In the context of people with Alzheimer's disease, anosognosia was construed as the denial or lack of awareness of impairments in activities of daily living ( ...SkiptomaincontentYouarehereHomeArchiveVolume77, Issue6AdiagnosticformulationforanosognosiainAlzheimer’sdiseaseEmailalertsArticleTextArticlemenuArticleTextArticleinfoCitationToolsShareRapidResponsesArticlemetricsAlertsPDFPaperAdiagnosticformulationforanosognosiainAlzheimer’sdiseaseSEStarkstein1,RJorge2,RMizrahi3,RGRobinson21SchoolofPsychiatryandClinicalNeurosciences,UniversityofWesternAustralia,Australia2DepartmentofPsychiatry,UniversityofIowa,IowaCity,Iowa,USA3PETCenterforAddictionandMentalHealth,ClarkeDivision,Toronto,CanadaCorrespondenceto:
DrSergioEStarkstein
EducationBuildingT-7,FremantleHospital,Fremantle,6959WA,Australia;ses{at}cyllene.uwa.edu.auAbstractObjective:TodeterminetheearliestsymptomsofanosognosiainpeoplewithAlzheimer’sdiseaseandtovalidateacriteria-guidedstrategytodiagnoseanosognosiaindementia.Methods:Aconsecutiveseriesof750patientswithverymildorprobableAlzheimer’sdiseaseattendingamemoryclinic,aswellastheirrespectivecaregivers,wasassessedusingacomprehensivepsychiatricevaluation.Results:Thefactorsofanosognosiafor(1)basicactivitiesofdailyliving(bADL),(2)instrumentalactivitiesofdailyliving(iADL),(3)depressionand(4)disinhibitionwereproducedbyaprincipalcomponentanalysisonthedifferentialscores(ie,caregiverscoreminuspatientscore)ontheanosognosiaquestionnairefordementia.Adiscrepancyoftwoormorepointsintheanosognosia-iADLfactorwasfoundtohaveahighsensitivityandspecificitytoidentifyclinicallydiagnosedanosognosiainpeoplewithAlzheimer’sdisease.Bylogisticregressionanalysis,theseverityofdementiaandapathywerebothshowntobenoticeablyassociatedwithanosognosiainpeoplewithAlzheimer’sdisease.Conclusion:AnosognosiainthosewithAlzheimer’sdiseaseismanifestedaspoorawarenessofdeficitsiniADLandbADL,depressivechangesandbehaviouraldisinhibition.Thefrequencyofanosognosiaisfoundtoincreaseconsiderablywiththeseverityofdementia.