Anosognosia in Dementia

  title={Anosognosia in Dementia},
  author={Robert S. Wilson and Joel Sytsma and Lisa L. Barnes and Patricia A. Boyle},
  journal={Current Neurology and Neuroscience Reports},
Progressive decline in memory (and other functions) is the defining feature of late-life dementia but affected individuals are often unaware of this impairment. This article reviews recent research on anosognosia in dementia, including methods of assessing anosognosia, its prevalence and developmental course in dementia, its occurrence in different forms of dementia, neuroimaging findings, and hypothesized component mechanisms. The results suggest that anosognosia is eventually exhibited by… 

Functional Neural Correlates of Anosognosia in Mild Cognitive Impairment and Alzheimer’s Disease: a Systematic Review

Although the current evidence suggests differences in activation between AD or MCI patients with anosognosia and healthy controls, more evidence is needed exploring the differences between MCI and AD patients with and without anosogenosia using resting state and task related paradigms.

Anosognosia in Dementia: Evaluation of Perfusion Correlates Using 99mTc-HMPAO SPECT and Automated Brodmann Areas Analysis

The evaluation of anosognosia perfusion correlates across various types of dementia using automated Brodmann areas (BAs) analysis and comparison with a database of normal subjects found that automated analysis of brain perfusion Single Photon Emission Computed Tomography could be useful for the investigation of anotemporal neural correlates in dementia.

Olfactory anosognosia is a predictor of cognitive decline and dementia conversion in Parkinson’s disease

Olfactory anosognosia is a predictor of cognitive decline and dementia conversion in PD and remains a significant predictor of time to develop dementia in the Hyposmia-OA+ group compared to the Normosmia group.

Neuropsychological Correlates of Anosognosia for Objective Functional Difficulties in Older Adults on the Mild Cognitive Impairment Spectrum.

Results support the Conscious Awareness Model, which theorizes that accurate metacognitive output is reliant on attentional, memory, and executive functioning systems, and suggest that anosognosia for different IADLs may arise from breakdowns at varying points in this model.

Subjective cognitive decline: opposite links to neurodegeneration across the Alzheimer’s continuum

The findings suggest that the subjective memory decline score should be interpreted differently from normal cognition to dementia, while in more advanced stages lower scores might reflect decreased memory awareness, i.e. more anosognosia associated with advanced neurodegeneration.

Explicit and implicit monitoring in neurodegeneration and stroke

Joint assessment of explicit and implicit monitoring could favor a better differentiation of neurological profiles (frontal damage vs AD) and eventually contribute to delineating clinical interventions.

Antecedents and Consequences of Unawareness of Memory Impairment in Dementia

Unawareness of memory impairment is a common manifestation of dementia, particularly in White persons, but is not strongly related to adverse disease outcomes and has a marginal association with slower cognitive decline in mild cognitive impairment.



The heterogeneity of anosognosia for memory impairment in Alzheimer's disease: A review of the literature and a proposed model

Abstract Anosognosia for memory impairment is a phenomenon in Alzheimer's disease that has historically only been noted anecdotally. It is only recently that it has been investigated independently.

Anosognosia in Alzheimer's disease: relationships to depression, cognitive function, and cerebral perfusion.

There is further evidence that dementia severity alone does not account for anosognosia in Alzheimer's disease; frontal lobe involvement and the presence of specific memory impairments may be important determining factors.

Anosognosia in neurodegenerative disease

  • H. Rosen
  • Psychology, Biology
  • 2011
A working model is offered that incorporates these functions and stipulates specific processes that may be important for awareness of changes in one's abilities and can establish a roadmap for future studies.

Memory complaints are related to Alzheimer disease pathology in older persons

It is demonstrated that the relationship between memory complaints and AD pathology was present in those with and without dementia, and could not be explained by the potentially confounding effects of depressive symptoms or coexisting common chronic health problems.

Temporal course and pathologic basis of unawareness of memory loss in dementia

Awareness of memory impairment typically begins to decline about 2–3 years before dementia onset and is associated with postmortem evidence of TDP-43 pathology, tangles, and gross cerebral infarcts.

Anosognosia in mild cognitive impairment: Relationship to activation of cortical midline structures involved in self-appraisal

Regression analysis revealed a highly significant relationship between BOLD response during self-appraisal and self-awareness of deficit in MCI, highlighting the level of anosognosia inMCI as an important predictor of response to self- appraisal in cortical midline structures, brain regions vulnerable to changes in early AD.

Anosognosia in Alzheimer disease: Disconnection between memory and self‐related brain networks

This study aims at improving the understanding of the neural mechanisms underlying anosognosia of memory deficits in AD by combining measures of regional brain metabolism and intrinsic connectivity and fMRI.

Dementia, awareness and depression

It is concluded that intact awareness of deterioration was not clearly related to the development of depression or depressive symptoms in dementia.