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.
School of Behavioral Health
Fogel, Travis G.
Ropacki, Susan A.
Gilweski, Michael J.
Vermeersch, David A.
Doctor of Philosophy (PhD)
Year Degree Awarded
Date (Title Page)
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
Loma Linda University Libraries
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.
Barrera, Krystle Dina, "Neuropsychological Correlates of Anosognosia in MCI and Dementia" (2013). Loma Linda University Electronic Theses, Dissertations & Projects. 114.
Loma Linda University Electronic Theses & Dissertations
Loma Linda University. Del E. Webb Memorial Library. University Archives