OBJECTIVE: To examine the presence of different dimensions of unawareness in patients with probable Alzheimer's disease. METHODS: A consecutive series of 170 patients with probable Alzheimer's disease were assessed with the anosognosia questionnaire-dementia (AQ-D) which includes items related to cognitive deficits and behavioural problems. RESULTS: A factor analysis of the AQ-D produced two factors: a "cognitive unawareness" factor, which loaded on items of memory, spatial and temporal orientation, calculation, abstract reasoning, and praxis, and a "behavioural unawareness" factor which loaded on items of irritability, selfishness, inappropriate emotional display, and instinctive disinhibition. A stepwise forward regression analysis showed significant correlations between the cognitive unawareness factor and more severe cognitive deficits, delusions, and apathy, but less depression. On the other hand, the behavioural unawareness factor correlated significantly with higher mania and pathological laughing scores. Whereas the cognitive unawareness factor showed a significant correlation with cognitive tests assessing verbal comprehension and long term memory, and was significantly associated with a longer duration of illness, no significant correlations were found between the behavioural unawareness factor and the neuropsychological tasks. CONCLUSION: Unawareness of cognitive deficits and unawareness of behavioural problems may constitute independent phenomena in Alzheimer's disease. Whereas unawareness of cognitive deficits is related to the severity of intellectual impairment and the presence of delusional apathetic mood, unawareness of behavioural problems may be part of a disinhibition syndrome.
OBJECTIVE: To examine the presence of different dimensions of unawareness in patients with probable Alzheimer's disease. METHODS: A consecutive series of 170 patients with probable Alzheimer's disease were assessed with the anosognosia questionnaire-dementia (AQ-D) which includes items related to cognitive deficits and behavioural problems. RESULTS: A factor analysis of the AQ-D produced two factors: a "cognitive unawareness" factor, which loaded on items of memory, spatial and temporal orientation, calculation, abstract reasoning, and praxis, and a "behavioural unawareness" factor which loaded on items of irritability, selfishness, inappropriate emotional display, and instinctive disinhibition. A stepwise forward regression analysis showed significant correlations between the cognitive unawareness factor and more severe cognitive deficits, delusions, and apathy, but less depression. On the other hand, the behavioural unawareness factor correlated significantly with higher mania and pathological laughing scores. Whereas the cognitive unawareness factor showed a significant correlation with cognitive tests assessing verbal comprehension and long term memory, and was significantly associated with a longer duration of illness, no significant correlations were found between the behavioural unawareness factor and the neuropsychological tasks. CONCLUSION: Unawareness of cognitive deficits and unawareness of behavioural problems may constitute independent phenomena in Alzheimer's disease. Whereas unawareness of cognitive deficits is related to the severity of intellectual impairment and the presence of delusional apathetic mood, unawareness of behavioural problems may be part of a disinhibition syndrome.
Authors: R Migliorelli; A Tesón; L Sabe; G Petracca; M Petracchi; R Leiguarda; S E Starkstein Journal: J Neuropsychiatry Clin Neurosci Date: 1995 Impact factor: 2.198
Authors: G A Marshall; D I Kaufer; O L Lopez; G R Rao; R L Hamilton; S T DeKosky Journal: J Neurol Neurosurg Psychiatry Date: 2004-10 Impact factor: 10.154
Authors: David L Sultzer; Lorraine P Leskin; Rebecca J Melrose; Dylan G Harwood; Theresa A Narvaez; Timothy K Ando; Mark A Mandelkern Journal: Am J Geriatr Psychiatry Date: 2013-09-08 Impact factor: 4.105
Authors: Craig Williamson; Oscar Alcantar; Johannes Rothlind; Deborah Cahn-Weiner; Bruce L Miller; Howard J Rosen Journal: J Neurol Neurosurg Psychiatry Date: 2009-02-09 Impact factor: 10.154
Authors: Sarah Cines; Meagan Farrell; Jason Steffener; Liz Sullo; Edward Huey; Jason Karlawish; Stephanie Cosentino Journal: Am J Geriatr Psychiatry Date: 2015-05-19 Impact factor: 4.105
Authors: C A Defanti; A Tiezzi; M Gasparini; M Gasperini; M Congedo; P Tiraboschi; D Tarquini; E Pucci; C Porteri; V Bonito; L Sacco; S Stefanini; L Borghi; L Colombi; N Marcello; O Zanetti; R Causarano; A Primavera Journal: Neurol Sci Date: 2007-08 Impact factor: 3.307