Anosognosia in Mild Cognitive Impairment and Mild Alzheimer's Disease: Frequency and Neuropsychological Correlates
Anosognosia in Mild Cognitive Impairment and Mild Alzheimer's Disease: Frequency and Neuropsychological Correlates
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DOI：
10.1097/jgp.0b013e3181dd1c50
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发表时间：
2010-12-01
影响因子：
7.2
通讯作者：
Spalletta, Gianfranco
中科院分区：
文献类型：
--
作者：
Orfei, Maria Donata;Varsi, Ambra Erika;Spalletta, Gianfranco
目的：评估疾病感缺失的严重程度，并确定其在临床前和临床阿尔茨海默病（AD）的神经心理学相关性。研究方法：采用临床自知力评定量表、痴呆病感失认问卷（AQ-D）和精神恶化成套测验评估轻度AD（N = 38）、遗忘型轻度认知损害（α-MCI; N = 35）和多领域MCI（md-MCI; N = 38）的病感失认和认知表现。结果：轻度AD患者的病感缺失比两个MCI组都要多，但两组之间没有差异。在42%的轻度AD患者中进行了疾病感缺失的分类诊断，3%的md-MCI患者中进行了疾病感缺失的分类诊断，但没有α-MCI患者进行了疾病感缺失的分类诊断。言语情景记忆原始评分降低仅与MCI患者认知困难（AQ-D总分和智力功能评分）意识降低相关。在轻度AD中，病感失认症仅与年龄增加和日常生活基本活动减少有关。结论：疾病感缺失在轻度AD患者中较常见，但在MCI患者中不常见。在后一种情况下，作者不能说是真正的病感失认症，而只是对疾病的认识减少。此外，认知困难的意识降低与MCI患者的言语记忆表现有关，但与AD患者无关，这表明后者涉及神经心理学以外的因素。因此，AD患者中常见的神经精神方面应与病感失认一起进行沿着研究。(Am J Geriatr Psychiatry 2010; 18：1133-1140）
Objectives: To evaluate severity of anosognosia and to identify its neuropsychological correlates in preclinical and clinical Alzheimer's Disease (AD). Methods: The Clinical Insight Rating Scale, the Anosognosia Questionnaire for Dementia (AQ-D), and the Mental Deterioration Battery were used to assess anosognosia and cognitive performances in mild AD (N = 38), amnesic mild cognitive impairment (alpha-MCI; N = 35), and multiple domain MCI (md-MCI; N = 38). Results: Patients with mild AD were more anosognosic than both MCI groups, which, however, did not differ from one other. A categorical diagnosis of anosognosia was made in 42% of patients with mild AD, 3% of md-MCI, but in no subjects with alpha-MCI. Reduced verbal episodic memory raw score was associated with decreased awareness of cognitive difficulties (AQ-D total and intellectual functioning scores) only in MCI. In mild AD, anosognosia was linked only to increased age and reduced basic activities of daily living performances. Conclusions: The diagnosis of anosognosia is frequent in patients with mild AD but not in those with MCI. In the latter case, the authors cannot speak of true anosognosia but only of decreased awareness of illness. Furthermore, reduced awareness of cognitive difficulties is linked with verbal memory performances in patients with MCI but not in those with AD, suggesting for the latter the involvement of factors other than neuropsychological. Thus, neuropsychiatric dimensions commonly present in patients with AD should be investigated along with anosognosia. (Am J Geriatr Psychiatry 2010; 18: 1133-1140)