Anosognosia in dementia – Relevance for clinical-practice in a memory clinic

Abstract

IntroductionAnosognosia is a common symptom in patients with dementia, although data on prevalence vary widely. It is associated with decreased compliance to medical diagnosis and treatment. The rejection of assistance challenges professionals as well as caring relatives.ObjectivesAnosognosia increases with progression of disease but is also found in early stages. The underlying mechanisms are not completely understood; past studies described an association with executive dysfunction.AimsOur study aims to identify the frequency of anosognosia in our memory clinic.MethodsWe evaluated disease awareness using the Clinical Insight Rating Scale in 124 patients presenting with diagnosis of Alzheimer's disease in our memory clinic. We correlated the degree of awareness with standardized cognitive, affective, and functional parameters.ResultsOne hundred and fourteen patients (90.9%) showed decreased awareness, in 51.7% of our sample awareness was seriously impaired or even entirely lacking. In accordance with the literature, anosognosia correlated significantly with the result of the Mini-Mental-Staus-Examination as indicator of global cognitive functioning (r = −0.291, P < 0.05) and with the need for assistance in everyday-life (r = .364, P < 0.05). We found no correlation with depressive symptoms or age.ConclusionThe phenomenon of anosognosia is frequent in the setting of a memory clinic and has special impact on clinical practice as it is well correlated with executive functioning and global cognition and, thus, is a relevant factor for the initiation of medical care for patients with dementia.Disclosure of interestThe authors have not supplied their declaration of competing interest.