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Anosognosia in Alzheimer’s disease: The role of impairment levels in assessment of insight across domains

Published online by Cambridge University Press:  01 March 2010

HANNA LEICHT ,
MARTIN BERWIG  and
HERMANN-JOSEF GERTZ
HANNA LEICHT*
Affiliation:
Department of Psychiatry, Faculty of Medicine, University of Leipzig, Leipzig, Germany
MARTIN BERWIG
Affiliation:
Department of Psychiatry, Faculty of Medicine, University of Leipzig, Leipzig, Germany
HERMANN-JOSEF GERTZ
Affiliation:
Department of Psychiatry, Faculty of Medicine, University of Leipzig, Leipzig, Germany Clinic for Psychiatry, University of Leipzig, Leipzig, Germany
*
*Correspondence and reprint requests to: Hanna Leicht, Health Economics Research Unit, Department of Psychiatry, University of Leipzig, Liebigstr. 26, D-04103 Leipzig, Germany. E-mail: hannaleicht@gmx.de
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Abstract

Impaired insight for deficits (anosognosia) is common in Alzheimer’s disease (AD). However, it has not yet been determined clearly (a) whether different methods for assessing insight are comparable, and (b) whether anosognosia affects different domains to different degrees (domain-specificity). Impaired insight was investigated in 32 patients with AD, who were each accompanied by a caregiver. Anosognosia was assessed by a global clinical rating, questionnaire discrepancies (patient vs. caregiver) covering different domains, and performance discrepancies (self-assessment vs. performance) based on four neuropsychological tests which were compared with those of a healthy control sample. The results of clinical rating and questionnaire discrepancies were closely correlated, but performance discrepancies showed no association with the other methods. Anosognosia was present in the majority of the sample, and occurred across domains. The domains corresponding to core deficits in AD (recent memory, activities of daily living) appeared especially prone to anosognosia. However, results do not suggest that anosognosia itself is domain-specific. Rather, it appears that insight may be invariant, while differences in patient-caregiver discrepancies arise largely from different degrees of deficit across domains. (JINS, 2010, 16, 463–473.)

Keywords

DementiaAwarenessSelf-assessmentQuestionnairesCaregiversNeuropsychology
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 16 , Issue 3 , May 2010 , pp. 463 - 473
Copyright
Copyright © The International Neuropsychological Society 2010

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