Abstract

Anosognosia is a general term used to describe a lack of awareness of a disability and is well documented in various disorders associated with neurological compromise. While anosognosia is well documented as part and parcel to Alzheimer's dementia, less research has focused on determining the presence of anosognosia in what has come to be viewed as the subclinical precursor to dementia, mild cognitive impairment. In addition, a number of different methodologies and instruments are employed in quantifying and assessing anosognosia in various populations, which make comparison across studies and diagnoses difficult. Research commonly employs a paradigm that uses the discrepancy between informant and patient reports as measures of anosognosia, using informant reports as the benchmark against which patient ratings are compared. Little research has been done, however, to investigate the accuracy of informant reports as they relate to actual patient performance. The current study sought to investigate the accuracy of patient and informant reports as they relate to actual neuropsychological function, identify the presence or absence of anosognosia within the MCI population, and explore the diagnostic utility of anosognosia assessment in MCI and dementia populations. A total of 49 patients were included in the sample (n=24 MCI patients and n=25 dementia patients). Patients underwent routine neuropsychological evaluation across 6 domains of function. They were asked to predict their performance on each neuropsychological measure prior to administration, and then evaluate their actual performance subsequent to administration. Parallel prediction ratings were solicited from an informant. Results indicated that informant predictions were often less accurate with respect to actual neuropsychological performance than patient predictions. In addition, MCI patients often demonstrated greater levels of anosognosia than their dementia counterparts, with their ratings being less favorable than their actual performance. Lastly, results indicate that anosognosia measures are reliable in predicting group membership, with anosognosia for general cognitive ability and delayed contextual memory being the most predictive of all the measures administered. Thus, the current study provides evidence for the utility of routine assessment of anosognosia in MCI and dementia neuropsychological evaluation.

LLU Discipline

Clinical Psychology

Department

Psychology

School

School of Behavioral Health

First Advisor

Fogel, Travis G.

Second Advisor

Ropacki, Susan A.

Third Advisor

Gilweski, Michael J.

Fourth Advisor

Vermeersch, David A.

Degree Name

Doctor of Philosophy (PhD)

Degree Level

Ph.D.

Year Degree Awarded

January 2013

Date (Title Page)

9-1-2013

Language

English

Library of Congress/MESH Subject Headings

Dementia - Diagnosis; Memory Disorders; Alzheimer's disease; Self-perception

Subject - Local

Anosognosia, Mild Cognitive Impairment, Dementia, Alzheimer's, Frontotemporal lobe dementia, Self-reported ability, Informant-report ability, Awareness

Type

Dissertation

Page Count

210 p.

Digital Format

Application/PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses & Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

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