On the Relation among Mood, Apathy, and Anosognosia in Alzheimer's Disease

Mograbi, Daniel C.; Morris, Robin G.

doi:10.1017/s1355617713001276

Cited by 68 publications

(60 citation statements)

References 51 publications

(64 reference statements)

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“…Anosognosia and apathy has been particularly related to executive dysfunction, where AD patients show a lack of awareness of errors in these tasks [11]. Furthermore, this type of error monitoring has been found to be associated with the anterior cingulate, an area implicitly associated with Levy and Dubois subtypes [27,28].…”

Section: Discussionmentioning

confidence: 99%

“…Although apathy related anosognosia has been observed in earlier stages of the disease course [9,10], it has also been suggested that this might be due to progression of neuropathology [7] with individuals later in the illness showing both symptoms. Mograbi and Morris [11] further reinforced this and proposed that apathy increases with lack of awareness of failures in cognitive tasks (error monitoring), while emotional reactions in response to experiences of illness or deficit (emotional reactivity), bearing similarity to awareness, remained relatively intact. They further dichotomized apathy against depression, in that the former is associated with more anosognosia.…”

Section: Introductionmentioning

confidence: 92%

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A Novel Assessment and Profiling of Multidimensional Apathy in Alzheimer’s Disease

Radaković

Starr

Abrahams

2017

JAD

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 92%

A Novel Assessment and Profiling of Multidimensional Apathy in Alzheimer’s Disease

Radaković

Starr

Abrahams

2017

JAD

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“…In a recent review investigating the relation between mood and anosognosia in Alzheimer’s disease (Mograbi and Morris 2014), depression and anxiety were associated with awareness assessed by self-report or clinician ratings. Specifically, higher depressed mood correlated with more apparent awareness in dementia.…”

Section: Metamemory In Alcoholism: Subjective Representation and Monimentioning

confidence: 99%

Anosognosia for Memory Impairment in Addiction: Insights from Neuroimaging and Neuropsychological Assessment of Metamemory

Berre

Sullivan

2016

Neuropsychol Rev

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In addiction, notably, Alcohol Use Disorder (AUD), patients often have a tendency to fail to acknowledge the reality of the disease and to minimize the physical, psychological, and social difficulties attendant to chronic alcohol consumption. This lack of awareness can reduce the chances of initiating and maintaining sobriety. Presented here is a model focusing on compromised awareness in individuals with AUD of mild to moderate cognitive deficits, in particular, for episodic memory impairment—the ability to learn new information, such as recent personal experiences. Early in abstinence, alcoholics can be unaware of their memory deficits and overestimate their mnemonic capacities, which can be investigated with metamemory paradigms. Relevant neuropsychological and neuroimaging results considered suggest that the alcoholics’ impairment of awareness of their attenuated memory function can be a clinical manifestation explained mechanistically by neurobiological factors, including compromise of brain systems that result in a mild form of mnemonic anosognosia. Specifically, unawareness of memory impairment in AUD may result from a lack of personal knowledge updating attributable to damage in brain regions or connections supporting conscious recollection in episodic memory. Likely candidates are posterior parietal and medial frontal regions known to be integral part of the Default Mode Network (DMN) and the insula leading to an impaired switching mechanism between the DMN and the Central-Executive Control (i.e., Lateral Prefronto-Parietal) Network. The cognitive concepts and neural substrates noted for addictive disorders may also be relevant for problems in self-identification of functional impairment resulting from injury following war-related blast, sport-related concussion, and insidiously occurring dementia.

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“…Multiple variables, such as patient characteristics and depression or anxiety symptoms, are involved in determining the most reliable source of information regarding cognitive status (i.e., the patient or a relative). 1 Cognitively healthy elderly persons may over/ underestimate their own cognitive status, providing inaccurate reports. 2 Mild cognitive impairment (MCI) is highly prevalent among elderly persons with depressive symptoms, and cognitive decline may persist even after pharmacological treatment of depression.…”

Section: Introductionmentioning

confidence: 99%

Awareness of memory deficits is useful to distinguish between depression and mild cognitive impairment in the elderly

Coutinho

Drummond

Teldeschi

et al. 2016

Rev. Bras. Psiquiatr.

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Objective: To investigate whether the level of awareness of memory deficits is useful for discriminating between major depressive disorder (MDD) and mild cognitive impairment (MCI) in the elderly. Methods: Sixty-three consecutively referred patients (38 women and 25 men) with memory concerns comprising three groups (clinical control, MDD and MCI) underwent a memory test (Rey Auditory Verbal Learning Test [RAVLT]) and completed the Memory Assessment Complaints-Questionnaire (MAC-Q). Level of awareness was estimated by the difference between the MAC-Q score and the score on the fifth presentation of the RAVLT. Memory performance, Mini-Mental State Examination (MMSE) and depressive symptoms (Geriatric Depression Scale [GDS]) were also assessed. Results: The control (n=25), MDD (n=16), and MCI (n=22) groups were similar in age, educational level, and MMSE (p 4 0.05). Among the groups, the MDD group had the most memory complaints, whereas the MCI group had the worst objective memory performance. Level of awareness was capable of discriminating between MDD and MCI (p o 0.05), but not between MDD and clinical controls (p 4 0.05). MDD subjects tended to underestimate their memory functioning as compared to controls (p o 0.05). Conclusion: Level of awareness of memory deficits was significantly useful to discriminate between MCI and MDD, which is a common difficulty faced by clinicians. Future studies with larger samples are needed to confirm these findings.

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On the Relation among Mood, Apathy, and Anosognosia in Alzheimer's Disease

Cited by 68 publications

References 51 publications

A Novel Assessment and Profiling of Multidimensional Apathy in Alzheimer’s Disease

A Novel Assessment and Profiling of Multidimensional Apathy in Alzheimer’s Disease

Anosognosia for Memory Impairment in Addiction: Insights from Neuroimaging and Neuropsychological Assessment of Metamemory

Awareness of memory deficits is useful to distinguish between depression and mild cognitive impairment in the elderly

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