atividades funcionais, do funcionamento socioemocional e prejuízos comportamentais. Métodos: Realizou-se uma busca nas bases de dados PsycINFo, Pilots, PubMed/Medline e ISI de acordo com a metodologia do Prisma. Os artigos incluídos, publicados entre 2010 e 2015, avaliavam a consciência na DA com as combinações de palavras-chave: "Alzheimer AND consciência do déficit", "Alzheimer AND anosognosia", "Al- zheimer AND insight", "demência AND consciência do déficit", "demência AND anosognosia", "demência AND insight". Os artigos foram categorizados conforme os objetos específicos da consciência. Resultados: Setecentos e dez estudos foram identificados e, após a aplicação dos critérios de exclusão, 191 foram selecionados. Após a exclusão dos duplicados, 46 estudos foram incluídos. A maioria dos estudos avaliou o domínio cognitivo da consciência, seguido do funcional, do funcionamento socioemocional e prejuízos comportamentais. Dé-ficits na memória não se mostraram suficientes para explicar o prejuízo da consciência na DA. Os estudos longitudinais não encontraram discrepâncias entre os relatos de pacientes e cuidadores, indicando...

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Anosognosia and depression in patients with Alzheimer's dementia

Cited by 45 publications

References 43 publications

The Italian Validation of the Anosognosia Questionnaire for Dementia in Alzheimer’s Disease

The Italian Validation of the Anosognosia Questionnaire for Dementia in Alzheimer’s Disease

Mood-congruent recollection and anosognosia in Alzheimer's disease

Concepts and objects of awareness in Alzheimer’s disease: an updated systematic review

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