Self-awareness of cognitive efficiency: Differences between healthy elderly and patients with mild cognitive impairment (MCI)

Fragkiadaki, Stella; Kontaxopoulou, Dionysia; Beratis, Ion; Andronas, Nikolaos; Economou, Antonis; Yannis, George; Papanicolaou, Andrew C.; Papageorgiou, Sokratis G.

doi:10.1080/13803395.2016.1198469

Cited by 35 publications

(36 citation statements)

References 58 publications

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“…Specifically, with respect to depression or subclinical mood changes, future research is needed to better understand the mechanisms associated with the relationship between familial risk and declines in brain health. Although our examination of the subjective impairment is less susceptible to the effects of hyper- or anosognosia of memory decline 35,37 when compared with a dichotomous assessment, 21 multi-item scales would allow further differentiation of subjective cognitive deficits beyond memory.…”

Section: Discussionmentioning

confidence: 99%

Family History of Alzheimer’s Disease and Subjective Memory Performance

Haußmann

Ganske

Gruschwitz

et al. 2018

Am J Alzheimers Dis Other Demen

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People with a first-degree family history of Alzheimer's disease are at an increased risk of developing dementia. Subjective memory impairment among individuals with no measurable cognitive deficits may also indicate elevated dementia risk. It remains unclear whether nondemented people with a positive family history of Alzheimer's disease are more likely to experience cognitive deficits and whether such an association reflects underlying neuropathology. We therefore investigated subjective memory impairment and hippocampal cortical thickness in 40 healthy older adults and 35 patients with amnestic mild cognitive impairment. We found greater subjective memory impairment and left hemispheric hippocampal cortical thinning associated with a first-degree family history of Alzheimer's disease in healthy older adults. This suggests that subjective memory impairment could reflect preclinical stage neurodegeneration among individuals with the family history risk factor.

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Section: Discussionmentioning

confidence: 99%

Family History of Alzheimer’s Disease and Subjective Memory Performance

Haußmann

Ganske

Gruschwitz

et al. 2018

Am J Alzheimers Dis Other Demen

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“…Furthermore, this information refers to the functioning of self-awareness in general, not related to a specific task (in an offline fashion), although they refer to the functioning of the subject in his natural environment, theoretically with greater ecological validity. The third modality, mainly used in experimental studies dealing with meta-cognition, is based on the quantification of the accuracy of the subject in judging previously or after his performance to a standardized neuropsychological task (typically memory or executive functions) and comparing it with its actual performance (Fragkiadaki et al, 2016). This methodology has the undoubted advantage of being able to have an online quantification of the subject’s self-awareness, but at the same time, the used tasks and the traditional neuropsychological tests are useful for evaluating specific cognitive domains and deficient in an ecological evaluation of functional abilities.…”

Section: Self-awareness In Neurodegenerative Disordersmentioning

confidence: 99%

Virtual Reality as a Possible Tool for the Assessment of Self-Awareness

Tuena

Pedroli

et al. 2019

Front. Behav. Neurosci.

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The absence of self-awareness is a crucial aspect in the symptomatology of various neurodegenerative disorders. This characteristic becomes relevant due to the strong implications it has on the patient’s quality of life, on the effects that functional dependence has on the caregiver and on the efficacy of the therapy. Faced with a construct as complex as self-awareness, there are in the literature investigations on different aspects of this phenomenon, such as the creation of cognitive models, the study of the neural substrate and the research of appropriate assessment methods that can reliably detect this function. With regard to the assessment methods, there are methodologies in the literature that provide complementary information. The first modality is a quantitatively online measurement based on the discrepancy between the estimate of the patient of his performance and his actual performance, but often neglecting the ecological validity and the real functioning of the subject. The second kind collecting subjective information on the actual daily functioning of the patient resulting from clinical observation or interviews with the subject and caregivers, but obtaining offline information on the functioning of the subject, liable to bias that may imply an overestimation or underestimation of subject’s ability. The absence of acknowledged metacognitive functional assessment with normative data to evaluate awareness winks at the emerging and increasingly consistent use of virtual reality (VR) also in the context of cognitive research and clinical assessment. This article aims to make a theoretical proposal regarding the use of this innovative and promising tool as a supplement to the assessment methods of self-awareness.

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“…In a study by Galeone et al (12), global prediction of recall performance before and after study was found to be less accurate in aMCI patients compared to controls. MCI patients also overestimated their cognitive performance in various tasks including memory during post-test ratings (28). In contrast, Clare et al (25) found that MCI patients were as good as controls in the rating of their performance in the Rivermead Behavioral Memory Test after each subtest completion.…”

Section: Introductionmentioning

confidence: 95%

Anosognosia in Mild Cognitive Impairment: Lack of Awareness of Memory Difficulties Characterizes Prodromal Alzheimer's Disease

et al. 2021

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While anosognosia is often present in Alzheimer's disease, the degree of awareness of cognitive difficulties in the earlier stages, such as Mild Cognitive Impairment (MCI), is less clear. Using a questionnaire and Feeling-of-Knowing tasks, the aims of this study were (1) to test the hypothesis that anosognosia is present specifically in prodromal AD stage in patients that, owing to a more severe AD neuropathology, will rapidly progress to overt dementia and (2) to assess the neural bases of self-awareness for memory functioning. A group of 44 patients with amnestic MCI and a group of 29 healthy older participants (CTRL) performed two Feeling-of-Knowing tasks (episodic and semantic FOK) and responded to the Functional Memory Scale (MARS), also completed by one of their relatives. They underwent FDG-PET and structural MRI. The participants were followed clinically for 4 years. At the end of follow-up, 23 patients with MCI developed Alzheimer's disease (converters) and 21 patients still presented symptoms of MCI without progression (non-converters). The analyses focused on the data from inclusion stratified according to clinical status 4 years later (converters, non-converters, CTRL). On the episodic FOK task, converters patients overestimated their ability to later recognize unrecalled words and they showed prediction accuracy (Hamann coefficient) at the level of chance. No difficulty was observed in any group with the semantic FOK task. On the MARS, converters patients had a higher anosognosia score than non-converters patients and CTRL, which did not differ from each other. Correlations between self-awareness scores and neuroimaging data using small volume correction analyses in a priori regions of interest in converters indicated that inaccurate episodic FOK judgments was related to changes in brain areas that might support interpretation of retrieved content for judging the likelihood of recognition. For the MARS, the association between anosognosia and decreased gray matter density of the left inferior prefrontal cortex in converters might indicate poor inhibition over outdated personal knowledge. In amnestic MCI, anosognosia could be an early sign of neurodegeneration in brain areas that would support control mechanisms over memory representations.

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Self-awareness of cognitive efficiency: Differences between healthy elderly and patients with mild cognitive impairment (MCI)

Cited by 35 publications

References 58 publications

Family History of Alzheimer’s Disease and Subjective Memory Performance

Family History of Alzheimer’s Disease and Subjective Memory Performance

Virtual Reality as a Possible Tool for the Assessment of Self-Awareness

Anosognosia in Mild Cognitive Impairment: Lack of Awareness of Memory Difficulties Characterizes Prodromal Alzheimer's Disease

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