A - 180 Anosognosia across the Spectrum of Alzheimer's Pathology and Validation of a New Measure.

Abstract

Two studies were performed to validate a brief, new method for assessing informant-patient discrepancies to quantify cognitive insight, and to compare it to an empirically supported model - the Cognitive Awareness Model (CAM). Study 1 included 31 (52% male; Mage = 69.42) patients from an outpatient neuropsychological assessment clinic. Seven patients were diagnosed with probable Alzheimer's dementia (PAD), 15 mild cognitive impairment (MCI), and 9 no diagnosis (i.e., healthy controls; HC). The Cognitive Coding Form (CCF) was compared with several measures to assess convergent and discriminant validity. Study 2 entailed archival data extraction of 240 patients (80 HC, 80 MCI, and 80 PAD; 53.3% female; Mage = 72.8) to examine the ability of the CCF to predict various cognitive domains, including executive functioning (Trail-Making Test Form B). In study 1, the 8-item CCF demonstrated good convergent and discriminant validity with established measures. Study 2 identified that both patient-reported cognitive concerns and, to a greater degree, CCF informant-patient discrepancy scores, can distinguish HCs from those with MCI and PAD. Further, a regression indicated that depression (Geriatric Depression Scale; 5.5%; β= -0.38, p < 0.001) and TMT-B (13%; β= -0.43, p < 0.001), together accounted for 18.5% of the variance in insight (R2 = 0.19, F(2,219) = 26.10, p < 0.001), supporting the CAM. In addition to establishing an efficient measure of insight with high clinical utility (the CCF), these studies inform the literature on the role of insight in predicting performance in those with Alzheimer's pathology.