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      Anosognosia and Anosodiaphoria in Mild Cognitive Impairment and Alzheimer's Disease

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          Abstract

          Aims: To evaluate the occurrence ofanosognosia (lack of awareness) and anosodiaphoria (insouciance) in mild cognitive impairment (MCI) and Alzheimer's disease (AD) and to evaluate the influence of a worsening of dementia on these phenomena. Methods: A self-evaluation scale was used assessing degrees of anosognosia and anosodiaphoria; furthermore, a neuropsychological assessment and statistical analyses with nonparametric tests which could cope with data on an ordinal scale level and small samples were employed. Results: Cognitive ability was lower in AD (n = 9) than in MCI patients (n = 12), but AD patients self-rated lower cognitive disabilities, which is interpreted as one relative sign of anosognosia in AD. Awareness of the reasons for cognitive problems was also lower in AD, which is considered as another sign of anosognosia. The main pattern in MCI found that the higher the awareness, the lower the cognitive ability. In AD low awareness paralleled low cognitive functioning. Anosodiaphoria was present in AD but not in MCI. Conclusion: According to the literature anosognosia and anosodiaphoria seem to increase with progression of dementia from MCI as a result of right hemispheric alterations.

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          Most cited references 63

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          Diagnostic and statistical manual of mental disorders.

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            Consciousness as integrated information: a provisional manifesto.

             Giulio Tononi (2008)
            The integrated information theory (IIT) starts from phenomenology and makes use of thought experiments to claim that consciousness is integrated information. Specifically: (i) the quantity of consciousness corresponds to the amount of integrated information generated by a complex of elements; (ii) the quality of experience is specified by the set of informational relationships generated within that complex. Integrated information (Phi) is defined as the amount of information generated by a complex of elements, above and beyond the information generated by its parts. Qualia space (Q) is a space where each axis represents a possible state of the complex, each point is a probability distribution of its states, and arrows between points represent the informational relationships among its elements generated by causal mechanisms (connections). Together, the set of informational relationships within a complex constitute a shape in Q that completely and univocally specifies a particular experience. Several observations concerning the neural substrate of consciousness fall naturally into place within the IIT framework. Among them are the association of consciousness with certain neural systems rather than with others; the fact that neural processes underlying consciousness can influence or be influenced by neural processes that remain unconscious; the reduction of consciousness during dreamless sleep and generalized seizures; and the distinct role of different cortical architectures in affecting the quality of experience. Equating consciousness with integrated information carries several implications for our view of nature.
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              International classification of diseases

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                Author and article information

                Journal
                DEE
                DEE
                10.1159/issn.1664-5464
                Dementia and Geriatric Cognitive Disorders Extra
                S. Karger AG
                1664-5464
                2014
                September – December 2014
                03 December 2014
                : 4
                : 3
                : 465-480
                Affiliations
                aDepartment of Psychology, Stockholm University, Stockholm, Sweden; bColorado Springs Neurological Associates, Colorado Springs, Colo., USA
                Author notes
                *Maria Lindau, Department of Psychology, Stockholm University, SE-106 91 Stockholm (Sweden), E-Mail maria.lindau@psychology.su.se
                Article
                369132 PMC4282043 Dement Geriatr Cogn Disord Extra 2014;4:465-480
                10.1159/000369132
                PMC4282043
                25759713
                © 2014 S. Karger AG, Basel

                Open Access License: This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC) ( http://www.karger.com/OA-license), applicable to the online version of the article only. Distribution permitted for non-commercial purposes only. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Tables: 5, Pages: 16
                Categories
                Original Research Article

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