Anosognosia in Alzheimer's disease: A neuropsychological approach.

Bárbara Bomfim Caiado De Castro Zilli,Benito Pereira Damasceno

doi:10.1590/s1980-57642008dn10100013

Bárbara Bomfim Caiado De Castro Zilli, Benito Pereira Damasceno

Open Access

https://doi.org/10.1590/s1980-57642008dn10100013

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Abstract

Anosognosia is often found in Alzheimer's disease (AD), but its relationship with cognitivebehavioral changes is not well established.ObjectiveTo verify if anosognosia is related to cognitive-behavioral disturbances, and to regional brain dysfunction as evaluated by neuroimaging.MethodsWe included AD patients with Mini-Mental State Examination (MMSE) scores of 12 through 24, and Clinical Dementia Rating (CDR) scores of 1 or 2. Dementia diagnosis was based on DSM-IV and NINCDS-ADRDA criteria.We used Self-Consciousness Questionnaire (SCQ) and Denial of Illness Scale (DIS), and following neuropsychological counterproofs: WAIS-R digit span, Rey auditory verbal learning, verbal fluency test (category: animals), Cummings' neuropsychiatric inventory (NPI) and Cornell scale for depression in dementia (CSDD).ResultsWe studied 21 patients (12 men, 9 women) with AD (14 mild, 7 moderate), age 72.4±8.5 years, education 4.9± 4.2 years, and MMSE score 18.2±5. SCQ and DIS did not correlate to age, education, or regional cerebral perfusion defects, but they tended to correlate to disease duration (and only SCQ also to MMSE). SCQ and DIS were correlated neither to CSDD, NPI, CDR, nor to any neuropsychological test. Significant correlations were found between SCQ and DIS, as well as between SCQ domain of “moral judgment” and MMSE.ConclusionSCQ and DIS were not correlated to age, education, disease duration, cognitive-behavioral measures, dementia severity, or regional cerebral perfusion defects, but were correlated to each other, suggesting SCQ and DIS evaluate similar mental functions.

Highlights

Anosognosia is often found in Alzheimers disease (AD), but its relationship with cognitivebehavioral changes is not well established
We included patients with probable AD consecutively attended at our university hospital, aged 45 to 95 years, and presenting scores from 12 to 24 on Mini-Mental State Examination (MMSE)[21,22], and scores 1 or 2 on Clinical Dementia Rating (CDR)[23]
We studied 21 patients (12 men, 9 women) with probable AD (14 mild and 7 moderate), age 72.4±8.5 years, education 4.9±4.2 years, and score on MMSE 18.2±5.0 (Table 1)

Summary

Introduction

Anosognosia is often found in Alzheimers disease (AD), but its relationship with cognitivebehavioral changes is not well established. SCQ and DIS did not correlate to age, education, or regional cerebral perfusion defects, but they tended to correlate to disease duration (and only SCQ to MMSE). Conclusion: SCQ and DIS were not correlated to age, education, disease duration, cognitive-behavioral measures, dementia severity, or regional cerebral perfusion defects, but were correlated to each other, suggesting SCQ and DIS evaluate similar mental functions. Métodos: Incluimos pacientes com DA apresentando escores de 12 a 24 no Mini-Exame Mental (MEM) e 1 ou 2 na escala CDR (Clinical Dementia Rating). SCQ e DIS não relacionaram-se com idade, educação, defeito perfusional cerebral, CSDD, NPI, CDR ou testes neuropsicológicos, mas tenderam a relacionar-se com duração da doença (e apenas o SCQ também com o MEM). Correlações significativas foram encontradas entre o SCQ e a DIS, bem como entre o domínio de “julgamento moral” do SCQ e o MEM

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