Anosognosia in very mild Alzheimer's disease but not in mild cognitive impairment

被引:121
作者
Kalbe, E
Salmon, E
Perani, D
Holthoff, V
Sorbi, S
Elsner, A
Weisenbach, S
Brand, M
Lenz, O
Kessler, J
Luedecke, S
Ortelli, P
Herholz, K
机构
[1] Max Planck Inst Neurol Res, DE-50931 Cologne, Germany
[2] Univ Hosp, Dept Neurol, Cologne, Germany
[3] Univ Liege, Cyclotron Res Ctr, Liege, Belgium
[4] Dept Neurol San Raffaele Ville Turro, Milan, Italy
[5] Univ Vita Salute San Raffaele, Milan, Italy
[6] Tech Univ Dresden, Dept Psychiat & Psychotherapy, D-8027 Dresden, Germany
[7] Univ Florence, Dept Neurol & Psychiat Sci, Florence, Italy
[8] Univ Bielefeld, Dept Physiol Psychol, D-4800 Bielefeld, Germany
关键词
anosognosia; self awareness; insight; dementia; cognitive dysfunction; Alzheimer's disease; mild cognitive impairment;
D O I
10.1159/000084704
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Objective: To study awareness of cognitive dysfunction in patients with very mild Alzheimer's disease (AD) and subjects with mild cognitive impairment (MCI). Methods: A complaint interview covering 13 cognitive domains was administered to 82 AD and 79 MCI patients and their caregivers. The patient groups were comparable according to age and education, and Mini Mental State Examination (MMSE) scores were >= 24 in all cases. The discrepancy between the patients' and caregivers' estimations of impairments was taken as a measure of anosognosia. Results: Self-reports of cognitive difficulties were comparable for AD and MCI patients. However, while in comparison to caregivers MCI patients reported significantly more cognitive impairment (p < 0.05), AD patients complained significantly less cognitive dysfunctions (p < 0.001). Conclusions: While most MCI patients tend to overestimate cognitive deficits when compared to their caregiver's assessment, AD patients in early stages of disease underestimate cognitive dysfunctions. Anosognosia can thus be regarded as a characteristic symptom at a stage of very mild AD (MMSE >= 24) but not MCI. Accordingly, medical history even in mildly affected patients should always include information from both patient and caregiver. Copyright (C) 2005 S. Karger AG, Basel.
引用
收藏
页码:349 / 356
页数:8
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